W O R L D H E A L T H ORGANIZATION
ORGANISATION MONDIALE DE LA SANTÉ
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU RÉGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE WPR/RC70/9
Seventieth session Manila, Philippines
28 August 2019
7–11 October 2019 ORIGINAL: ENGLISH
Provisional agenda item 14
COORDINATION OF THE WORK OF
THE WORLD HEALTH ASSEMBLY, THE EXECUTIVE BOARD AND THE REGIONAL COMMITTEE
Coordinating the work of WHO governing bodies is critical to accomplish the strategic priorities set out in the Thirteenth General Programme of Work 2019–2023 (GPW 13) and the WHO transformation. To improve transparency and inclusiveness in governing body processes, Member States are invited to review and prioritize proposed agenda items for the seventy-first session of the Regional Committee in 2020, with additional supporting information provided in Annexes 1 and 2. During Regional Committee interventions, Member States may also share proposals for technical agenda items, along with information to support their prioritization.
This document also provides Member States with an update on WHO’s work in countries as well as the Region’s engagement with the Organization’s global transformation in support of effective implementation of the GPW 13 (with updates on these items in Annexes 3 and 4). Additionally, the document contains items highlighted by the World Health Assembly and the Executive Board to request Regional Committee feedback.
Included as well for Regional Committee review is a requested update on geographically dispersed specialized offices in the Region. For easy reference, World Health Assembly resolutions in 2019 are listed in Annex 5, and the provisional agenda of the 146th session of the WHO Executive Board is in Annex 6.
1. AGENDA FOR THE SEVENTY-FIRST SESSION OF THE REGIONAL COMMITTEE IN 2020
In accordance with the revised agenda development process endorsed in 2015 by the Regional Committee for the Western Pacific, the Secretariat proposes five technical agenda items for the seventy-first session of the Regional Committee in 2020. In identifying proposed agenda items, the Secretariat has considered: (a) regional strategies to be renewed; (b) adaptation of World Health Assembly resolutions to the context of the Region; and (c) issues proposed by Member States or the Secretariat.
Table 1 shows the list of proposed technical agenda items along three agenda categories.
Annex 1 provides the list of technical agenda items discussed at the Regional Committee from 2013 to 2019, along with information on categories for inclusion. Annex 2 provides background information on each proposed agenda item for 2020.
Member States are requested to review proposed technical agenda items for the seventy-first session of the Regional Committee in 2020. Member States may also wish to share proposals for technical items along with background information to support their prioritization.
Table 1. Proposed technical agenda items for the seventy-first session of the Regional Committee
Categories Agenda item
(a) Renewal of regional strategies
1. Traditional medicine (b) Adaptation of World
Health Assembly resolutions
(No items proposed for 2020) (c) Issues proposed by
Member States or the Secretariat
2. Ageing and health
3. Safe and affordable surgery
4. Policy and governance of medical products 5. School health
2. WHO REFORM
a. WHO’s work in countries Background
Strengthening WHO’s work and impact at the country level has been central to the Western Pacific Region’s reforms over the past decade. This emphasis is also a key priority globally in the WHO Thirteenth General Programme of Work 2019–2023 (GPW 13) and a renewed focus for the Region in For the Future: Towards the Healthiest and Safest Region (RC70/INF/1), a document prepared in consultation with Member States, partners and other stakeholders that will guide WHO work in the Region in the coming years.
Member States have expressed strong support for WHO’s work in countries. Following well- received side events at the previous three Regional Committee sessions, country support is now on the standing agenda to give Member States an annual opportunity to strengthen oversight and feedback on that work.
An analysis of the past decade of reforms in the Region identified six attributes for ensuring WHO is able to provide good country support: (a) focusing WHO support where the Organization can make a difference; (b) leveraging the three levels of the WHO Secretariat; (c) enhancing communications; (d) effectively engaging partners; (e) placing the right people in the right places; and (f) improving operational intelligence. Previous Regional Committee side events have focused on aspects of the first three attributes. This report summarizes developments related to WHO’s engagement with partners. Annex 3 provides an update on the other five attributes.
Effectively engaging partners
Engaging partners is essential for tackling all health issues. WHO can play many roles in improving health in each country, and the variety of partners is increasingly complex. The following illustrates some key roles and types of partners with which WHO endeavours to engage to help improve health in each country and also the changing mechanisms that may be used for engagement.
Convening and coordinating partners: A key role at the country level is to support health ministries to convene, coordinate and engage with a wide range of partners. In countries such as Cambodia, the Lao People’s Democratic Republic and Viet Nam, health partner groups are a key vehicle to facilitate discussion between the government and partners on health sector priorities, emerging issues, health sector plans and policies, and monitoring progress against these plans. WHO
has often provided secretariat support and/or co-chaired the health partner groups with ministry counterparts. These groups have evolved from a means to exchange information towards a real partnership mechanism, facilitating dialogue and collaboration among all parties in support of national priorities and plans, rather than partners pursuing individual objectives. The context and nature of each partnership group varies depending on country context. WHO will continue to support this evolution as a key means for coordinating the effective participation by all parties interested in supporting health development, with the government leading efforts.
