World Health Assembly on WHO Reform Simulation

Transcription

1 GHP 548, Sessions 5-7 February 25, 2014 World Health Assembly on WHO Reform Simulation OVERVIEW WHAT: The simulation will decide on two key issues on World Health Organization (WHO) reform via debate and potential passage of a resolution on the financing of WHO and the policy for engagement with non-state actors (NSA policy). The World Health Assembly (WHA) is the governing body of the WHO. It is the body that agrees on formal resolutions that guide the work of the WHO. The WHA meets annually and includes all Member States (MS), countries that are members of the WHO. MS send delegates to the WHA, and each MS, regardless of size, gets one vote. Only MS representatives vote in the formal proceedings and have the right to speak. Other actors such as representatives of non-governmental organizations (NGOs), the media, think tanks, foundations, or industry may be allowed to give oral statements if they are in official relations with the WHO, and if time permits after MS have finished speaking. Mostly, these non-state actors participate in the WHA debates and negotiations through informal channels (side-meetings, conversations in the hallways, issuing press releases or otherwise feeding stories to journalists, etc.). The WHA simulation will be run by the Chair a country representative with support from the WHO Director General (DG) as well as one or more advisors to the DG. Advisors and the DG are members of the WHO Secretariat (staff). Generally, the WHA tries to pass resolutions by negotiating a consensus, but resolutions can also be passed by majority vote. This simulation was originally developed by the Harvard Global Health Institute Suerie Moon, MPA, PhD, Research Director and Co-Chair, Forum on Global Governance for Health, and Rachel Gordon, MBA, Case Studies Manager. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. Cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illustrations of effective or ineffective management.

2 WHEN: Present, WHERE: WHO: WHY: Formal one hour negotiation sessions will take place over two class sessions: o Day 1 Session (3/7) Speakers list with each MS presenting a one-minute opening statement on their position followed by a moderated caucus. If time allows, NSAs will also be called on to deliver their 1-minute statements. All students except those representing WHO should be prepared to deliver an opening statement, but the NSAs may not have the chance to speak. o Day 2 Session (3/14) Moderated caucus and maybe an unmoderated caucus (a short break from formal negotiations where all actors have the opportunity to interact directly with one another). In addition to negotiation held during class time, informal negotiations will take place (eg during the week, by , during class breaks) and will most likely be critical to achieving your objectives to influence the contents of the final resolution. Students should consider interacting with one another to develop alliances and strategies to influence the negotiations. WHA at the UN in Geneva Roles in this simulation will include: Chair MS representatives from selected countries WHO DG and Advisor to DG Representatives from NGOs, foundations, think tanks/experts, industries, and journalists covering the proceedings The main learning objectives for this activity are: To understand the role of the WHO within the global health system, and its strengths and limitations, through an in-depth consideration of two key issues in WHO reform debates. To grasp the challenges of achieving effective, efficient, equitable and legitimate global governance in a complex, interdependent world. To understand the different types of power that actors have to influence processes of global governance (i.e. compulsory, economic, structural, institutional, normative, discursive, expert). To understand the different types of tools and mechanisms that actors deploy to shape processes of global governance (i.e. agenda and priority-setting; framing; establishing informal norms and expectations; establishing formal rules (norms); mobilizing human or financial resources; accountability mechanisms; enforcing compliance). 2

3 DELIVERABLE: Individual student preparation for Day 1 Negotiation on March 7 Due Thursday, March 6, 9 AM to course isite. A background paper on the interests and objectives of your assigned role in the simulation (~ words). One minute opening statement that states your position on both issues (financing and NSA policy). All students except those representing WHO should be prepared to deliver an opening statement; WHO DG and Advisor should be prepared to respond to opening statements. (Note: All will be cut off after one minute.) Individual or Group Preparation for Day 2 Negotiation on March 14 Draft due Thursday, March 13, 9am to course isite. MS: Propose, co-sponsor, or seek to amend a draft resolution for each of the two issues being debated. Draft resolutions may be no more than 250 words. NSAs do not officially propose, co-sponsor or amend resolutions. However, informally, they can suggest text to MS representatives, indicate their political support or opposition to a resolution, or try to influence the resolution through other means. Individual Assignment Post-Negotiation Completion Due Monday, March 19 by midnight. Individual written reflection (~500 words). Assignment is meant to be brief and should take no more than two hours. Nevertheless, proper grammar and punctuation is expected. Students should reflect on: o How successful were you in achieving your objectives? o What was your strategy? Did it change during the negotiations? If so, why? o What did you learn about WHO specifically? Global governance more broadly? 3

