WHO Reform and Public Interest Safeguards: An Historical Perspective

The following reflections were sparked by the concern that WHO’s Director-General (DG) has embarked on a ‘reform’ of our highest authority in international public health. This might ultimately result in trading off the ‘soul’ of the World Health Organization – its decision-making processes in the public interest – against the hope of attracting more funds from profit or neoliberal ideology-driven actors. I have focused much of my professional life on issues of corporate accountability and regulation with a particular focus on the transnational pharmaceutical and infant food industries. Starting in 1998, I served as a consultant for UNICEF’s Children in a Globalizing World project. In the course of this project, I became increasingly concerned over the lack of attention given to conflicts of interests, and to the predictable harmful effects of public-private partnerships (PPPs) and multi-stakeholder initiatives on global health policy making and architecture. Several public interest NGOs and the Finnish government provided me with an opportunity to explore these issues and outline some possible solutions. In 2005, I was commissioned to summarize concerns about global health partnerships for WHO’s Director-General, the late Dr. Jong-wook Lee, and his Assistant Director Generals (ADGs).2 From 1998 until 2005, the focus of my work shifted increasingly to what is now termed ‘global health governance.’ This entails questions of how to: • Maintain democratic principles; • Establish adequate and effective accountability mechanisms; • Safeguard public interests in ‘global health governance.’ These are the issues I would like to explore in this editorial.