The WHO’s decision-making body, the World Health Assembly (WHA), has just concluded its 70th annual meeting in Geneva. Among the dozens of items on the Agenda was the Framework Engagement with non-State actors (FENSA), an agreement on how to manage relationships with organisations representing industry, philanthropic and academic institutions and international NGOs with WHO ‘Official Relations’ status. FENSA was agreed and adopted in May 2016 by the 69th WHA, and at this year’s meeting, certain clarifications and updates were made.
More than a billion poor people around the world depend mostly on public health systems for their health and well-being, and so are directly affected by the decisions and policies of WHO, which guides national programmes. If you can not afford private health care, qualified specialists, advanced treatments or most medicines, the public health services are your only hope when serious illness or injury arrives. WHO plays an important role in leading governments to improve their health systems, and is responsible for pushing them forward so that one day, hopefully, everyone will enjoy their right to health, not just those with money.
FENSA is essential as it defines how civil society, including the private sector, academic institutions and NGOs, can interact with the WHO. Yet for those most impacted by WHO policies, FENSA is an obstacle to participation and institutionalises our exclusion. The agreement makes no provisions for enabling those from affected communities that lack the resources to develop an international NGO (INGO) needed to be in Official Relations with the WHO, nor provides for any means of seeing if the few ‘official’ big INGOs that claim to represent marginalised communities actually do. As WHO resolutions, such as FENSA, are very hard to alter or change, our efforts to develop meaningful participation and the accountable representation of those most in need has been made more difficult.