Engagement with parliamentarians: WHO supported the establishment of the Asia-Pacific Parliamentarian Forum on Global Health, initiated by Member States in 2015. Themes for discussion have included global health security, the 2030 Agenda for Sustainable Development, NCDs and healthy ageing, and strengthening financing and regulation for UHC. The Forum’s fifth meeting was convened in Fiji in August 2019, focusing on the role of parliamentarians in addressing the health impacts of climate change, including through strengthening climate-resilient health systems. This platform has enabled parliamentarians at a regional level not only to exchange ideas, build political will, strengthen capacity and foster collaboration towards sustainable action, but also to engage more on specific health matters within their countries. Consequently, the legislature in countries is increasingly reaching out to WHO for support in the development and passage of health-related laws and regulations.
Engagement with other sectors: The health sector alone cannot tackle most health issues. This is even more evident with the Sustainable Development Goals and is clearly reflected in GPW 13 and in For the Future. WHO supports engagement with other sectors in many ways. The Health Promoting Schools programme in Fiji has also engaged sectors other than health, involving 289 schools and 100 000 students, aiming to improve health outcomes for children. Multisectoral advocacy and engagement are also important components of the efforts in Kiribati and Tuvalu to support the development of climate-resilient health systems and wider efforts to combat the health impacts of climate change. In Tonga, WHO supported the Ministry of Internal Affairs to lead a coalition of nongovernmental organizations and providers working to improve access to services for people with disabilities. Supporting health counterparts to tackle these areas effectively requires WHO to engage more extensively with other sectors than in the past and is one of the key operational shifts identified in For the Future.
Engagement with other United Nations agencies: Building on established collaborations within the United Nations system, such as with UNICEF, UNFPA and UNAIDS, new United Nations reforms present an opportunity for WHO to champion greater engagement in support of health from a broader range of United Nations agencies and, in doing so, to also engage with their corresponding government
sector counterparts. WHO will work with Resident Coordinators and other United Nations agencies to strengthen the engagement of other sectors to address issues such as noncommunicable diseases and environmental health, also ensuring that health is directly reflected in the United Nations Sustainable Development Cooperation Frameworks.
Expanding existing collaborations is also proving beneficial. For example, the One Health approach, with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE), has been useful in relation to food safety as well as the control of zoonotic diseases. More recently, this concept is being applied to antimicrobial resistance using a cross-cutting, multisectoral approach. Over the past two years, country-specific plans have been developed in Cambodia, the Lao People’s Democratic Republic, Nauru, Tonga and Tuvalu to combat antimicrobial resistance through a coordinated One Health approach involving stakeholders in human and animal health, agriculture, the environment and other sectors.
Engagement with expert institutions: WHO collaborating centres are an invaluable resource for the Organization to achieve its goals. To make this relationship as effective as possible, WHO has convened a biennial Regional Forum for WHO Collaborating Centres in the Western Pacific. The third Regional Forum was held in Ho Chi Minh City, Viet Nam, in late 2018. Representatives from 140 of the 175 centres based in the Region attended the Forum, which focused on sharing good practices, strengthening and promoting innovative collaboration and networking mechanisms among collaborating centres, and overall better understanding how to maximize contributions towards WHO support at the country level.
WHO also works with expert institutions through various networks. For example, through the WHO Regional Polio Laboratory Network, Australia’s Victorian Infectious Diseases Reference Laboratory supported WHO and Papua New Guinea between June 2018 and May 2019 by conducting virology testing and genotyping for stool samples, which generated evidence of interruption of circulating vaccine-derived poliovirus (cVDPV) transmission in Papua New Guinea.
Engagement with development banks: Over the past year, steps have been taken to facilitate and strengthen collaboration between WHO and the Asian Development Bank (ADB). A five-year memorandum of understanding was finalized in 2018 between ADB and the WHO (signed by the regional directors for South-East Asia and the Western Pacific on behalf of the entire Organization) to support each institution’s objectives, including universal health coverage, health security, urban health, responsive elderly care interventions and addressing the health impacts of climate change (especially in small island developing states). The agreement emphasizes cooperation at country-level
and includes support for high-level policy dialogue, country-level dialogue between WHO and ADB, information exchange and possible collaboration/alignment on country-level priorities and activities.
Engaging with civil society and communities: Most country offices have strong ongoing relationships with civil society; some have institutionalized these relationships by including civil society in project steering groups or regular civil society forums. In the Philippines, for example, WHO has worked with other United Nations agencies to form a Youth Advisory Group. A community-based approach has been used in the Mekong Malaria Elimination programme to engage forest-goers in Cambodia, the Lao People’s Democratic Republic and Viet Nam in order to identify and develop local strategies to protect against malaria.
