WHO Are You Talking About?

By Brigid McConville, Director of Media and Outreach, White Ribbon Alliance Global Secretariat

A grand, forbidding aspect, enormous closed doors, interminable marbled corridors, a baffling absence of signage and other humans to ask - where on earth am I? If an architect had been briefed to design a building to block access, discourage participation and exhaust newcomers, he (probably) would build Geneva's Palais des Nations (The Palace of Nations).

Yet this is the venue for the annual World Health Assembly (WHA), governing body of the World Health Organisation (WHO), which concluded recently without most of us having any clue as to how decisions were made behind those doors - decisions that will affect us all for years to come.

But the portents of change are large and small. According to old hand Kate Eardley of World Vision International, at WHA for the eighth time, the iron grip of control previously exerted by WHO organizers is beginning to loosen. Online broadcasts from the corridors, numerous side events now permitted in committee time, plus the proliferation of social media signal the breeze of democracy.

Not before time. WHO is having its own post-Ebola identity crisis, branded 'not fit for purpose' by delegates and governments who were alarmed by the organization's slow response to the epidemic. Reform looks certain with a panel reporting on WHO's future this summer.

And in a world first this week, governments and WHO decision makers met with citizen representatives to hear their views and give their responses on women's and children's health. It has taken 68 years so far, but the people now have a voice during the World Health Assembly. Just.

Richard Horton, The Lancet editor in chief, wrote last week that "the most exciting moment [of WHA] was not in the Assembly Hall or Committees. Instead, it was in a small room in the Palais des Nations. For the first time in the history of WHO and its Assembly, a civil-society led forum was held to strengthen political accountability for global health. The White Ribbon Alliance, together with the Governments of Bangladesh and Sweden, convened the first Global Dialogue between Citizens and Governments. It was an historic moment."

Certainly, accountability was this year's buzzword. Tens of thousands of people around the world who have taken part in a series of Citizens' Hearings in some 30 countries so far (in the build up to the Global Dialogue) have been using the motto 'Nothing About Us Without Us'; we heard the same words over and over again at a range of meetings at WHA.

Yet, old habits are far from dying, and we saw a citizen leader bumped off a panel at the last minute, while a young citizen from Africa was stopped from speaking at one meeting because his government didn't know what he was going to say. "I call that censorship," said Kenneth Simbaya, a citizen journalist who was there to report on proceedings to the Tanzanian Guardian newspaper.

By contrast, the Global Dialogue demands a new kind of World Health Assembly, one that puts the people at the heart of decision-making about their own health. Horton certainly thinks so: "While WHO reflected (sometimes painfully) on its role and purpose, civil society found its voice. Mark this moment."

It was only a side event at WHA, but the Dialogue ('Hearing' was deemed too radical for Geneva) ended with a call to keep going until citizens can truly participate with their views and experiences represented on the main agenda.

And maybe a re-branding of the venue, plus signage, as the Palais of the People. Imagine!