UN Health Summit must stop philanthrocapitalism taking over the WHO
23 September: UN High-Level meeting on Universal Health Coverage
Global UN Watchdog warns that while big donors bridge the gap in WHO funding they are also shaping health programmes according to business norms, and marginalising public health programmes. The writers suggest measures to reinstate the WHO at the centre of Universal Health Coverage
New York, 22 September: When the Global Health Summit opens on Monday, its morning session will focus on using the campaign for Universal Health Coverage as a driver of the Sustainable Development Goal 3: Ensuring healthy lives.
“The debate today must start from the principle that global health is a public good, and the aim of Primary Health Care for people-centred health services has to be applied”, emphasised Karolin Seitz, from Global Policy Forum, a member of the Reflection Group.*
Writing in Spotlight2019**, Karolin Seitz and Nicoletta Dentico, from Health Innovation in Practice, say the creeping trend of philanthrocapitalism in health is changing the way the WHO builds and executes its programmes.
Philanthrocapitalism is a trend in which wealthy, motivated donors give millions of dollars to the United Nations, often to support development work. The OECD estimates that between 2013 and 2015 private foundations gave US$7.8 billion a year, mainly for health, education and nutrition.
Applying a business model to solving health problems may mean quick fixes
The Gates Foundation has provided the cash-starved UN World Health Organisation much-needed funds. While lauding the generosity, critics say this forces the WHO to adopt its donor’s business models in programme execution and design, which is inappropriate for a ‘rights-based solution’ to health provision, envisaged in the 2030 Agenda.
Donors often push for technological quick-fixes or choose to support problems with the quickest solutions, veering away from longer-term needs like strengthening health systems or changing the social reasons for poor health.
“In the discussion, any attempt to place the market at the centre of health provision should be avoided”, says Seitz.
The lack of democratic responsibility
There is also concern that these global foundations are taking over the remit of intra-governmental institutions like the WHO in health, shaping the global development agenda and setting priorities for international institutions and national governments.
They also lack democratic responsibility. They not accountable to anyone: not to the UN, nor to governments, nor to the communities with which they are working.
The growing use of public-private partnerships
One popular philanthrocapitalism move is to suggest public-private partnerships, making private sector involvement a prerequisite for cooperation and funding. This is reflected in Panel 2 at the Health Summit: ‘Accelerating multi-sectoral and multi-stake-holder action and investment for achieving UHC’. The presence of different stakeholders frequently results in the fragmentation of health provision and governance.
Multi-stakeholder partnerships implicitly devalue governments and the public sector, and overvalue the status of private actors in providing public goods and services.
Putting health provision and governance back into public hands
Dentico and Seitz argue that this trend needs to be reversed, and WHO restored to centre-stage in overseeing global health provision, via the following measures:
- Undertake independent assessments of cooperation with philanthropists at national and international levels. This should cover cost/benefit analysis, conflict of interests, and long-term impacts on the chain of responsibilities.
- Design fiscal policies for raising income and for fair wealth distribution.
- Identify measures to bind Member States to contribute financially to common goods’ delivery in health, which will increase state funding to WHO.
- Devise regulations for interaction with private actors, including philanthropic foundations at the UN. These should legislate against conflict of interest and the revolving-door phenomenon.
- Devise measures to clarify the rules that dictate philanthropic organisations’ roles in implementing the 2030 Agenda and the SDGs.
For more information, please contact: Daphne Davies: Tel/WhatsApp:US: + 1 917 291 3560, US: +44 7770230251, Daphnedoubled@gmail.com