Policy on WHO engagement with global health partnerships and hosting arrangements, 21st May 2010 (A63/44, Annex – 22 April 2010, A63/44 Corr.1 – 13 May 2010), OXIO 282
World Health Organization [WHO]
- External relations of international organizations — Practice and procedure of international organizations
1. The criteria which guide the World Health Organization’s (WHO) decisions on whether to participate in global health partnerships.
2. The extent to which formal partnerships hosted by the WHO share its internal rules, legal status, and privileges and immunities.
Although the World Health Organization (WHO) is the ‘directing and coordinating authority on international health work’ in the United Nations (UN) system (Article 2(a) Constitution of the World Health Organization (‘WHO Constitution’)), it is not by any means the only actor at the international level with a mandate that relates to health. Particularly over the last two decades, the number and types of organizations working on health issues at the international level have dramatically increased. In addition to traditional intergovernmental organizations and UN programmes, such as the World Bank, the Joint United Nations Programme on HIV/AIDS, and the United Nations Children’s Fund, these actors now include many bodies known as ‘global health partnerships’, collaborative arrangements that bring together a mix of state, intergovernmental, and non-state partners around a given issue area.
Such bodies, which include public-private partnerships external to the WHO—such as the Global Fund for AIDS, Tuberculosis and Malaria, and the GAVI Alliance—as well as entities hosted within the WHO such as UNITAID, now play a significant role in financing and delivering health activities in WHO Member States. Many such partnerships have formal relationships with the WHO, whether through the WHO’s participation in their governing bodies, strategic and technical cooperation activities, or hosting arrangements with the WHO Secretariat.
As global health partnerships have proliferated, coordinating their work and managing their relationship with the WHO has become more complex. As such, at the 122nd meeting of the WHO Executive Board (‘Executive Board’) in 2008, the WHO Secretariat presented a report to the Executive Board seeking strategic guidance on various issues relating to the WHO’s relationship with partnerships, noting that the WHO was at the time host to more than fifteen formal partnerships and seventy programmes and initiatives (Partnerships: Report by the Secretariat).
In response to the report, the Programme, Budget and Administrative Committee of the Executive Board requested that the WHO Secretariat develop draft policy guidelines for the WHO’s engagement with such partnerships (Report of the Programme, Budget and Administration Committee of the Executive Board). The draft guidelines developed by the WHO Secretariat were discussed at the 123rd and 124th meetings of the Executive Board (Global Health Partnerships: Progress on Developing Draft Policy Guidelines for WHO’s Involvement – Report by the Secretariat; 123rd Session - Decisions / Summary Records; 124th Session - Summary Records), and adopted at the 63rd World Health Assembly (Resolution 63.10 on Partnerships).
The Policy on WHO engagement with global health partnerships and hosting arrangements (‘Policy’) document sets out two areas to guide the WHO’s engagement with global health partnerships. First, it outlines criteria for when the WHO will participate in a global health partnership, whether external or hosted. [paras 6–8] Second, it provides the policy framework that applies to global health partnerships hosted within the WHO. [paras 9–28] For the latter, the Policy distinguishes between formal partnerships with separate governance structures, which are covered by the Policy, and other collaborative efforts, which are simply part of the WHO Secretariat and therefore covered by the WHO’s ordinary internal rules and procedures. [paras 5-6]
The Policy provides a decision tree and criteria for the WHO’s engagement with global health partnerships. Criteria for determining whether to engage include: the extent to which the partnership is of mutual benefit; the governance of the partnership; potential conflicts of interest and risks; and the minimization of duplication and administrative burdens within the WHO and for national governments of WHO Member States. [ref 1]
The Policy also sets the framework for the WHO’s hosting of formal partnerships without separate legal personality, which it notes should be an ‘exceptional’ arrangement. [paras 9-11] Hosted partnerships are covered by the WHO’s internal rules and accountability framework, share the WHO’s legal identity and status, and are covered by the WHO’s privileges and immunities. [paras 12-13] Staff of partnership secretariats, including partnership secretariat heads, are employed and appointed by the WHO Secretariat, although assigned solely to service with the partnership. [paras 15-16] Partnerships must also communicate with WHO Member States through WHO diplomatic channels. [para 24] However, partnerships have separate finances and programme budgets, and are responsible for raising their own resources. [paras 17-23] Proposals to host a partnership are subject to the review and decision of the Executive Board. [para 14]
The Policy provides that all hosting arrangements will be evaluated at the end of their term, with the evaluation resulting in a decision to continue the partnership, amend the partnership structure or hosting arrangement, fully integrate the partnership into the WHO, or separate the partnership into its own entity. [paras 25–28]
The WHO has wide legal powers under its constitution to participate in a variety of collaborative arrangements (see eg Articles 2, 18, 33, 38–42, 50, and 70–71 WHO Constitution). The Policy established a formal framework for deciding when to do so in relation to global health partnerships, and for regulating the relationship between the WHO and partnerships when it does.