Using technology to engage with partners: The consultations on For the Future provide a recent example of how WHO can use social media platforms to engage more directly with communities. A three-day virtual Partners’ Forum attracted active engagement of 450 partners from all over the Region and beyond. The Forum also included a youth town hall to seek inputs on the health priorities for the Region in the coming years and ideas about how WHO can better engage with young people. This online consultation demonstrated the feasibility and potential for using a similar approach in the future at regional and country levels.
Member States are invited to note this report.
b. The WHO Thirteenth General Programme of Work and the global transformation During discussions related to WHO reform in 2018 (subitem 17.2, document WPR/RC69/11), the Regional Committee requested that Member States be provided with greater information on collaboration between the Regional Office and WHO headquarters related to the transformation, for future Regional Committee sessions. Annex 4 contains a report that summarizes the Region’s collaboration and engagement with the WHO global transformation.
3. ITEMS RECOMMENDED BY THE WORLD HEALTH ASSEMBLY AND THE EXECUTIVE BOARD
The Seventy-second World Health Assembly adopted 16 resolutions and 24 decisions contained in Annex 5. The 145th session of the Executive Board adopted one resolution and seven decisions. The draft provisional agenda of the 146th session of the Executive Board is available in Annex 6.
Five items are referred to regional committees for further action or consideration. Information on each of these items is provided below (labelled 3.1 to 3.5). For the first four items, Member States may provide comments directly to the respective focal point at WHO headquarters. For the fifth item, Member States may email comments to [email protected], and correspondence will be forwarded to the respective focal point.
Two other items were also referred to regional committees for comments. These items have been included for discussion as part of the progress reports on technical programmes, specifically subitems 13.2 and 13.5, respectively (document WPR/RC70/8). They are:
Executive Board decision EB144(2) on accelerating the elimination of cervical cancer as a global public health problem
World Health Assembly resolution WHA71.3 on preparation for a high-level meeting of the General Assembly on ending tuberculosis.
3.1 World Health Assembly resolution WHA69.3 on the global strategy and action plan on ageing and health 2016–2020: towards a world in which everyone can live a long and healthy life Through resolution WHA69.3, the Director-General was requested to leverage the experience and lessons learnt from the implementation of the Global Strategy and Action Plan on Ageing and Health in order to better develop a proposal for the Decade of Healthy Ageing 2020–2030 with Member States and with inputs from partners, including United Nations agencies, other international organizations and nongovernmental organizations. Member States may request copies of the draft proposal for a Decade of Healthy Ageing and/or send inputs to inform its development to the global focal point: Ms Alana Officer ([email protected]).
3.2 World Health Assembly resolution WHA71.7 on digital health
Through resolution WHA71.7, the Director-General was requested to develop, within existing resources, and in close consultation with Member States and with inputs from relevant stakeholders as appropriate, a global strategy on digital health, identifying priority areas including where WHO should focus its efforts. Member States may request copies of the draft global strategy on digital health and/or send comments and input to inform its development to the focal point: Dr Edward Kelley ([email protected]).
3.3 World Health Assembly resolution WHA72.1 on the Programme budget 2020–2021 Through resolution WHA72.1, the Director-General was requested to continue developing the results framework in consultation with Members States, including through the regional committees,
and to present it to the Executive Board at its 146th session. Member States are asked to send input on the results framework, as further described in the document: Thirteenth General Programme of Work, 2019–2023 – Results framework: an update, to the global focal point Dr Samir Asma ([email protected]).
3.4 Executive Board document EB145/4 on the involvement of non-State actors in the governance of WHO
The Executive Board at its 145th session noted a report by the Director-General concerning the involvement of non-State actors in the governance of WHO (document EB145/4) and supported a proposal to have online and face-to-face consultations. Member States are requested to send further comments and inputs on this issue to the global focal point. These comments will be used to elaborate a proposal/package of measures for the involvement of non-State actors in the governance of WHO, for further consideration by the Executive Board at its 146th session in January 2020. The global focal point is Dr Gaudenz Silberschmidt ([email protected]).
3.5 World Health Assembly information document A72/INF./4 on WHO presence in countries, territories and areas: 2019 Report
Through decision WHA69(8), the Director-General and the Regional Directors were requested to provide the biennial WHO country presence report for review by the regional committees, and as an information document for the World Health Assembly, through the Executive Board and its Programme, Budget and Administration Committee. The 2019 report on WHO Presence in Countries, Territories and Areas, also summarized in document A72/INF./4, has been provided to the thirtieth session of the Programme, Budget and Administration Committee and the Seventy-second World Health Assembly. The Regional Committee may wish to provide comments on the report.
4. OTHER ITEMS
a. Geographically dispersed specialized offices in the Region
Geographically dispersed specialized offices (GDSOs) are WHO offices that are housed in a different location from the major WHO office that manages them but contribute to the major office’s work. In 2017, in considering the Secretariat’s review of WHO GDSOs globally, the Regional Committee for the Western Pacific supported the use of GDSOs as an innovative modality for attracting resources and advancing WHO’s programme of work (document WPR/RC68/12).
The WHO Regional Director for the Western Pacific issued a request for expressions of interest to ministers of health on 5 December 2017. The request identified three areas of Secretariat interest for establishing a GDSO in line with WHO priorities: ageing, environmental health and urban health.
