Thursday, May 18, 2017

Open letter

Response from Dr Sania Nishtar
Response from Dr David Nabarro

Open letter to WHO DG candidates: keep policy and priority setting free of commercial influence

Patti Rundall  Tim Lobstein  Modi Mwatsana, Bill Jeffery
on behalf of 61 signatories; a full list of signatories is available in the appendix     Published: 27 April 2017
In May, 2017, WHO Member States will meet in Geneva for the 70th World Health Assembly (WHA) and a new WHO Director-General (DG) will be elected. As public-interest non-government organisations (NGOs) involved in global health governance and the prevention and treatment of chronic diseases, we believe that a fundamental consideration for Member States when electing the DG will be how the new leadership will ensure appropriate interactions with alcohol, food, pharmaceutical, and medical technology industries. We invite the three candidates to describe what steps they commit to take to ensure greater transparency, rigor, and public scrutiny of WHO's policy and regulatory and norm-setting activities so that they are adequately protected from undue commercial interests.
In May, 2016, WHA adopted the Framework of Engagement with Non-State Actors (FENSA), a policy due to be fully operational by May, 2018. While FENSA envisages that WHO will “exercise particular caution…when engaging with private sector entities …whose policies or activities are negatively affecting human health..”,1 the rhetoric and direction of WHO's reform process as well as WHO's chronic funding challenges have left us deeply concerned rather than reassured. We fear that instead of protecting WHO's mandate, FENSA risks relegating WHO to a limited role, unable to stand up for human rights and democratic decision making.
We draw attention to the conflict of interest statement signed by more than 175 NGOs and networks representing more than 2000 groups and first launched at the UN High-Level Meeting on Non-communicable Diseases in 2011: “The policy development stage should be free from industry involvement to ensure a ‘health in all policies’ approach, which is not compromised by the obvious conflicts of interests associated with food, alcohol, beverage and other industries, that are primarily answerable to shareholders.”2
Alcohol, food, pharmaceutical, and medical technology industries should comply with policies developed by WHO and its Member States. Their role is not in public health policy formulation, risk assessments, risk management, or priority setting, nor in determining normative quality standards and legally binding regulations to protect and promote public health. These processes must be undertaken in an environment free of commercial influence.
We believe that only a WHO that protects its independence and integrity of decision making will have the ability to fulfil its constitutional mandate, and look forward to your response to our request.
PR holds shares in Nestlé SA, for the purpose of attending the Annual General Meeting. All other authors declare no competing interests.


  1. Sixty-ninth World Health Assembly. (Agenda item 11.3(accessed April 21, 2017)Framework of engagement with non-state actors. ; May 28, 2016
  2. Conflict of Interest Coalition. (accessed April 21, 2017)Statement of concern. ; 2011

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    Signatories to 'Ensuring integrity, independence and credibility: Open letter to the candidates for WHO DG'


    Institute of Alcohol Studies, BROWN, Katherine
    World Obesity Federation, LOBSTEIN, Tim
    International Baby Food Action Network (IBFAN), RUNDALL, Patti
    UK Health Forum, MWATSAMA, Modi
    Center for Health Science and Law, JEFFRY, Bill
    The Alliance for Nutritional Health (Alianza por la Salud Alimentaria)  MACARI, Marisa
    World Cancer Research Fund International, ALLEN, Kate
    Global Alcohol Policy Alliance, BAKKE, Oystein
    International Blue Cross, BABB, Anne
    Alliance Against Conflict of Interest (AACI), GUPTA, Arun
    International Association for Social Pediatrics and Child Health (ISSOP), SPENCER, Nick
    International Committee of Drug Bulletins (ISDB), BIJL, Dick
    International Lactation Consultant Association, PARKER, Meredith
    IOGT International, SPERKOVA, Kristina
    Medicus Mundi International. Network Health for All, SCWARTZ, Thomas
    Wemos, MEURS, Mariska
    Bread for the World – Protestant Development Service, HASSE, Mareike
    Public Eye (formerly known as Berne Declaration), DURISCH, Patrick
    El Poder del Consumidor, MACARI, Marisa
    Ntakuka East African Alcohol Policy Alliance, MELAU, William
    European Alcohol Policy Alliance (Eurocare), SKAR, Mariann
    European Centre for Monitoring Alcohol Marketing (EUCAM), VAN DALEN, Wim
    European Fetal Alcohol Spectrum Disorders Alliance, BLACK, Diane
    European Mutual help Network for Alcohol related problems (EMNA), PALMESINO, Ennio
    European Network of Teratology Information Services (ENTIS), WEBER-SCHOENDORFER, Corinna
    European Public Health Alliance (EPHA), RENSHAW, Nina
    Alcohol Policy Youth Network, GALKUS, Lukas
    AlcoHelp, MARTIN, Teryy
    Alcohol Action Ireland, COSTELLO, Suzanne
    Alcohol Focus Scotland, DOUGLAS, Alison
    Alcohol Forum Ireland, DOHERTY Kieran
    Alcohol Health Alliance, GILMORE, Ian
    Alcohol Justice, LIVINGSTON, Bruce Lee
    Association of Directors of Public Health, FURBER, Andrew
    British Association for the Study of the Liver, ALEXANDER, Graeme
    British Liver Trust, LANGFORD, Andrew
    British Society of Gastroenterology, MORIARTY, Kieran
    British Medical Association
    BUKO Pharma-Kampagne, SCHAABER, Jorg
    Crime and Security Research Institute, Cardiff University, SHEPARD, Jonathan
    Dutch Institute for Alcohol Policy STAP, VAN DALEN, Wim
    FASD Fachzentrum Berlin, BECKER, Gisela
    Fetal Alcohol Syndrome Foundation of the Netherlands, BLACK, Diane
    Finnish Association on Intellectual and Developmental Disabilities, SOMER, Sari
    Foundation for Alcohol Research & Education (FARE), THORN, Michael
    Forum Savonese del Terzo Settore, PESCE, Davide
    First Steps Nutrition Trust, CRAWLEY, Helen
    Innovation in Practice (HIP), DENTICO, Nicoletta Health
    Institute for Social Marketing, University of Stirling, BAULD, Linda
    Lithuanian Tobacco and Alcohol Control Coalition, MIDTTUN, Nijole
    Royal College of Physicians and Surgeons of Glasgow, GALLOWAY, David
    Royal College of Physicians of Ireland, MURRAY, Frank
    SAF Group, IZUEL, Itziar
    School of Public Health, University of the Western Cape, Cape Town, South Africa,
    SCHNEIDER, Helene
    Scottish Health Action on Alcohol Problems (SHAAP)CARLIN, Eric,
    UK & European Birth Mother Network - FASD
    UK Centre for Tobacco and Alcohol Studies (UKCTAS) BAULD, Linda
    UK Faculty of Public Health, CAPEWELL, Simon,
    Violence Prevention Group, Cardiff Partnership, SHEPARD, Jonathan
    Vivre avec le SAF, METELSKI, Catherine,
    Royal College of General Practitioners