With regard to the WHO’s participation in partnerships, the Policy established an overarching strategy for the WHO’s participation in partnerships, which had previously taken place on a largely ad hoc basis. The criteria it sets aim to balance the benefits of the WHO taking part in partnerships—which can provide an innovative way of addressing global health problems not well-served by traditional intergovernmental cooperation models—with the potential risks of duplication, unclear lines of reporting and accountability, additional administrative burdens, or differences of interest between partnership members (see Partnerships: Report by the Secretariat; and Burci 380–381).
With regard to hosting arrangements, the Policy clarified certain legal issues that arose from hosting separately-governed partnerships within the WHO. It confirmed the extent to which the secretariat of a formal, separately governed partnership is part of the WHO Secretariat and therefore the extent to which it is covered by WHO policies and agreements. According to the Policy, although a hosted partnership is to be financed and governed separately, it ‘shares the legal identity and status of’ the WHO, including its privileges and immunities. [para 13] This necessarily implies that the WHO is the legal entity that bears responsibility for the conduct of hosted partnerships. As such, the Policy also sets a common framework for managing potential risks to the WHO arising from the activities of partnerships, including: the application of internal rules regarding communications, staff, and legal, political, and financial accountability; the requirement that the WHO have decision-making power in a hosted partnership and not just provide administrative support for its secretariat; and provisions for the WHO to recover costs and be indemnified by the partnership for any liabilities incurred. [paras 11–12, 16, 18–19, 23]
The Policy should be read in conjunction with the hosting terms for each partnership, as well as the WHO’s 2016 Framework of Engagement with Non-State Actors (Resolution 69.10 on Framework of Engagement with Non-State Actors), which regulates the WHO’s interactions with non-state actors—including non-state partnership members—more generally.
Since the adoption of the Policy, the WHO has developed additional documents that govern the relationship between the WHO and hosted partnerships at an operational level. In 2013, the Executive Board asked the WHO Director-General to develop generic hosting terms to apply to all host partnerships (Resolution 132(10) on WHO Reform: Hosted Partnerships), which the Director-General promulgated in 2016 (Generic Hosting Terms for WHO Hosted Partnerships). The same Executive Board resolution established regular reviews of existing hosted partnerships as a standing agenda item of the Executive Board.
The adoption of the Policy and operational framework for hosted partnerships is part of a broader ongoing discussion within the WHO on reforming the organization, which looks at, among other things, the role of the WHO in an increasingly diverse field of actors in global health (see eg WHO’s Arrangements for Hosting Health Partnerships and Proposals for Harmonizing WHO’s Work with Hosted Partnerships: Report by the Secretariat).