Non-binding expressions of interest were received from China to host a GDSO on urban health and from the Republic of Korea to host a GDSO on environmental health.
Thereafter, the Secretariat entered into a memorandum of understanding on 15 January 2019 with the Ministry of Environment of the Republic of Korea and the Seoul Metropolitan Government to support the establishment of the WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region, together with subsequent agreements with the Seoul Metropolitan Government and the Seoul Facilities Corporation concerning the premises for the Centre. Discussions with China concerning the GDSO on urban health will progress further in the coming months.
ANNEX 1 LIST OF TECHNICAL AGENDA ITEMS DISCUSSED AT THE REGIONAL COMMITTEE
FROM 2013 TO 2019 WITH INFORMATION ON CATEGORIES FOR INCLUSION
Regional Committee session (Year)
Agenda items
Categories for inclusion for main technical agenda items
(a) Regional strategies to be renewed
(b) Adaptation of World Health Assembly resolutions
(c) Issues proposed by Member States or the
Secretariat1 Seventieth
(2019)
Ageing and health
Tobacco control
Protecting children from the
harmful impact of food marketing
Antimicrobial resistance
Sixty-ninth (2018)
Neglected tropical diseases
Rehabilitation
Strengthening legal frameworks for health in the Sustainable Development Goals
E-health for integrated service
delivery
Planning and managing hospitals
Sixty- eighth (2017)
Measles and rubella elimination
Protecting children from the
harmful impact of food marketing
Health promotion in the
Sustainable Development Goals
Triple elimination of mother-to- child transmission of HIV, syphilis and hepatitis B
Transitioning to integrated
financing of priority health services
Regulatory strengthening and
convergence for medicines and health workforce
Food safety
1 Items classified under category (c) issues proposed by Member States or the Secretariat were newly raised issues or those not recently addressed by the Regional Committee or the World Health Assembly. Proposal by Member States or the Secretariat is also a prerequisite for categories (a) and (b).
Annex 1
Regional Committee session (Year)
Agenda items
Categories for inclusion for main technical agenda items
(a) Regional strategies to be renewed
(b) Adaptation of World Health Assembly resolutions
(c) Issues proposed by Member States or the
Secretariat2 Sixty-
seventh (2016)
Dengue
Malaria
Environmental health
Sustainable Development Goals
Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies
Sixty-sixth
(2015)
Viral hepatitis
Tuberculosis
Universal health coverage
Violence and injury prevention
Urban health
Sixty-fifth (2014)
Mental health
Tobacco Free Initiative
Antimicrobial resistance
Expanded Programme on
Immunization
Emergencies and disasters
Sixty- fourth (2013)
Blindness prevention
Ageing and health
Hepatitis B control through
vaccination
Noncommunicable disease
2 Items classified under category (c) issues proposed by Member States or the Secretariat were newly raised issues or those not recently addressed by the Regional Committee or the World Health Assembly. Proposal by Member States or the Secretariat is also a prerequisite for categories (a) and (b).
ANNEX 2 PROPOSED AGENDA ITEMS FOR THE SEVENTY-FIRST SESSION
OF THE REGIONAL COMMITTEE FOR THE WESTERN PACIFIC WITH SOME BACKGROUND INFORMATION
1. (a) Renewal of regional strategies Traditional medicine
Traditional medicine plays an important role in primary health care in many parts of the WHO Western Pacific Region. WHO has supported Member States in integrating traditional medicine into primary health care systems, where appropriate, as part of advancing UHC. In 2017, the Regional Committee reviewed progress on implementing the Regional Strategy for Traditional Medicine in the Western Pacific (2011-2020), along with a proposal to develop a new regional action to start in 2021.
The new plan would align with the global WHO Traditional Medicine Strategy 2014–2023 and the regional UHC action framework Universal Health Coverage: Moving Towards Better Health, as well as better address recent issues faced by Member States. The new plan would provide strategic direction and actions to move forward the traditional medicine agenda in ways that contribute to achieving UHC, specifically improved access to quality, people-centred primary health care and quality-assured, safe and effective essential medicines. This will also contribute to addressing one of the priorities for WHO in the Region going forward: noncommunicable diseases (NCDs) and the health needs of ageing populations.
(b) Adaptation of World Health Assembly resolutions to the Region (No items proposed)
(c) Issues proposed by Member States or the Secretariat 2. Ageing and health
Adults over the age of 65 years are the fastest-growing age group in the Western Pacific Region, presenting complex multisectoral societal challenges that will grow in size and scope over time. The Region as a whole must take steps to address the needs of its growing older population against a backdrop of rapid socioeconomic transformation and globalization, particularly as 80% of older people in the Region live in lower- and upper-middle-income countries. A transformation of all of society – not just health systems – will be essential to ensure health and well-being for older people throughout the Region. Given the speed at which countries are ageing, it is paramount for countries to act early for greater population health benefits. The necessary whole-of-society approach requires time and vested commitment to health and ageing by Member States. Including ageing and health in the 2020 Regional Committee agenda is particularly timely, with the finish of the Regional Framework for Action on Ageing and Health in the Western Pacific (2014–2019). The year 2020 also marks the beginning of the decade of concerted global action on healthy ageing, which is central in the Region’s thematic priorities for the coming years. Depending of the outcome of the high-level panel discussion, Member States will define future actions on ageing and health.