4 GENERAL DESCRIPTION OF SIMULATION Introduction: Purpose and Rules of Engagement This exercise explores both concrete aspects of the global health system, and theoretical aspects of global governance. First, the simulation seeks to provide students with a deeper understanding of the unique role of WHO in the global health system, and its strengths and limitations. Second, it seeks to illustrate and facilitate understanding of more theoretical topics, such as how power operates through the tools and mechanisms of global governance, and the challenges of achieving effective, efficient, equitable and legitimate global governance in a complex, interdependent world. The simulation focuses on the negotiation of two resolutions relating to WHO reform in the areas of financing and the policy for engagement with non-state actors ( NSA policy ). Participants will be responsible for developing proposals for these two issues. Formal negotiations will take place in the classroom and informal negotiation outside of the classroom. During the classroom portion of this simulation, students will participate in a World Health Assembly (WHA) meeting. The WHA is the ultimate governing body of the World Health Organization (WHO). Students will represent different countries (member states (MS)), WHO staff, members of the media, foundation or NGO staff, industry representatives and selected experts. While MS have the primary right to speak during the WHA formal proceedings, other actors are often also present as observers and may be given the right to offer short, prepared statements; they may also try to influence negotiations through writing notes to country representatives or lobbying them during breaks or prior to the negotiation sessions. The Chair will run the meeting and has the power to recognize speakers. In addition, the Chair moderates the discussion, announces decisions, and enforces rules on any points or motions. The WHO Director General (DG) will sit next to the chair and interacts discreetly with the chair if s/he wishes to make a point. The DG s Advisor will sit next to the DG. Participants indicate they would like to speak by raising their placard and may only speak when called upon by the Chair. Exchange is formal so students will address individuals formally (eg Madame Chair, the honorable delegate from India etc.). Students should plan to negotiate with one another outside of formal class sessions to mimic the evolution of reallife negotiations. This is especially critical for those assigned to non-country roles. Students may consider establishing coalitions with others and examining options for common ground. The collective goal of this exercise is to pass two resolutions, one on financing and one on the NSA policy, at the 67 th WHA in May Preferably the resolutions will be developed and agreed on by consensus, as is often done in real life. However, a resolution can also be passed by majority rule. Course of the Simulation The first negotiation session on March 7th will last approximately one hour divided equally between the two topics with the first 30 minutes of the session focusing on WHO financing. Both sessions will begin with the chair asking each MS to present a one-minute opening statement on their position. MS may choose to speak on their own behalf or they may form coalitions and give a single one-minute statement that represents their coalition s position. If time allows the chair may also ask for opening statements from non-state actors, who should be prepared to deliver such statements. All participants should anticipate very little actual negotiating time during this formal session, the main purpose of this session is to provide an opportunity for all students to make public their starting positions. All participants are expected to negotiate in between the March 7 and March 14 sessions to develop their resolutions or lobby for their interests to be represented in the proposed resolution. MS will engage in negotiations and prepare resolutions based on those negotiations. Non-state actors will not formally present resolutions but have other avenues for influence. Non-state actors can offer delegates resolution text, set up one-on-one meetings with MS representatives, issue press releases outlining their positions, write articles, etc. Having side conversations with 4