Further analysis of Relevant Materials
- G L Burci ‘Public/Private Partnerships in the Public Health Sector’ (2009) 6 International Organizations Law Review 359
- L Clarke ‘Responsibility of International Organizations under International Law for the Acts of Global Health Public-Private Partnerships’ (2011) 12 Chicago Journal of International Law 55
- L Clarke Public-Private Partnerships and Responsibility under International Law: A Global Health Perspective (Routledge 2014)
World Health Organization
- Generic Hosting Terms for WHO Hosted Partnerships (2016)
- Resolution 69.10 on Framework of Engagement with Non-State Actors (28 May 2016) WHA Res 69.10
- Resolution 132(10) on WHO Reform: Hosted Partnerships (29 January 2013) EB/132/REC/1
- WHO Reform: Report by the Secretariat (8 January 2013) EB/132/5
- WHO’s Arrangements for Hosting Health Partnerships and Proposals for Harmonizing WHO’s Work with Hosted Partnerships: Report by the Secretariat (23 November 2012) EB132/5 Add.1
- Resolution 63.10 on Partnerships (21 May 2010) WHA Res 63.10
- 124th Session - Summary Records (19-26 January 2009) EB124/2009/REC/2
- 123rd Session - Decisions / Summary Records (26 May 2008) EB123/2008/REC/1
- Global Health Partnerships: Progress on Developing Draft Policy Guidelines for WHO’s Involvement – Report by the Secretariat (18 April 2008) EB123/6
- Report of the Programme, Budget and Administration Committee of the Executive Board (21 January 2008) EB122/3
- Partnerships: Report by the Secretariat (20 December 2007) EB122/19
- Constitution of the World Health Organization (signed 22 July 1946, entered into force 7 April 1948) 14 UNTS 185
World Health Organization
- Partnerships: Report by the Secretariat (22 April 2010) WHA A63/44
Reproduced from World Health Assembly, Resolutions and decisions, Annexes – document WHA63/2010/REC/1, Geneva 2010, FROM WHA63 REC 1 on page 17 “Partnerships” and page 77 "Policy on WHO Engagement with Global Health Partnerships and Hosting Arrangements" Copyright WHO (2010) [http://apps.who.int/gb/ebwha/pdf_files/WHA63-REC1/WHA63_REC1-en.pdf]
The Sixty-third World Health Assembly,
Having considered the report on partnerships;2
Recognizing the critical need for, and contribution of, collaborative work by WHO to achieve health outcomes and the diversity of such collaborations;
Noting that WHO’s Constitution, the Eleventh General Programme of Work, 2006–2015 and the Medium-term strategic plan 2008–2013 describe collaboration and coordination as core functions of the Organization;
Noting further that the growth of health partnerships and other forms of collaboration have increased greatly in the past decade;
Considering the need for WHO to have a policy governing its engagement in, and hosting of, partnerships in a manner that avoids duplication of WHO’s core responsibilities in partnerships’ activities;
Welcoming the collaboration of WHO with stakeholders based on clear distinction of roles that creates added value, synergies and coordination among different programmes that support achievement of global and national health outcomes and reduced transaction costs,
1. ENDORSES the policy on WHO’s engagement with global health partnerships and hosting arrangements;3
2. CALLS UPON Member States to take the policy into account when seeking engagement by the Director-General in partnerships, in particular with regard to hosting arrangements;
3. INVITES concerned organizations of the United Nations system, international development partners, international financial institutions, nongovernmental organizations, representatives of communities affected by diseases, and private-sector entities to enhance their collaboration with WHO, in a synergistic manner, in order to attain the strategic objectives contained in the Medium-term strategic plan 2008–2013;
4. REQUESTS the Director-General:
(1) to continue collaboration with concerned organizations of the United Nations system, international development partners, international financial institutions, nongovernmental organizations, representatives of communities affected by diseases, and private-sector entities in implementing the Medium-term strategic plan 2008–2013 in order to advance the global health agenda contained in the Eleventh General Programme of Work, 2006–2015;
(2) to create an operational framework for WHO’s hosting of formal partnerships;
(3) to apply the policy on WHO’s engagement with global health partnerships and hosting arrangements, to the extent possible and in consultation with the relevant partnerships, to current hosting arrangements with a view to ensuring their compliance with the principles embodied in the policy;
(4) to submit to the Executive Board any proposals for WHO to host formal partnerships for its review and decision;
(5) to report on progress in implementing this resolution to the Sixty-fifth World Health Assembly through the Executive Board, and on the various actions taken by the Secretariat in relation to partnerships in implementing the policy on partnerships.
Annex 1 Policy on WHO engagement with global health partnerships and hosting arrangements1
1. This document presents WHO’s policy that provides a framework to guide WHO’s assessment of, and decision concerning, potential engagement in different types of health partnerships; it also provides specific parameters to be applied in cases where WHO agrees to host a formal partnership.
2. The set of criteria noted below aims to guide WHO’s decision making about when and how to engage in partnerships, and how to develop, revise or terminate that engagement. WHO favours, as a general principle, mechanisms within WHO that facilitate collaboration without involving separate governance structures.
