World Health Organization : The mandate of a specialized agency of the United Nations

PART II : What is WHO's mandate?

Chapter 1

NATURE OF THE WHO : A SPECIALISED AGENCY OF THE UNITED NATIONS

The aim of this contribution is to discuss the current and relevant topic of the World Health Organization's mandate, in order to understand what role the Organization should play in international health[1]. In order to answer this question, one must first understand the historical process which led to the constitution of the Organization, its structure and functions. This has already been discussed above. Now to further discuss the WHO's mandate, the nature of the WHO must be detailed. Once it is understood what the WHO is, one can then begin to answer the question of what the WHO's role in international health should be.

Inquiring as to the nature of the Organization, the WHO is a specialised agency of the United Nations. In the first part of this chapter, I will give a general definition of what is meant by a  specialised agency, thus, defining some of its most important characteristics. In the second part, the direct implications for the WHO and for its specific role will be discussed.

1.1.  Definition and characteristics of specialised agencies

Article 57 of the UN Charter provides for specialised agencies, "the various specialised agencies, established by inter-governmental agreement and having wide international responsibilities, as defined in their basic instruments, in economic, social cultural, educational, health and related fields, shall be brought into relationship with the United Nations"[2].

A complete definition of a specialised agency is that one outlined by Beigbeder as, "one which conducts a programme of importance for the United Nations, in a specific field of competence, under the general review of the General Assembly and of the Economic and Social Council, but with important scope of autonomy in matters of membership, programme, personnel and finances"[3].

As a result, two things are always to be borne in mind when one speaks of a UN specialised agency: first, as within the UN system, the aims and purposes of a specialised agency have to be compatible with those of the UN; second, a specialised agency always maintains a degree of autonomy and independence from the UN. In particular, a specialised agency usually has its own Constitution, its own programme of work and its own budget. Memberships and structure are also normally diverse and separate from the UN. Therefore, even if a specialised agency forms part of the UN system, it does not follow that it is subordinated to the UN. In other words, even though there is close cooperation between the UN and each specialised agency, its independence is recognised by the Charter.

One interesting view point a specialised agencies as "executive organs of the UN in their own field of speciality or competence and their main tasks are the coordination of cooperation among states in different fields"[4]. The UN system has a star-shaped configuration: the UN may be the sun and the specialised agencies several different stars and planets rotating around it, but having their own courses. Ameri recalls that the UN system is a decentralised system[5]. Certain responsibilities are accepted by the UN itself, whereas other responsibilities, especially in economic and social fields, are allocated to the specialised agencies.

As previously stated by article 57, the relationship of the specialised agency with the UN is guaranteed by a formal agreement. A relationship between independent organisations can be legally accomplished only through agreement negotiated and accepted by all the parties concerned. This agreement has to be agreed on by the Committee on Negotiations with Intergovernmental Agencies, established for this purpose by the Economic and Social Council. Then, it has to be approved by the appropriate organ of the specialised agency concerned and submitted for approval to the Council, and by it to the General Assembly[6]. Once the agreement has been negotiated, the ECOSOC[7] is the organ of the UN, which, according to articles 63 and 64 of the UN Charter, is empowered to coordinate the work of the specialised agency and to obtain from them information about their work. The means provided by the Constitution to guarantee co-ordination are: presentation of reports by the specialised agency (article 64), consultation (article 63) and formulation of recommendations by the Organization (articles 58, 62, 63). For the rest, the agreements "generally follow a standard pattern. As a rule, they provide for reciprocal representation at meetings; reciprocal inclusion of agenda items when requested; exchange of information and documents; uniformity of personnel arrangements; and coordination of statistical services as well as budgetary and financial arrangements"[8]. The agreement is always based on the principle of reciprocity. On one hand, the agreement specifies the responsibilities assigned by the UN to the specialised agency in question; on the other hand, the specialised agency guarantees that it will give assistance to the UN on the required field.