5 appropriate participants will improve the quality of the outcome and most likely allow the group to focus on more substantive issues. (The class list may be used to distribute press releases, articles, or other materials to fellow participants; please use WHO Reform in the subject line of your .) At the second negotiation session on March 14th all MS will be expected to present or have signed onto two separate resolutions stating their proposals for financing and NSA policy. (Different coalitions may form depending on whether the issue is financing or the NSA policy.) The resolutions will be posted by 9 AM the day before (March 13th) so that participants have an opportunity to view them prior to the final negotiation session the next morning. Negotiations on Day 2 will start with the topic of WHO financing, the negotiation session will last no longer than a maximum of 30 minutes. Negotiations on the NSA policy will begin either after a successful resolution passage or at the end of 30 minutes whichever comes first and will also last a maximum of 30 minutes. During each session, the Chair will moderate but the Chair also has a right to call a break at the Chair s discretion. These breaks may be used to a participant s strategic advantage as it gives all participants the opportunity to engage with one another directly. ROLES Students will be assigned different roles. The list below provides a description of each role. As previously mentioned Member State representatives have the primary right to speak during the WHA negotiations. Nevertheless, other actors representatives from NGOs, the press, think tanks, industry etc. want to make sure that the agreed upon resolutions will be in their organization s best interest. They will try to influence the outcome of the negotiations through informal channels. Chair: You will not represent a specific country during the negotiations but instead will facilitate the proceedings. Responsibilities include recognizing speakers, periodically summing up the state of the deliberations by noting both areas of agreement and where more discussion is needed, and suggesting potential ways to reach consensus. Foundations: These are private actors such as the Rockefeller or Gates Foundations. These organizations may attend WHA proceedings. Their resources (e.g. funds, personal connections) often make them attractive partners to member countries. As a representative of such an organization you may wish to ensure that you have appropriate influence given your resource investment. Industry Representative: For profit companies such as those in the pharmaceutical or food and beverage industry have a significant interest in WHO actions and policies. For example, those in the pharmaceutical industry share an interest in drug development with WHO while those in the food and beverage industry share an interest in food security and availability with WHO. However, in both instances, industry s incentives may differ significantly from those of WHO. For example, WHO prioritizes widespread access to food and medicines, while pharmaceutical and food companies might also prioritize market demand, profitability and protection of intellectual property. Media: Your role as a journalist for a well-known media outlet is to understand the issues at stake, the consequences of any decisions made, and to explain these in clear, accessible terms to the wider public. Your coverage of the debates can influence public opinion, and thereby, the positions of various actors in the negotiations. You may also be interested in uncovering any surprising stories that will capture the headlines. To do so, you will want to understand the dynamics and interactions of all the actors in the simulation. Member State Representative: You will be responsible for representing your country s best interests. You may prepare for your role using the assigned readings and any other materials you think would be helpful. You should do some basic background research on your assigned country in order to understand its likely positioning. Depending on your country assignment, you may want to consider forming either a formal coalition or a loose alliance with countries (or non-state actors) that might have similar objectives. 5

6 Non-governmental organization (NGO): Your goal as an NGO representative is to advocate for your organization s agenda and to ensure that the final resolution aligns as much as possible with your organization s priorities. You may also wish to raise public awareness about the issues as they impact your organization s interests. As you do not have a formal role in the classroom negotiations, success in this role depends on advocacy and persuasion. Think Tank Representative: You will represent an expert from a think tank. Think Tanks range across the political spectrum and seek to influence the public policy debate through analysis, convening, and publishing expert opinions or reports. Some think tanks may seek to be perceived as neutral, while others may clearly seek to advance a particular political agenda. WHO Director-General (DG): You will not represent a specific country but instead will consider what is in the best interests of the organization as a whole. You are responsible for understanding WHO s perspective and priorities around these issues. During the session you may be asked by the Chair to offer your assessment of how feasible it will be for the WHO Secretariat to implement the resolution as proposed, and to respond to any specific questions raised by the Member States. WHO DG Advisor: Like the DG, you do not represent a specific country as you are WHO staff. Between sessions, you may also be responsible for helping to coordinate changes made to the initial resolution language. You are responsible for understanding WHO s perspective and priorities around these issues and offering support and advice to the DG as needed. The DG may at times ask you to answer specific questions during the negotiations. In addition, as a WHO representative, you may also engage in (discreet) lobbying. 6