3. The number of global health partnerships, initiatives and other forms of collaboration has increased steadily over the past decade. The term “partnerships” is being used generically to include various organizational structures, relationships and arrangements within and external to WHO for furthering collaboration in order to achieve better health outcomes. These range from legally incorporated entities with their own governance to simpler collaborations with varied stakeholders. Diverse terms such as “partnership”, “alliance”, “network”, “programme”, “project collaboration”, “joint campaigns,” and “task force” may be used in the title of these partnerships, although this list does not represent a typology.
4. Examples of different partnerships include legally incorporated entities external to WHO (e.g., Global Fund to Fight AIDS, Tuberculosis and Malaria, the GAVI Alliance, the Medicines for Malaria Venture) and unincorporated partnerships within WHO with their own governance (e.g., Stop TB Partnership, Partnership for Maternal, Newborn and Child Health, Roll-Back Malaria Partnership, UNITAID, the Global Health Workforce Alliance, and the Health Metrics Network).
5. As part of its core functions, WHO manages several collaborative efforts that are fully under its managerial control and accountability and for which there are no separate governance arrangements, and are designed to provide a means to collaborate with multiple stakeholders. Examples include networks, programmes, task forces and project collaborations such as the Global Outbreak and Response Network, Global Noncommunicable Disease Network, Guinea Worm Eradication Program, Meningitis Vaccine Project, Global Polio Eradication Initiative, and the Global Task Force on Cholera Control.
6. For the purposes of this policy, the term “formal partnerships” refers to those partnerships with or without a separate legal personality but with a governance structure (for example, a board or steering committee) that takes decisions on direction, workplans and budgets. WHO currently serves as the host organization for several formal partnerships which have not been established as legal entities. WHO’s decision-making process for engaging in partnerships, outlined below, applies in all cases whether or not the partnership is external to the Organization.
Criteria for WHO’s engagement in a partnership
7. In all situations in which the Secretariat identifies a need for, or is asked to participate in, a partnership it will use a decision tree (see Appendix) based on the criteria below to review such requests and identify alternatives as necessary. This process applies to all forms of partnership regardless of whether WHO is hosting it, or those not hosted by WHO in which WHO seeks, or is asked, to serve as a partner at a technical level.
8. The following criteria will be used to assess future partnerships and will guide the relationship with the existing formal partnerships.
(a) The partnership demonstrates a clear added value for public health in terms of mobilizing partners, knowledge and resources, and creating synergy, in order to achieve a public-health goal that would otherwise not be met to the same extent.
(b) The partnership has a clear goal that concerns a priority area of work for WHO reflected in WHO’s strategic objectives, and for which realistic time frames are provided. Participation would represent an extension of WHO’s core functions, policies, and relative strengths to other organizations, and would reinforce the quality and integrity of WHO’s programmes and work.
(c) Partnerships are guided by the technical norms and standards established by WHO.
(d) The partnership supports national development objectives. In cases where a partnership is active at country level and seeks to help to build capacity in-country, WHO’s engagement would help to harmonize efforts and thus reduce the overall management burden on countries.
(e) The partnership ensures appropriate and adequate participation of stakeholders. The agreed goals of the partnership shall be ensured through the active participation of all relevant stakeholders (including, as relevant, beneficiaries, civil society and the private sector) and the respect of their individual mandates. Partnerships may benefit from the contribution of organizations and agencies outside the traditional public-health sector as relevant.
(f) The roles of partners are clear. In order for WHO to participate in a partnership, the latter must clearly articulate the strengths of the partners, avoid duplication of WHO’s and partners’ activities, and the introduction of parallel systems.
(g) Transaction costs related to a partnership must be evaluated, along with the potential benefits and risks. Expected additional workloads for WHO (at all levels) shall be assessed and quantified.
(h) Pursuit of the public-health goal takes precedence over the special interests of participants. Risks and responsibilities arising from public–private partnerships need to be identified and managed through development and implementation of safeguards that incorporate considerations of conflicts of interest. The partnership shall have mechanisms to identify and manage conflicts of interest. Whenever commercial, for-profit companies are considered as potential partners, potential conflicts of interest shall be taken into consideration as part of the design and structure of the partnership.