Annex 2
3. Safe and affordable surgery
Safe surgical services are integral for a well-functioning health system and an essential component of universal health coverage (UHC). Timely access to surgical care can reduce death and disability from easily treatable surgical conditions. However, many countries of the Region face similar challenges, such as limited capacities, vast distances, shortages of skilled health workers and high costs.
Improving surgical, obstetric and anaesthesia care is an investment that reduces mortality, bolsters public trust in health services, creates healthier communities and stimulates economic growth.
Achieving this requires expansion of basic surgical services in primary care settings, including strengthened referral pathways between primary care and hospitals. The proposed regional action agenda will present actions that Member States may adopt, depending on their specific contexts, to ensure surgical services are a core component of health systems for all countries at all levels of development.
4. Policy and governance of medical products
Access to medicines, vaccines and medical products of assured safety, quality and efficacy is key to the achievement of UHC. The effectiveness of systems for ensuring access (such as production and distribution, selection, financing, procurement, pricing and use) depends on coherent policies and strong governance mechanisms. The proposed regional framework would guide Member States to develop policies and governance mechanisms to improve access to medicines, vaccines and essential medical products.
5. School health
Behaviours and habits develop in early childhood as children acquire basic knowledge and experiences that influence their lifestyles through adulthood. By promoting healthy behaviour through school settings, schools can directly enhance the lives of children and reach out to families and communities. In low- and middle-income countries, school-based interventions have successfully helped prevent communicable diseases and other health problems; in high-income countries, health promoting schools have contributed to improving health by reducing risk factors for NCDs. School settings represent an extended arm of primary health care as a potential platform for basic treatment services as well as health promotion. Building on the Regional Action Plan on Health Promotion in the Sustainable Development Goals (2018–2030), WHO’s approach in the Region will be informed by the Global Standards for Health Promoting Schools and the School Health Services Guideline, currently being developed at the global level, as well as lessons from past efforts to develop health promoting schools. This item proposes a regional action plan to accelerate the use of health promoting schools and strengthen outcomes that can be achieved through this unique setting.
ANNEX 3 WHO’S WORK IN COUNTRIES:
UPDATE ON THE ATTRIBUTES OF GOOD COUNTRY SUPPORT
In addition to the summary provided in the main body of this document related to the attribute of effectively engaging partners, this Annex provides an update of the five other attributes for ensuring WHO is able to provide good country support.
Focusing WHO support where the Organization can make a difference
WHO must ensure that its limited resources are used effectively to support countries. To do this, a different approach has been taken in the process of developing country cooperation strategies (CCSs) in the Region: focusing on the health and development priorities and goals of countries, while also taking into account the current country situation and realities as well as looking forward a few years (strategic foresight). WHO’s priorities and its comparative advantage are considered in relation to this. The resulting CCSs are agreed jointly with governments to guide collaboration that is more targeted and effective, including for budget planning. CCSs developed in this way have continued to prove useful as direct input into the new planning approach to support implementation of GPW 13 and the Programme Budget 2020–2021.
In the coming year, new CCSs will be developed for Cambodia, China, Malaysia and Papua New Guinea, building on achievements and focusing on each country’s health and development priorities, GPW 13, For the Future, and the new United Nations Sustainable Development Cooperation Frameworks.
Leveraging the three levels of the WHO Secretariat
To fully exploit the Organization’s technical capacity, WHO in the Western Pacific has strengthened teamwork among country offices and the Regional Office. Planning and implementing technical support together has helped break down barriers between offices and technical areas. This approach, crystalized in technical programme country support plans, has been used in developing CCSs and has contributed to strategic programme and operational budget planning and implementation. Recently, the global transformation confirmed WHO’s roles: country offices lead WHO engagement with governments based on their country needs and priorities; regional offices lead technical cooperation as the primary providers of technical support through subject-matter experts; and headquarters will focus on global health goods, specialized assistance and surge capacity.3 Therefore, the teamwork approach used in the Western Pacific Region will expand and result in more effective engagement across WHO’s three levels, to jointly understand the key objectives and technical priorities and to identify how technical support can be best provided for each country, to ensure more effective support at the country level.
Enhancing communications
Strategic communications are critical for WHO to perform effectively. Over the past decade, communications capacities have been enhanced at both the regional and country levels, including
3 WHO reform processes, including the transformation agenda, and implementation of United Nations development system reform: the WHO transformation agenda. Report by the Director-General. A72/48, paragraph 26.
Annex 3
strengthening country office staff capabilities, using more digital and social media platforms including the development of a new regional website featuring pages for each of the 37 countries and areas in the Region, and developing more appropriate, visually engaging products for different audiences.
