World Health Assembly Opens: Vote Expected Tuesday on Health Personnel Recruitment Code of Practice
Amy Hagopian, PhD, our Senior Health Workforce Policy Advisor, is in Geneva this week for the 63rd World Health Assembly. The WHA is the annual meeting for the decision-making body of the World Health Organization, and this year's meeting includes a vote on the adoption of a Global Code of Practice on the International Recruitment of Health Personnel. Along with other organizations and the Health Workforce Advocacy Initiative coalition, we helped provide comments on past drafts of this Code.
As a member of the Global Health Council's delegation to the WHA, Amy will be blogging from Geneva this week on the discussions and vote related to this voluntary Code of Practice.
The 63rd annual World Health Assembly opens this afternoon with an address by Margaret Chan, director-general of the World Health Organization. There are several potentially important issues on the agenda, but the one I am following most closely is the scheduled vote Tuesday afternoon on item 11.5, "International recruitment of health personnel: draft global code of practice."
The Health Workforce Advocacy Initiative, of which my organization (Health Alliance International) serves on the steering committee, is advocating for the passage of the Code. Thanks to the good work of the HWAI secretariat Eric Williams of Physicians for Human Rights, we have organized several efforts to get the Code passed.
First, a little back story. The WHO web site reports: "Member States of WHO adopted resolution WHA 57.19 at the World Health Assembly in May 2004 mandating that the WHO Director-General develop a code of practice on the international recruitment of health personnel in consultation with WHO Member States and all relevant partners. This historic resolution authorizing the elaboration of the proposed code marks the first time that WHO has used its constitutional authority to develop a non-binding code to be adopted by the World Health Assembly since the 1980 International Code of Marketing of Breast-milk Substitutes."
So this is a big deal. There was an initial draft of the Code in September 2008 that was pretty weak. Advocates felt it was too weak to support, and made several recommendations to strengthen it. Important organizations such as Realizing Rights were an important part of advocating for a better version. In January, the WHO Executive Board agreed to forward the Code to the World Health Assembly. And now we've arrived!
The version of the code dated 15 April 2010 is scheduled for a vote TOMORROW (Tuesday)! This version also includes background on the development of the Code and the consultation process with member states. The Code text starts on page 5. You can also find a summary comments from WHO member states and NGOs in this document.
We have organized a side event to discuss how to monitor and implement the Code, assuming it passes. That will be held 5:30 pm Tuesday in Room IX of the UN headquarters building.
I'm here on the delegation with the Global Health Council, of which our University of Washington Department of Global Health is a member. The GHC submitted my 400-word "intervention" on my behalf Sunday, and so I will be asked to speak to the Assembly Tuesday at its plenary session for three minutes in support of the Code.
Here's what I'll say: 1) The Code represents a terrific opportunity for wealthy nations to slow the "reverse foreign aid" that flows from poor countries to staff rich country health systems. 2) The Code should pass as is, despite calls for watering it down from such countries as the U.S and Canada (for example, the U.S. wants to remove the word "ethical," and wants to take out references to the universal right to the "highest attainable standard of health"). 3) There are claims by rich countries with decentralized or privatized health systems, such as the U.S., that they can't implement the code because they don't control the hiring decisions of health workforce employers or the decisions of training schools about how many students to admit. These arguments are specious--more on this in a separate post, but you can read more about training medical students in one of our previous posts on the Global HEALTH Act.
So this will be fun and interesting and potentially important. I'll let you know tomorrow what happens!
(A version of this post also appeared on the Global Health Council blog.)
UPDATE 5/17/10, 9:12pm GMT:
There was late-breaking news at the end of the day at the World Health Assembly on Monday with regard to the Code of Practice on the International Recruitment of Health Personnel.
The Spain delegation made a late-afternoon motion in Committee A to move the Code OFF the agenda for a Tuesday vote, and instead to send it to a drafting committee for improvements. Norway supported the motion, which is generally a good sign, as Norway has one of the strongest ethical codes committing itself as a nation to not poaching health workers from low-income countries. The advocates felt if this move was going to happen with any hope of still passing the Code during this World Health Assembly, it would need to occur on Monday. Which it did! This now gives the WHO secretariat and drafting committee a full three days of negotiation/revision before the Code comes forward for adoption. The new committee began meeting immediately in the late afternoon but there was as yet no translation support. The committee is scheduled to meet again Tuesday morning at 9 am in room 40.
The Assembly generally divides it work between Committee A (which deals with scientific issues) and Assembly B (which deals with administrative issues). Arrangements had been made for me to speak (in technical terms, "intervene") in Committee A when this came to floor this afternoon, as a member of the Global Health Council delegation. Maybe that is now delayed until nearer the end of the week. Several of our advocacy team is held up in airports around Europe, awaiting a clearing of ash from the Eyjafjallajökull volcano.
Our side-event to discuss implementation of the Code is still scheduled for tomorrow afternoon at 5 pm in room IX, where we hope to attract supporters to drum up some enthusiasm for tracking compliance when the Code passes. Assuming, of course, that it does.
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