(i) The structure of the partnership corresponds to the proposed functions. The design of the structure of the partnership should correspond to its function. For example, those with a significant financing element may require a more formal governance structure, with clear accountability for funding decisions. Those whose role is primarily a coordinating one could most effectively operate without a formal governance structure. Task-focused networks can be highly effective and efficient in achieving partnership goals with maximum flexibility, and can limit the transaction costs often associated with formal structures and governance mechanisms.
(j) The partnership has an independent external evaluation and/or self-monitoring mechanism. The time frame, purpose, objectives, structure and functioning of a partnership shall be regularly reviewed and modified as appropriate. Criteria for modifying or ending a partnership shall be clearly presented, along with consideration for transition plans.
9. In some cases, WHO agrees to host a formal partnership without a separate legal personality. Hosting should be considered an exceptional arrangement that must be in the overwhelming interest of all parties.
10. For formal partnerships hosted by WHO, overarching considerations include ensuring that the overall mandate of the partnership and its hosting are consistent with WHO’s constitutional mandate and principles and do not place additional burdens on the Organization, that it minimizes transaction costs to WHO, adds value to WHO’s work, and adheres to WHO’s accountability framework.
11. The decision for WHO to serve as the host will depend first and foremost on WHO’s participation in the partnership as a strategic and technical partner. Most importantly, WHO must be a member of, and fully participate in, the steering body of the partnership. The partnership must also recognize, be in harmony with, and complement WHO’s mandate and core functions, without duplicating or competing with them.
12. WHO will ensure that its hosting of the partnership and provision of its secretariat is congruent with WHO’s accountability framework1 and operational platform (covering political, legal, financial, communication and administrative activities) and protects WHO’s integrity and reputation. The consideration and implementation of hosting arrangements will be in accordance with WHO’s Constitution, Financial Regulations and Financial Rules, Staff Regulations and Staff Rules, and administrative and other relevant rules (“WHO’s rules”). When WHO acts as the host, the operations of the partnership’s secretariat must, in all respects, be administered in accordance with WHO’s rules.
13. The hosting of a partnership by WHO goes beyond the simple provision of administrative services. The secretariat of a hosted partnership is part of WHO’s Secretariat and, as such, shares the legal identity and status of the Organization. In particular, the staff of the partnership will, as staff members of WHO, enjoy the applicable privileges and immunities for the protection of their functions. To this end, it is essential that the function of the secretariat be, and be seen as, part of the functions of WHO. This consideration is particularly relevant for Switzerland, the host country of WHO’s headquarters, which has granted privileges, immunities and facilities to the Organization and its staff for the performance of its constitutional mandate. In order to comply with the host agreement between WHO and the Swiss Federal Council, the functions of the partnership secretariat must be part of the overall functions of WHO and may not be seen as separate from them. The Director-General will consult with the Swiss authorities when considering the hosting of formal partnerships.
15. Although the organizational structure and specific duties of the partnership secretariat are normally determined by the steering body of the partnership, the secretariat staff are selected, managed and evaluated in accordance with WHO’s rules. The staff members of the partnership secretariat will be recruited solely for service with the partnership secretariat.
16. As regards the head of a partnership secretariat, he or she will be appointed by the Director-General in compliance with WHO’s Staff Regulations, Staff Rules and selection procedures and in consultation with the partnership’s steering body. Similarly, the performance of the head of the partnership secretariat will be assessed under WHO’s Performance Management and Development System, with an opportunity to receive feedback from the partnership’s steering body.
Programme and financial management
17. Formal partnerships, where WHO’s role is notnot exclusive in respect of governance, strategic and operational planning, will be outside the programme budget. This approach differentiates formal partnerships from WHO programmes. Separate accounts shall be established for each partnership so that relevant income and expenditure is recorded and reported upon in a manner separate from WHO’s accounts. WHO shall invest any available balances of cash or cash equivalents in accordance with its own regulations for the use of the partnership. Although these partnerships are outside the programme budget, their work must be synergistic with WHO’s respective strategic objectives.
18. Regardless of programme budget status, all payments from the respective partnership accounts must be in accordance with WHO’s Financial Regulations and Financial Rules in order to enable appropriate monitoring of the financial accountability of grantees and other recipients and of progress towards programme objectives.