WHO has also strengthened its support for risk communications at the country level, particularly outbreaks and emergencies. Overall, GPW 13 and For the Future both call for strategic communications to be scaled up and strengthened, as a health and development intervention in its own right.
Placing the right people in the right places
Efforts to ensure WHO has the right capabilities to deliver effectively for countries are continuing, with improvements in human resource management including greater efficiency and timeliness in staff recruitment, from vacancy notice issuance to final approval. The streamlined staff recruitment process now averages 105 days, compared with 148 days five years ago. The target in the Region is to bring this down to 90 days, compared with the global target of 114 days. There has also been significant progress in gender balance among staff in the Region: women comprise 50% of professional staff as of July 2019, up from 43% five years ago.
WHO’s country presence has also improved markedly over the past decade. The Division of Pacific Technical Support was established, the Solomon Islands office upgraded to a representative office, and a country liaison office established for Northern Micronesia. The Organization continues to review its country presence, particularly when planning for each biennium to assess the nature of WHO’s presence in each country. Ensuring the capacity of staff to meet country needs has also been strengthened by the Western Pacific Region’s mobility process for internationally recruited staff, which has been expanded and improved over the past decade to the point where the Region’s experiences are now being used to inform development of the global mobility scheme.
The country offices and the Regional Office work as a team across the Region. Support for countries remains a major focus in For the Future, and WHO is in the process of strengthening its regional capacity for greater strategic policy dialogue, improved data and analytics, as well as new capabilities to support innovation and “backcasting”, among others.
WHO also provides occasional assistance at other levels within a country. Finding flexible, cost- effective ways to do this is essential. For example, Cambodia with WHO assistance has developed over the past two years an intensification plan targeting seven operational districts with the highest malaria burden. Under the leadership of local governments, WHO supported its implementation by boosting WHO presence at the provincial level through a combination of recruiting short-term consultants as well as intensified supervisory visits by country and Regional Office staff. Further support was provided by the Mekong Malaria Elimination programme team, based in the WHO Cambodia office, including epidemiology data analysis, communications, partner coordination and additional supervisory visits. These efforts have contributed to a significant reduction in malaria cases in the country.
Annex 3 Improving operational intelligence
Building capacity to collect and analyse information is central for building evidence for policy decision-making. It is also critical to more quickly identify and respond to emerging priority issues.
Measures to improve the flow of information between WHO offices in the Region in recent years have also helped the Regional Office become more responsive to country needs and emerging issues.
This has been key in strengthening the WHO Health Emergencies Programme in the Region.
Improved information flows have also helped staff to work in a more cross-cutting way, fostering a more consultative and participative culture. Additional analytical capacity and new skills will also be important to carry out the new approaches geared towards longer-term results described in For the Future.
Annex 3
ANNEX 4 WESTERN PACIFIC REGION ENGAGEMENT
WITH THE WHO GLOBAL TRANSFORMATION
The elements of the transformation are described in the Director-General’s report on the WHO transformation agenda presented to the Seventy-second World Health Assembly (document A72/48).
This Annex refers to these elements and provides information about the Region’s collaboration and engagement with the WHO global transformation.
A new WHO strategy
GPW 13, endorsed at the World Health Assembly in May 2018, is a central strategy for the whole of WHO, setting the mission and strategic priorities for the Organization’s work over the next five years.
In order to deliver on GPW 13, however, it was recognized that WHO must work differently if the SDGs and global health goals are to be achieved. Three strategic shifts were identified: stepping up leadership at all levels; driving impact in every country; and focusing global public goods on impact.
As a result, WHO commenced a transformation process, in order to ensure the highest quality in the Organization’s normative and technical work. The transformation process aims to make WHO’s work more focused on the needs, demands and expected actions of Member States, so that it translates directly into results at the country level. In other words, the transformation process seeks to reposition, reconfigure and capacitate WHO in order to enable the Organization to play a central role in helping countries to achieve the health-related SDGs, within the broader purview of United Nations reform.
To operationalize the broad strategic goals of GPW 13, For the Future identifies four thematic priorities for WHO’s work in the Region for the next five years: health security including antimicrobial resistance; NCDs and ageing; climate change and the environment; and reaching the unreached. Likewise, For the Future identifies seven new ways of working that will enable WHO to implement the strategic shifts outlined in GPW 13 in the Region and deliver more effective support to Member States.4 The aim is for the Western Pacific Region to become the world’s healthiest and safest region, able to effectively address new and increasingly complex health challenges.
For WHO in the Western Pacific Region, the global transformation builds on a solid foundation of regional reforms undertaken since 2009, which have made WHO in the Western Pacific Region more efficient, effective, people-centred, country- and impact-oriented, and a stronger organization overall, with a culture of continuous improvement.