Given the definition of specialised agency, a debate concerning the agencies' level of politicisation often arises. One of the specialised agencies' characteristics is that their aims and purposes should be non political. Cox and Jacobson give a clear explanation of this issue, which is derived from a principle which can be applied to international organisations as a whole. They affirm that, "the more salient the decisions and area under concern of an organisation, the less autonomy it receives from the major powers […] Autonomy is also enlarged depending on the technicality of the issues that the organisations deal with. That is to say: the less salient and the higher its degree of technicality, the more autonomy will be granted to the organisation by the powerful states"[9]. Therefore, among international organisations, the specialised agencies are supposed to stand outside political issues, as their fields of work are mainly technical and not particularly involved with international politics. However, is this really feasible and does it represent the reality?

For many authors, the non-politicisation of the specialised agencies is a myth because it overlooks the fact that these entities are intergovernmental organisations, and therefore composed of member states. International organisations in general constitute "a channel of communication between the political units (member states), interacting in both cooperative and conflictual situations. Consequently all intergovernmental institutions are exposed to politics"[10] and they are "subject to the power struggle of nation states"[11]. For example, Ameri thinks that the system of the specialised agencies "cannot possibly remain independent of the politics of states, especially the great powers, each of which will try to utilize its influence with a view to making the system of the Organization work in its favour"[12]. Furthermore, Ameri reports opinions of various authors to sustain his thesis. Stoessinger affirms that any "organisation in a position to contribute significantly to the solution of the critical problems of international relations will be subject to the buffeting of political forces"[13]. Osakwe stresses that, "if one follows up the discussion in some of the organs of those organizations, one comes to the more realistic conclusion that the question of international education, cultural or scientific cooperation, or even the problems of international postal and telecommunication exchanges, not to mention the highly sensitive areas of international labour or health legislation, may be only slightly less political than the job of maintaining international peace and security which the so called political organizations are designed to carry out".[14]

The politicisation of the specialised agencies seems to be a reality, and it is mainly seen as a problem[15], which is visible in their work. In terms of international relation theories, "realism triumph over functionalism"[16].

For instance, taking the WHO as an example, the issue of health is considered to be technical in nature. It still is. However, some changes have occurred. As we have seen in the first part, the EB members are no longer persons acting on a personal capacity, but representatives of those countries elected to designate its members. This reform has surely provided the Organization with a higher degree of politicisation[17]. Furthermore, in the last few decades, Dr Brundtland has tried to place health at the top of the development agenda, so that no actor involved at an international level with poverty and economic development issues, could dare not to take the WHO into account in its programmes and activities. Health has started to become an item of Prime Ministers and Ministers of Finance's agenda[18].

1.2. Implications for the WHO: relations between the WHO and the UN

The Preamble of the World Health Organization Constitution states that the Organization was established as a specialised agency within the terms of article 57 of the UN Charter. Moreover, article 69 of the WHO Constitution affirms that "the Organization shall be brought into relationship with the United Nations as one of the specialised agencies referred to in article 57 of the Charter of the United Nations". Therefore, the WHO acquires the previously described characteristics of a specialised agency of the UN.

The WHO is the specialised agency of the United Nations concerning health and related fields: it is the health agency of the UN. This is to say that the WHO cooperates in pursuing several important UN aims, however keeping a certain autonomy relatively to its own purpose, its programme of work, its budget, and even its membership and structure.

As far as it concerns the cooperation with the UN, the WHO has been brought into relationship with the UN by a formal agreement[19] subject to approval by the ECOSOC and General Assembly on the UN side, and to the World Health Assembly on the WHO side. With this agreement, the WHO affirms its intention of cooperating with whatever measures may be necessary to make coordination of its activities and those of the United Nations fully effective. The agreement provides different forms of cooperation between UN and WHO. Article II presents the possibility of reciprocal representation between UN and WHO, respectively at the ECOSOC or General Assembly meeting and at the WHA or EB sessions. The following article, article III, offers to the UN the chance of including on the agenda of the WHA or of the EB items of its interest. According to article IV, the UN can submit formal recommendations to the WHA or to the EB, and the WHO is required to enter in consultation with the UN, upon request, with respect to such recommendations. The cooperation can also consist in exchanging information and documents, according to article V.

One of the recent major objects of cooperation between UN and WHO is the achievement of the Millennium Development Goals (MDGs). These goals represent the focal point of the UN system's action in development. They have been agreed by heads of State and Government in 2000, and since then, the UN and its specialised agencies have been working towards their achievement. In particular, the WHO is involved because MDGs are strictly related to health. For this reason, the WHO has been called to cooperate with the UN on these fundamental directions of work.