19. As regards financial management for formal partnerships outside the programme budget, the partnership secretariat will need to prepare separate financial statements of income and expenditure, certified by the Office of the Chief Accountant of WHO, which will be provided to the partnership’s board on an annual basis. The statements will normally require a separate audit opinion from WHO’s External Auditor. All partnerships are in addition subject to internal audit in accordance with WHO’s Financial Regulations, Financial Rules and practices. Before the selection of a new head of a partnership secretariat, the Director-General may request an internal audit of the partnership.
20. As an exception to the above, a small number of formal partnerships exists in which WHO’s role in respect of governance is not exclusive, but where the partnerships concerned contribute directly and fully to the achievement of the Organization-wide expected results and indicators as set out in the Programme budget. The work of these entities is exclusive to and follow strictly WHO’s results hierarchy. These partnerships are included within the programme budget under the budget segment “Special programmes and collaborative arrangements”. Most notable in this small group are long-established research programmes whose activities have been embedded in WHO’s work for many years.1
Resource mobilization and cost recovery
22. Each hosted partnership shall be responsible for mobilizing adequate funds for its effective operation, including the costs of its secretariat and all related activities provided for in its budget and workplan. The obligation of WHO to implement any particular aspect of the partnership’s workplan will be conditional on WHO having received all necessary funding. Resource mobilization by hosted partnerships shall be closely coordinated with WHO, and those partnerships shall be required to indemnify the Organization for any financial risks and liabilities incurred by the latter in the performance of its hosting functions. Fundraising by a WHO-hosted partnership from the commercial private sector shall be subject to WHO’s guidelines on interaction with commercial enterprises.
23. Unless otherwise stated in the hosting arrangement, WHO shall be reimbursed for its programme support costs as determined by the Health Assembly and/or WHO’s internal policy. Hosted partnerships can impose heavy workloads on different parts of the Organization, including at regional and country levels. WHO will seek to be reimbursed for all administrative and technical support costs incurred in providing hosting functions for partnerships and implementing or supporting their activities. Similarly, partnerships that may have human resource implications for WHO at the regional and country levels shall be required to meet the related costs. Hosting arrangements will also require hosted partnerships to indemnify WHO for costs, expenses and claims incurred as a result of activities carried out by the partnership secretariat.
24. In order to protect the integrity of the partnership and of WHO, the partnership secretariat will follow WHO’s guidelines and administrative procedures for internal and external communications (including media products, publications, technical reports and advocacy material). Official communications by the partnership secretariat with Member States, WHO offices and staff will follow WHO’s normal channels.
Evaluation and “sunset clauses”
25. WHO’s arrangements with all its hosted partnerships will contain an “evaluation and sunset clause”, whereby an assessment will be carried out before the expiration of the hosting arrangement based on the past performance of the partnership, its relationship with WHO, the continued demand or emerging alternatives to fostering collaboration, and future expectations. Working with the partnerships, WHO will design a monitoring and evaluation framework for such an assessment.
26. Following the assessment, WHO and the partnership will discuss the results with a view to choosing one of four possible approaches, namely: (1) continuing the current arrangement for a new specified period; (2) making recommendations for changes to the partnership structure and/or purpose and for revision of WHO’s hosting arrangement; (3) integrating the partnership into WHO with clear specifications for ensuring broad and inclusive collaboration with partners; or (4) separating the partnership from WHO.
Appendix Decision tree for evaluating the criteria for WHO engagement
Reproduced from World Health Assembly, Resolutions and decisions, Annexes – document WHA63/2010/REC/1, Geneva 2010, FROM WHA63 REC 1 on page 17 “Partnerships” and page 77 “Policy on WHO Engagement with Global Health Partnerships and Hosting Arrangements” Copyright WHO (2010) [http://apps.who.int/gb/ebwha/pdf_files/WHA63-REC1/WHA63_REC1-en.pdf]
2 Documents A63/44 and A63/44 Corr.1.
3 See Annex 1.
1 See resolution WHA63.10.
1 With particular reference to Article 37 of WHO’s Constitution which reads: “In the performance of their duties the Director-General and the staff shall not seek or receive instructions from any government or from any authority external to the Organization. They shall refrain from any action which might reflect on their position as international officers. Each Member of the Organization on its part undertakes to respect the exclusively international character of the Director-General and the staff and not to seek to influence them.”
1 UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases and UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.