Redesigning WHO’s core processes
A key component of the transformation relates to redesigning WHO’s core processes. These include technical processes (technical cooperation, norms and standards, research, innovation and data);
external processes (such as resource mobilization and communications, both internal and external);
and business and administrative processes (including programme budget planning, recruitment,
4 The seven operational shifts are: (i) finding new approaches to meet future challenges (innovation); (ii) working backwards from a longer-term goal (backcasting); (iii) taking a systems approach, with UHC as the foundation;
(iv) building solutions from the ground (grounds up); (v) championing health beyond the health sector; (vi) driving and measuring country impact; and (vii) strategic communications as a means to deliver our mission and mandate.
Annex 4
performance management and the supply chain). WHO in the Region has fully engaged and contributed to this aspect of the transformation, ensuring that experienced staff from the Region have been involved in the working groups established for each of these processes, particularly including experienced staff from country offices for the technical processes. In addition, the Region has been directly involved in reviewing and prioritizing WHO’s work on global goods, mainly future norms and standards.
One of the first changes has been the process for developing the Programme Budget 2020–2021. The Western Pacific Region has been directly engaged in moving forward using the new budget planning process, while also identifying how to appropriately focus on the four thematic priorities and utilize the seven operational shifts for further strengthening collaboration and results for the countries and areas of the Region.
Aligning and optimizing WHO’s operating model
Careful consideration is ongoing to optimize and align WHO’s operating model, which combines roles, skills, structures and processes. Through this work, it has been confirmed that regional offices lead WHO technical cooperation and work on issues of regional significance. They will continue to be the primary providers of WHO technical support, with headquarters focusing on global health goods and providing specialized assistance and surge capacity.
The structure of the Regional Office has been aligned with the four pillars of the WHO global structure: emergency preparedness and response; programmes; business operations; and external relations and governance. Some differences are necessary at levels below this, given that the Regional Office has a smaller technical workforce than WHO headquarters. There are also different synergies between technical areas related to the nature of the work in the Region and the way programme areas need to be supported. In addition, how best to take forward the operational shifts identified in For the Future and effective ways of working on cross-cutting issues have been considered. Country offices in the Region also undergo periodic review, including the configuration of offices and capacities needed to provide tailored support to Member States with the resources available.
Optimizing organizational culture for collaboration, performance and impact
The Western Pacific Region has also engaged directly on this aspect of the transformation. Even before the transformation, the Region had introduced a number of innovations, including staff mobility and mentoring. These have been further strengthened with new initiatives, such as the introduction of group peer review with the aim of encouraging and supporting continuing professional development as well as strengthening peer networks and collaboration.
The Region also fully engaged with the culture survey in November 2017, which assessed staff perceptions of the Organization in the areas of leadership, whether staff have a shared vision/goals, WHO’s ability to work and deliver effectively, and WHO’s ability to adapt and innovate. In all, 82% of WHO staff from all offices in the Region participated in this survey, compared to 61% across the Organization. In addition, many staff members in the Region engaged in the consultation and development of the WHO Values Charter, which was launched in May 2019. To support the transformation, a network of change supporters in the Region has been established. They link
Annex 4 periodically with the global network of change supporters to update them and plan for key change events, such as the launch of the Values Charter.
In addition, the Regional Director, the Director of Programme Management, the Director of Administration and Finance, and the Director of the Regional Director’s Office have been involved since the start of the WHO transformation, providing advice and direction on all aspects, not only for the Region but also as part of WHO senior management globally, participating in the decision-making of the Organization at its highest levels, as well as various working groups.
The Regional Committee is requested to note that the Western Pacific Region is directly and fully engaged with the WHO global transformation.
Annex 4
ANNEX 5 RESOLUTIONS AND DECISIONS ADOPTED BY THE SEVENTY-SECOND
WORLD HEALTH ASSEMBLY
Resolution number Title of resolution
WHA72.1 Programme budget 2020–2021 WHA72.2 Primary health care
WHA72.3 Community health workers delivering primary health care: opportunities and challenges
WHA72.4 Preparation for the high-level meeting of the United Nations General Assembly on universal health coverage
WHA72.5 Antimicrobial resistance WHA72.6 Global action on patient safety
WHA72.7 Water, sanitation and hygiene in health care facilities
WHA72.8 Improving the transparency of markets for medicines, vaccines, and other health products
WHA72.9
Status of collection of assessed contributions, including Member States in arrears in the payment of their contributions to an extent that would justify invoking Article 7 of the Constitution
WHA72.10 Special arrangements for settlement of arrears: Central African Republic WHA72.11 Appointment of the External Auditor
WHA72.12 Scale of assessments for 2020–2021
