PHA-Exch> PHM and the World Health Assembly 2008

["Claudio Schuftan" <cschuftan@xxxxxxxxxxxxxx>]

Prior to the 61^st World Health Assembly (WHA), the Third World Network (TWN) in collaboration with the People's Health Movement (PHM) and Health Action International (HAI) called for a civil society meeting. The meeting was held in Geneva on Sunday 18^th May and discussed the civil society contribution during the 61^st (19-24 May 2008).

The workshop was participated by around 50 participants from civil society organizations/networks, academic institutions and few official representatives. The discussions can be concluded as follows:

 

n       WHO new publication policy: adopted under pressure from "a powerful" member state

In this policy, all documents of a "controversial" nature must now be cleared by the office of WHO's Director-General. The definition of what exactly "controversial" means is unclear and thus the policy clearly carries the danger of arbitrary censorship.

A group of organizations and networks, with the leadership of the Third World Network, has sent a letter to Dr Chan spelling out civil society concern that a potential abusive censorship can result from the new policy (refer to CIVIL SOCIETY LETTER TO WHO MEMBER STATES REGARDING WHO's PUBLICATIONS POLICY)..

n       Global Call for Action for a revival of "Health for All"

On the 30th anniversary of the Alma Ata Declaration, the People's Health Movement launched a global call for action:

"Health for All" cannot be realized while "the world's resources are increasingly concentrated in the hands of a few who strive to maximize profits. Neoliberal political and economic policies are made by a small group of powerful governments, and by international institutions such as the World Bank, the International Monetary Fund and the World Trade Organization. These policies, together with the unregulated activities of transnational corporations, have had severe effects on the lives and livelihoods, on the health and well‐being of people in both the North and the South". People's Charter for Health

During WHA 2008, PHM launched a statement: Primary Health Care remains the Best Tool to Achieve "Health for All". The statement was endorsed by civil society organizations and networks (refer to PRIMARY HEALTH CARE REMAINS THE BEST TOOL TO ACHIEVE "HEALTH FOR ALL").

n       WHO's Secretariat ignored an Assembly resolution

Despite the victory of passing a resolution on "Rational Use of Drugs" at the 60th WHA, WHO did not allocate funds to implement it. Our civil society workshop raised a question: whose decision is it to withdraw an action that the WHO's secretariat had mandated member states to tackle? Civil society representatives are aware of the budget limitations of WHO, however, such limitations cannot overrule mandates given to the organization by its governing body. Civil society asks for a transparent process of budget allocation.

n       WHO is accused of silence and complicity in the cover up of the health consequences of Chernobyl

Independent demands have risen for WHO to revise the 1959 Agreement with the International Atomic Energy Agency so that WHO can undertake serious scientific evaluations of nuclear disasters' consequences and also provide needed assistance to affected populations.

A Geneva-based group has prepared a resolution for the WHA in 2009. The group  is working closely with the Special Rapporteur on the Right to Food and will undertake legal action in which the most complete, up to date scientific and medical evidence will be presented to senior WHO staff and staff of the Department of Radiation; they will be informed that in any future court case, they will be unable to claim that they did not know.

n       Global Health Partnerships: progress on developing draft policy guidelines for WHO's involvement

The participants welcomed the review of the risks and responsibilities inherent to WHO's public-private partnerships.

The workshop released a statement which called the member states to pay a serious attention to:

-        the importance of using more descriptive title for the WHO Guidelines in report EB 123/6. Suggested is: "Guidelines on interaction with commercial enterprises to achieve health outcomes". Such Guidelines exist as an annex to the January 2001 Executive Board Report EB 107/20 entitled: "Working with the private sector to achieve health outcomes", but have been totally ignored by the WHO leadership; see these Guidelines at:http://ftp.who.int/gb/archive/pdf_files/EB107/ee20.pdf. (refer to Global Health Partnerships: progress on developing draft policy guidelines for WHO's involvement)

n       Influenza Virus: benefits of sharing

We recall last year's scandal of WHO giving developing countries' (Indonesia among others) virus samples to companies, for the development of a vaccine to which poor countries would have no access. This was in violation of WHO's own guidance and also in violation of the Convention on Biological Diversity which recognizes the sovereign rights of states over their biological resources.

During WHA60 (May 2007), resolution 60.28 linked virus sharing with benefit sharing. Instead, the rich countries are pushing for loose and informal guidelines, while the developing countries insist on standard material transfer agreements. Some progress over the year in terms of recognition of the problem, of the need for fair benefit sharing ended in various proposals from developing countries, and more transparency has been achieved in terms of records of all viruses provided being kept in terms of who received them and are using them. Still needed is to know which companies have obtained them and what profit they are making. It is a test case which will set a precedent.

n       Primary Health Care, health systems and global economic order

Discussions during the workshop referred many times to the negative impacts of the current global political and economic order in widening the equity health gap within and between countries.

Participants are of the opinion that the current economic crises, represented partially by the rise in food prices, will further widen the present inequity gap. It was also mentioned that it is high time for change, as people across the world have had enough; while people cannot access food, the international financial institutions remain protective of for profit corporations. In these trying times, WHO needs to fulfil its constitutional mandate and take the leading role of coordinating efforts to make "Health for All" a reality.

 The Anti-microbial resistance is a major threat to public health

Participants referred the worrisome problem of microbial resistance to antibiotics and the associated irrational use of drugs which is, to a great extent, due to the direct-to-public advertisement of drugs.

Participants viewed that it is understood that Big Pharma is profit-oriented, but WHO and its member states should protect the right of the next generations to find treatments that work.

WHO must provide guidance in the area of drug promotion to the public and to health professionals and governments must guarantee strict implementation.

n       Access to medicines

Participants acknowledged two challenges: a) how to use flexibilities in TRIPS and b) how to overcome the problem of innovation and market failure in the medicines domain. The current IPR system has not resulted in further innovation.

The Thai experience showed the serious obstacles found in using compulsory licensing as one of the important flexibilities. The use of the allowed flexibilities is very much dependent on political and economic pressures that manifest themselves as trade retaliation actions by rich countries, withdrawal of foreign investment, threatened legal action, withdrawal of new medical registration applications, IPR campaigns to undermine the image of the country which used these flexibilities, very long approval processes, delay in importation of generic products and threats from the patent holders. These pressures always come from both governments and pharmaceutical multinationals.  

The group urged the WHO Secretariat to:

-        technically assist member states, and provide them with the needed political support in the use of the flexibilities of the TRIPs agreement,

-        encourage the member states to increase their investment in pharmaceutical research and production.