The independence, that the WHO has from the UN, is guaranteed by the UN Charter which delegates to it certain 'international responsibilities' in the field of health. The outstanding autonomy of the WHO is shown by the careful analysis of its Constitution, of the current corporate strategy and of the proposed programme budget 2002-2003, which will follow in the third chapter of this second part. Further ensuring this independence is the fact that the Director-General of the WHO is not appointed by the UN Secretary-General, like in other specialised agencies, but by the members of the EB. The Secretariat itself also possesses a high level of independence in choosing the means to carry out the assigned work[20]. Therefore, even if the WHO forms part of the UN system, it is in no way subordinated to the UN.

If the mandate of the WHO is determined by its nature as a specialised agency of the UN, it will be partly influenced by the UN main directions of work, and it will partly maintain its own independence. The right balance between these two aspects has to be found so as not to misinterpret WHO's mandate.

The next two chapters will first describe the commitment and action of the WHO to the UN's main directions of work in development, and, secondly, I will deal with the elements which testify WHO's independence of the UN.


 

[1] Lee uses the term global health instead of international health, because "international is traditionally defined by the relations between states and their government (intergovernmental). Global encompasses relations beyond governments and includes individuals and groups within societies that interact across national boundaries, such as transnational corporations, nongovernmental organisations and religious movements". Lee, K., World health: shaping the future of global health cooperation: where can we go from here?, in The Lancet, vol. 351, no. 9106, 21 March 1998, pp. 899-902. I use the more common term international health, even if I consider several and different actors acting in this field aside states and their governments.

[2] UN Charter, art. 57

[3] Beigbeder, Y., L’Organisation Mondial de la Santé, PUF, Paris, 1997, p.23

[4] Ameri, H., Politics and process in the specialised agencies of the UN, Gower House, Hants, 1982, p. 26

[5] ibid.

[6] The General Assembly is the central deliberative organ of the United Nations.

 Intranet-stage.who.int/homes/cco/uni/un/ga/index.shtml

[7] The ECOSOC is the principal organ  of the UN dedicated to promoting higher standards of living, full employment, and conditions of economic and social progress and development, in addition to developing solutions to international economic social, health and related problems, as well as supporting international cultural and educational cooperation. Intranet-stage.who.int/homes/cco/uni/un/ecosoc/index.shtml

[8] Everyman's United Nations, in Ameri, H., Politics and process in the specialised agencies of the UN, Gower House, Hants, 1982, p. 54

[9] Cox and Jacobson quoted in Hazelzet, H., The decision-making approach to international organisations, in Autonomous policy making by international organisations, Ed. by Reinalda, B. and Verbeek, B., Routledge, New York, 1998, p. 28

[10] Ghebali, V.Y., The politicisation of UN specialised agencies: a preliminary analysis, in Millennium: Journal of International Studies, Vol. 14, No. 3, 1985, p. 321

[11] Verbeek, B., International organisations: the ugly duckling of international relations theory, in Autonomous policy making by international organisations, Ed. by Reinalda, B. and Verbeek, B., Routledge, New York, 1998, p. 17

[12] Ameri, H., Politics and process in the specialised agencies of the UN, Gower House, Hants, 1982, p. 104

[13] ibid.

[14] ibid., 106

[15] For  complete discussion  about the dysfunctions led by the politicisation of the specialised agencies, read Ghebali, V.Y., The politicisation of UN specialised agencies: a preliminary analysis, in Millennium: Journal of International Studies, vol. 14, no. 3, 1985, pp. 322-325

[16] Hazelzet, H., The decision-making approach to international organisations, in Autonomous policy making by international organisations, Ed. by Reinalda, B. and Verbeek, B., Routledge, New York, 1998, p. 29

[17] See Part I, Ch. 2, p. 17

[18] See Part II, Ch.2, p. 88 and Part II, Ch. 3, p. 138

[19] Agreement between the United Nations and the World Health Organization, in WHO, Basic Documents, 43rd Edition, Geneva, 2001, p. 41

[20] From a conversation with Dr Cassels, Director of the Strategy Unit in the Director-General's Office.

 

 

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Edited by Aldo Campana,