Intended for healthcare professionals


WHO open to “lobbying” by business

BMJ 2016; 353 doi: (Published 02 June 2016) Cite this as: BMJ 2016;353:i3134
  1. Anne Gulland
  1. London

The World Health Organization has been warned that it was now open to undue influence from commercial interests after member states agreed a framework for its relations with industry and other bodies.

Delegates at last week’s World Health Assembly in Geneva agreed the Framework for Engagement with Non-State Actors, a document that set out rules for the organisation’s relationship with bodies from industry, academia, and non-governmental organisations (NGOs) and philanthropic organisations.

Member states spent the last two years negotiating the framework, which WHO described as a “major step in WHO’s governance reform.” It said that the framework gave the organisation “comprehensive policies and procedures” on engagement with such bodies.

“The framework aims to strengthen WHO engagement with all stakeholders while protecting its work from conflicts of interest and undue influence from external actors,” the statement continued.

WHO director general Margaret Chan said, “The timely historical conclusion of [the framework] is critical for WHO’s leadership in global health. Without this framework we could not move forward to support member states in the 2030 agenda for sustainable development.”

The document set out the types of interaction that non-state actors will have with WHO: they can attend meetings and consultations; provide financial or other types of contributions, such as donations of medicine; provide evidence; advocate on health issues; or provide technical support.

NGOs, international business associations, and philanthropic foundations that had “sustained and systematic engagement in the interests of WHO” would be granted the privilege of “official relations” status. These bodies would be able to take part in WHO’s meetings, although they would not have the right to vote.

However, 60 NGOs from around the world said that the framework did not protect WHO from influence from the private sector.

In a statement they said that the framework “put private sector entities on an equal footing with other non-state actors, failing to recognise their fundamentally different nature and roles.”

It said that the proposal to allow business groups to obtain official relations status would “once and for all, legitimise lobbying by business associations.”

The NGOs were also wary of the influence of philanthropic foundations. In its statement to the assembly on the framework, Health Action International said that WHO had become “extraordinarily dependent” upon two very large philanthropic foundations—the Bill and Melinda Gates Foundation and the Wellcome Trust.

“Both inside and outside the WHO, the largest global philanthropic donor was now perceived to wield extraordinary influence over the institution, with inadequate transparency and oversight of this relationship.”

Tim Reed, director of Health Action International, said that, because countries did not contribute enough to WHO’s core funding, it had become reliant on donors.

“WHO is a United Nations body and should be funded properly at its core rather than turn into an implementing partner of philanthropic organisations,” he said.

WHO said that there would be a register of organisations it worked with on a publicly available website. Reed added, “Transparency is not a substitute for regulation. If you have interest declarations on the website then they have to be managed.”

WHO said that it would not engage with the tobacco or arms industries. It would also “exercise particular caution” when engaging with bodies whose polices or activities have had a negative effect on health and were not in line with WHO’s policies in relation to non-communicable diseases.

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