The launch of the Civil Society Commission by the Director-General of the World Health Organization (WHO) in September 2023 was a historic moment.
Since the WHO was set up in 1948, civil society organisations have tried to increase their involvement within its processes and discussions. We have:
- called for greater accountability and transparency in WHO’s decision-making and activities to ensure these actions serve public health interests and benefit the most vulnerable women and children
- asserted that the varied perspectives, local knowledge, grassroots focus and expertise we contribute will foster innovative, effective and equitable health policies, and will lead to programmes that are more impactful and more sustainable
- sought to demonstrate that civil society organisations (CSOs) – by identifying gaps, advocating for resources, and holding governments accountable – are important partners in the effort to strengthen health systems.
In short, the more WHO and CSOs collaborate, the better the health outcomes will be.
The launch of the WHO Civil Society Commission therefore represents a watershed moment. Its purpose is to enhance dialogue and foster collaboration between WHO and civil society, providing advice and recommendations on WHO’s engagement with civil society at global, regional, and national levels.
Hosted and administered by the WHO Secretariat, the Commission is not a separate legal entity: its formation and operations are governed by WHO regulations. However, the decision to set up the Commission responds to suggestions from civil society organisations seeking improved and more meaningful engagement with WHO.
The launch of the Civil Society Commission is accompanied by WHO's efforts to develop new strategies for engaging with key groups such as civil society, young people, academia, parliamentarians and the private sector.
How did we get here?
In 2016, WHO adopted the Framework of Engagement with Non-State Actors (FENSA), which aimed to regulate and streamline its interactions with non-state actors, including civil society. However, many civil society groups criticised FENSA for being too restrictive, bureaucratic and influenced by corporate interests. They argued that FENSA did not respond to their needs and expectations, and that it limited their participation in and contribution to WHO's decision-making processes.
In November 2017, a group of CSOs came together to start a dialogue with the WHO Secretariat and recommended that they set up an advisory committee on WHO-CSO engagement. The process picked up momentum again in 2020 with a series of meetings between civil society groups and Dr Tedros Ghebreyesus, the WHO Director-General, who accepted the recommendation to set up a WHO Civil Society Commission in October 2020 and requested an outline of what civil society had in mind.
An informal CSO task group was constituted, which submitted a draft outline of the Commission in January 2021. In August 2021, Dr Tedros committed to establish a WHO Civil Society Commission that would represent the diversity and expertise of civil society, and that would advise WHO on how to improve its engagement with civil society.
The Commission’s terms of Reference – developed with input from civil society actors – were published in January 2023, and the Commission was launched in August 2023. Membership applications remain open indefinitely without a cut-off date, to ensure more organisations can join.
What does the Civil Society Commission look like?
The Commission operates as a worldwide network aiming for broad and diverse participation, including from:
- grassroots community organisations
- civil society groups and networks
- faith-based organisations
- professional groups
- patient advocacy groups
What’s it for?
The Commission’s role is to advise WHO on its interactions with civil society. It’s informed by independent and evidence-based advice from civil society and can propose innovative and realistic solutions to the challenges and gaps in WHO’s engagement with civil society.
These recommendations are intended to inform and influence WHO's policymaking, governance and operations. And to enhance its accountability, transparency and responsiveness to civil society's needs and expectations.
The Commission’s role is also to foster a more constructive and collaborative dialogue and partnership between WHO and civil society, and to support joint efforts and actions in advancing global health.
Risks and opportunity
The decision to set up the Commission initially faced criticism and warnings of co-option.
Some civil society groups questioned the legitimacy and representativeness of the Commission. They expressed doubts about how feasible and effective some of the recommendations in the initial proposal were, and about the political will and capacity of WHO to adopt and operationalise them. They warned that the Commission’s proposal could be ignored or diluted by WHO's bureaucracy and politics, and that civil society's engagement could remain tokenistic and superficial.
For the long-term credibility of the Commission, such risks must be addressed by civil society, including CSOs both inside and outside the Commission. The civil society ‘Interest Group’ that emerged after the 2020 dialogues with WHO Director-General will continue to hold the Commission accountable from the outside to the principles and values with which it was set up.
Changing culture, slowly and steadily
Since the launch of the Commission, its Steering Committee, consisting of 21 members, has regularly met with WHO Director-General and representatives from WHO headquarters and regional offices to introduce the Commission and to explain its mandate.
Slowly, the Commission has seen WHO departments and teams start to reach out to the Steering Committee to ask for feedback into ongoing policy processes, to include members in working groups that lead on new initiatives, and to seek the Steering Committee’s help in connecting with the broader Commission membership. The Secretariat has made efforts to be more transparent about information and developments, in a bid to keep Steering Committee members and the Commission well informed.
To fulfil its mandate and contribute to developing essential tools for improving WHO-civil society relations, the Steering Committee has met regularly to set up working groups and project groups to:
- develop governance structures and systems for the Commission
- take stock of WHO policies, guidelines and documents that may already talk about engaging civil society
- document good practice that already exists across the various teams in WHO
- explore how other UN agencies engage with civil society
The Commission is also expected to bring civil society organisations together to feed into the development of a WHO Civil Society Engagement Strategy. It will need to reach out to a broad range of civil society organisations to share their experiences and views, and to gather information from their constituencies to enrich the strategy and make the process inclusive.
Hope and challenge
The WHO Civil Society Commission represents a new hope, but also a new challenge for both WHO and civil society.
It offers an opportunity to strengthen our partnership and collaboration, and to enhance our joint role and impact in global health. That requires a deep commitment from all sides, and a recognition of the complexities and tensions that shape the CSO-WHO relationship.
The establishment of the WHO Civil Society Commission is not the end, but rather the beginning. We must expect that the journey will be long and difficult. But it’s also a hopeful and vitally important process of change.
