The WHO reform stems from the need for a new sustainable financing model to help create the lean and efficient organization needed to face the challenges in global health. Head of the Norwegian delegation, Director General for Health Dr. Bjørn Guldvog provided us with the following reflections:
How is the Executive Board meeting going so far?
- The negotiations are going well. Director General Margaret Chan held a brief and precise introduction which emphasized the important progress that has been made in the WHO over the past couple of years. She emphasized the need to continue the reform process to identify ways to work more efficiently and focused to ensure better results.
Why is the reform needed?
- The organization needs improvements ingovernance, and greater efficiency in administrative procedures in order to enable the organization to deliver results. Norway has been engaged with improving management and leadership since the outset and for this meeting we are particularly engaged with how the organization should seek to involve non-state actors. In order to achieve tangible results, particularly in the work on non-communicable diseases, Member States and the WHO Secretariat need to engage a broad set of stakeholders, including NGOs and private sector entities. However, the WHO needs to actively manage their interaction with non-state actors, and practice due diligence to avoid conflicts of interest.
- Collaborating with certain industries, organizations or individuals could damage the credibility of the WHO, especially where those entities have agendas that are incompatible with or run contrary to the interests of global health. It is therefore important that we seek greater transparency about how and which organizations interact with the WHO says Dr. Guldvog.
What is the ideal end-result?
- The ideal end result is of course good health for all people in the world. In order to achieve that we need an organization that is relatively lean and well-managed, and that has sustainable financing which supports the plans and strategies developed jointly by the Member States. We also need to improve our decision-making processes, which is also something the WHO reform seeks to address.
What are your priorities in the reform process?
- At this meeting, Norway is particularly engaged on two key elements of the reform process, namely the implementation of a framework for engagement with non-State Actors which I have already spoken of, and the establishment of a new financing model for the WHO:
- The new financing model is intended to mitigate a range of challenges in how the organization is financed, among them the high proportion of ear-marked funds, a narrow donor base and how to finance WHO's administrative budgets.
- Ear-marked funds comprise the majority of the budget, in effect this means that the WHO cannot fully control its activities. The WHO can plan for the coming years, but when Member States contribute highly ear-marked funds they may take undue control over what and how activities are actually implemented. An objective of the reform has therefore become to make donors provide more flexible and predictable funding, aligned with the priorities of the organization.
What do you see as challenges for WHO in the years ahead?
- One key issue is that the majority of the world's poor people now live in medium-income countries. It is therefore necessary to develop approaches and strategies able to target low-income populations, as opposed to low-income countries. Many countries benefit from the good work of WHO, including Norway. But in the efforts WHO does to support low- and middle income countries in developing sound health policies, we will all need to rethink how we address and assist the individuals and populations in greatest need.