On the first day of the World Health Organisation (WHO)’s World Health Assembly, eight civil society organisations have sent an open letter [1] to Ms Zsuzsanna Jakab, Deputy Director-General of the WHO.

The letter raises concerns about a recent report [2] published by the WHO that could encourage the privatisation of healthcare amidst a COVID-19 pandemic that re-emphasised the challenges of commercialisation of healthcare systems, and without the necessary open debate that such an issue requires.

 On 7th December 2020, the WHO published a documented referred to as a ‘Strategy Report’, titled Engaging the private health service delivery sector through governance in mixed health systems. [2] This report was developed by an advisory group put together by the WHO.

While addressing the role and limitations of the private sector in healthcare delivery as an important issue that the WHO should address, the report alarmingly appears to promote, in part, commercialisation and privatisation of healthcare, despite the mounting evidence [3] of the negative effects this trend could have for the realisation of the right to health for all, in particular as it increases inequalities in access to care, creates inefficiencies, and lowers transparency, among other impacts.

 In an analysis [4] of the report that was annexed to the letter, the signing organisations note several elements that are particularly controversial and formulate a series of recommendations:

• The Strategy Report should not lead to the promotion of mixed healthcare system as preferred standards.
• The WHO should align its private sector analysis with the human right framework and the right to health.
• The WHO should clarify its position and not promote healthcare commercialisation.
• The Strategy Report should acknowledge the variety of private healthcare actors and their different impacts on the right to health.
• The Strategy Report must include mechanisms to include meaningfully civil society participation in private sector engagement. 

The GI-ESCR and other signing organisations call for a more balanced discussion on private involvement in healthcare, including through an assessment of the challenges brought about by growing healthcare commercialisation. By way of illustration, the report mentions, for instance, that local governments in India contracted private hospitals to face the COVID-19 pandemic, but it does not address the fact that a number of private healthcare facilities made the headlines for overcharging [5] and refusing to take COVID-19 patients.

In addition, although the report is meant to only provide advice, and is not based on a clear mandate from WHO Member States, the status of the report remains unclear, and the WHO is currently working on the implementation of the report recommendations. The signing organisations are thus particularly concerned that, amidst the COVID-19 pandemic, the report is being operationalised without the necessary open debate and consultations that such a sensitive issue requires, especially given the risks that powerful multinational companies overly influence the WHO position.

The signing organisations call on the WHO to:

• Set up a truly open and consultative process to define the organisation’s position on the issue of private sector engagement;
• Take all measures to ensure a democratic debate and approval of any position on private sector before moving to any implementation;
• This strategy should be clearly aligned with the right to health, international human rights law and WHO’s commitment to promote quality public healthcare, and not encourage commercialisation of healthcare in any direct or indirect way;
• Clarify the status of the December 2020 Strategy Report in WHO’s communication as an expert opinion, as it is stated in its disclaimer, and not as a WHO strategy.

As organisations specialised in health and human rights, and representing workers, the signing organisations welcome the interest and work of WHO on the issuer of healthcare privatisation and commercialisation, and would be open to support and the WHO in any of those steps.

Signatories of this public statement:

• Global Initiative for Economic, Social and Cultural Rights
• Global Justice Now
• Initiative for Social and Economic Rights
• Oxfam
• People’s Health Movement
• Public Services International
• STOPAIDS

Original source: The Global Initiative for Economic, Social and Cultural Rights [6]

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