7 POSITION PAPER ASSIGNMENT DESCRIPTION AND TIPS Keeping in mind the 750 word limit the following general outline is suggested for your position paper. If you are not representing a country, then consider how your organization might develop a strategy that will succeed in passing a resolution most aligned with your agenda. 1. First, do some basic background research on your assigned role. Try to develop a solid understanding of your country/stakeholder s key characteristics, including health, economic, social, political, geographical and historical details. 2. Next, clearly and succinctly summarize for your assigned role: What are your interests? What should be your main objectives with respect to the two issues in the simulation? Consider the problem from your assigned role s perspective, and the impact of current policies on your country/organization and its stakeholders. 3. Propose a set of options that you consider realistic. In other words, this position should be strategic and one that you believe feasible and possible to negotiate successfully when considering other parties demands and interests. 4. Lay out some possible strategies that you will use to try to ensure that the final resolutions meet your objectives. SIMULATION PREPARATION TIPS Please think through your position paper and preparations for the simulation with a careful consideration of the assigned materials. Additionally, be sure to clarify: Policy goals you aim to achieve and who, e.g. interest groups, may hold you to account for achieving those goals Identify decisions/positions you will not be willing to sign on to irrespective of other elements of a consensus deal, and define positions you will need to have in the consensus to agree. Key stakeholders you aim to influence and their interests The types of power, and the specific tools and mechanisms at your disposal to influence the negotiations or their outcome that your role may wield. In complex multiparty negotiations, serving as a facilitator and working to ensure agreement is found may sometimes be more effective than explicitly advocating for your position. Expected dynamics you hope to create, participate in, or potentially even undermine, and how the policy agenda you ve defined will affect other stakeholders and their interests. While not necessary for the simulation or position paper, a SWOT (Strengths, Weaknesses, Opportunities and Threats) or a PEST (political factors, economic influences, socio-cultural trends, and technological innovations) a analysis may help you define your own strategy as well as understand the stakeholder landscape to anticipate others, as well as develop a strategy for sequencing stakeholder interactions around the disclosure of sensitive information or the formation of new alliances. Consider material from the course, including: a For more detail on a PEST analysis see: accessed February

8 Types of Power: (Some will be more or less relevant to this particular debate.) 1. Compulsory: use of physical force 2. Economic: use of economic resources 3. Structural: use of an actor s position in the social structure 4. Institutional: use of rules and decision-making procedures 5. Normative ( soft ): use of ideas on appropriateness 6. Discursive ( soft ): use of framing to shape how others understand an issue (thinking) 7. Expertise ( soft ): use of authority derived from expert knowledge to shape what others understand to be true or correct (thinking) Tools and Mechanisms: (some will be more or less relevant to this particular debate) 1. Agenda and Priority-Setting: drawing political attention to a problem, shifting how much importance people put on a problem, getting something onto the agenda 2. Framing: framing how people see or understand a problem, especially at the early-stages of a negotiation. 3. Establishing informal norms and expectations of actors: creating or changing norms about what kind of behavior is appropriate or expected 4. Establishing formal rules (norms): codifying informal norms into a formalized system of rules, potentially including also measures for interpretation, adjudication and compliance 5. Decision-making procedures (can be seen as a tool to influence rulemaking) Rules of participation (who is allowed to observe, participate in, and vote in formal decision-making bodies, and under what rules) Rules of representation (who represents whom in decision-making bodies) Rules regarding information & transparency (what information is made available, to whom, and when) Rules of decision-making (how decisions are formally made in a given body) 6. Mobilizing Resources: financial and/or human, often through coalition-building 7. Accountability mechanisms: facilitating accountability for adherence to widely-accepted norms and/or agreed commitments (eg reporting requirements, transparency policies, Ombudsman/General Inspectors, summits+5 or +10, watchdog organizations, monitoring schemes, certification processes, impact assessments) 8. Enforcing compliance with rules when other measures have failed (physical force) 8

9 LIST OF SPECIFIC ROLES Totals: 21 total: 13 country delegates, 2 WHO Secretariat, 6 NSAs Country Member States with number of delegates attending negotiation: Bolivia (1) South Africa (1) Brazil (1) Switzerland (1) China (1) Thailand (1) India (1) United States (1) Kenya (1) United Kingdom (1) Lebanon (1) European Union representatives from Croatia and Germany (2) Note: In reality, certain countries have more resources so they will often send more delegates to the WHA. For the simulation, to have greater variety of perspectives, we have limited the roles to one delegate per Member State. Media Global News Reporter (i.e. reporter from an organization such as The Associated Press, The New York Times, Reuters) (1) Foundations: Gates Foundation (1) Non-Governmental Organizations (NGO s) Corporate Accountability International (1) People s Health Movement (working with the International Baby Food Action Network (IBFAN)) (1) Industry International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) (1) International Food and Beverage Alliance (IFBA) (1) 9

10 World Health Organization (WHO) Director General (DG) (1) Advisor to DG (1) Think Tanks (excluded from 2014 simulation) American Enterprise Institute Chatham House 10

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