WHA72.13 Salaries of staff in ungraded positions and of the Director-General WHA72.14 Special arrangements for settlement of arrears: Bolivarian Republic of
Venezuela
WHA72.15 Eleventh revision of the International Classification of Diseases
WHA72.16 Emergency care systems for universal health coverage: ensuring timely care for the acutely ill and injured
Decision number Title of decision
WHA72(1) Composition of the Committee on Credentials
WHA72(2) Election of officers of the Seventy-first World Health Assembly WHA72(3) Election of officers of the main committees
WHA72(4) Establishment of the General Committee WHA72(5) Adoption of the agenda
WHA72(6) Verification of credentials
WHA72(7) Election of Members entitled to designate a person to serve on the Executive Board
WHA72(8) Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan
WHA72(9)
WHO global strategy on health, environment and climate change: the transformation needed to improve lives and well-being sustainably through healthy environments
WHA72(10) Plan of action on climate change and health in small island developing States
Annex 5
Decision number Title of decision
WHA72(11)
Follow-up to the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases
WHA72(12) Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits
WHA72(13) The public health implications of implementation of the Nagoya Protocol WHA72(14) Promoting the health of refugees and migrants
WHA72(15) Report of the External Auditor
WHA72(16) WHO programmatic and financial reports for 2018–2019, including audited financial statements for 2018
WHA72(17) Human resources: annual report
WHA72(18) Appointment of representatives to the WHO Staff Pension Committee WHA72(19) 2020: International Year of the Nurse and the Midwife
WHA72(20) World Chagas Disease Day
WHA72(21) WHO reform: amendments to the Rules of Procedure of the World Health Assembly
WHA72(22) WHO reform: amendments to the Rules of Procedure of the World Health Assembly
WHA72(23) WHO reform: amendments to the Rules of Procedure of the World Health Assembly
WHA72(24) Selection of the country in which the Seventy-third World Health Assembly would be held
ANNEX 6
EXECUTIVE BOARD EB146/1 (draft)
146th session 26 June 2019
Geneva, 3–8 February 2020
Draft provisional agenda
1. Opening of the session 2. Adoption of the agenda
3. Report by the Director-General
4. Report of the Programme, Budget and Administration Committee of the Executive Board
5. Report of the regional committees to the Executive Board
Pillar 1: One billion more people benefitting from universal health coverage 6. Primary health care
7. Follow-up to the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases
8. Global vaccine action plan
9. Accelerating the elimination of cervical cancer as a global public health problem 10. Ending tuberculosis
11. Epilepsy
Pillar 2: One billion more people better protected from health emergencies 12. Public health emergencies: preparedness and response
12.1 The Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme
12.2 WHO’s work in health emergencies
Annex 6
12.3 Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits EB146/1 (draft)
12.4 The public health implications of implementation of the Nagoya Protocol 12.5 Cholera prevention and control
13. Poliomyelitis
13.1 Poliomyelitis eradication
13.2 Polio transition planning and polio post-certification
Pillar 3: One billion more people enjoying better health and well-being 14. Decade of Healthy Ageing
15. Maternal, infant and young child nutrition
Pillar 4: More effective and efficient WHO providing better support to countries 16. Data and innovation: global strategy on digital health
17. Budget and finance matters 17.1 Programme budget 2020–2021
17.2 Financing and implementation of the Programme budget 2018–2019 and outlook on financing of the Programme budget 2020–2021
17.3 Amendments to the Financial Regulations and Financial Rules [if any]
18. Governance matters 18.1 WHO reform
18.2 Engagement with non-State actors 18.3 World health days
18.4 Provisional agenda of the Seventy-third World Health Assembly and date and place of the 147th session of the Executive Board
19. Management matters
19.1 Evaluation: update and proposed workplan for 2020–2021
19.2 Evaluation of the election of the Director-General of the World Health Organization 19.3 Update on the infrastructure fund strategy EB146/1 (draft)
Annex 6 20. Committees of the Executive Board
20.1 Membership of the Independent Expert Oversight Advisory Committee 20.2 Participation in the Programme Budget and Administration Committee 20.3 Foundation committees and selection panels
20.4 Nelson Mandela Award for Health Promotion 21. Staffing matters
21.1 Appointment of the Regional Director for Africa 21.2 Appointment of the Regional Director for Europe
21.3 Statement by the representative of the WHO staff associations 21.4 Report of the Ombudsman
21.5 Human resources: update
21.6 Amendments to the Staff Regulations and Staff Rules [if any]
21.7 Report of the International Civil Service Commission
22. Matters for information: reports of advisory bodies: Expert committees and study groups
23. Closure of the session
Note: In line with resolution WHA67.2 (2014), the following items will be considered by the Health Assembly under progress reports.
Pillar 1. One billion more people benefitting from universal health coverage Addressing the burden of snakebite envenoming (resolution WHA71.5 (2018))
Global strategy and plan of action on public health, innovation and intellectual property: overall programme review (decision WHA71(9) (2018))
Strengthening integrated, people-centred health services (resolution WHA69.24 (2016)) Towards universal eye health: a global action plan 2014–2019 (resolution WHA66.4 (2013)) Eradication of dracunculiasis (resolution WHA64.16 (2011))
Reproductive health: strategy to accelerate progress towards the attainment of international development goals and targets (resolution WHA57.12 (2004))
Pillar 2. One billion more people better protected from health emergencies
Smallpox eradication: destruction of variola virus stocks (resolution WHA60.1 (2007)) Pillar 4. More effective and efficient WHO providing better support to countries WHO strategy on research for health (resolution WHA63.21 (2010))
