Open letter

Response from Dr Sania Nishtar

Response from Dr David Nabarro

IBFAN has not expressed a preference for any candidate for the post of WHO Director General. However, we have written to all three to ask how they intend to safeguard WHO from conflicts of interest.  Two candidates have responded and their letters are now published in the Lancet (see links above).
Both have carefully worded their responses, but  Dr David Nabarro’s final sentence (our emphasis) is worrying: “… If I am elected I shall continue working in the same way, being accountable for my conduct and leadership to the Member States, to civil society and to all other stakeholders in WHO.” 
IBFAN has been asking for WHO’s definition of the word ’stakeholder’ with no response. If WHO is to stay true to its mandate and uphold democratic principles – is it right that its leader should be accountable to the wide range of corporations, business associations and  philanthropic entities that consider themselves to be ‘stakeholders’?

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’


BROWN, Katherine Institute of Alcohol Studies

LOBSTEIN, Tim World Obesity Federation

RUNDALL, Patti International Baby Food Action Network (IBFAN)

MWATSAMA, Modi UK Health Forum

JEFFRY, Bill Center for Health Science and Law

MACARI, Marisa Alianza por la Salud Alimentaria (The Alliance for Nutritional Health)

ALLEN, Kate World Cancer Research Fund International

BAKKE, Oystein Global Alcohol Policy Alliance

BABB, Anne International Blue Cross

GUPTA, Arun Alliance Against Conflict of Interest (AACI)


SPENCER, Nick International Association for Social Pediatrics and Child Health (ISSOP)

BIJL, Dick International Committee of Drug Bulletins (ISDB)

PARKER, Meredith International Lactation Consultant Association

SPERKOVA, Kristina IOGT International

SCWARTZ, Thomas Medicus Mundi International. Network Health for All

MEURS, Mariska Wemos

HASSE, Mareike Bread for the World – Protestant Development Service

DURISCH, Patrick Public Eye (formerly known as Berne Declaration)

MACARI, Marisa El Poder del Consumidor

MELAU, William Ntakuka East African Alcohol Policy Alliance

SKAR, Mariann European Alcohol Policy Alliance (Eurocare)

VAN DALEN, Wim European Centre for Monitoring Alcohol Marketing (EUCAM)

BLACK, Diane European Fetal Alcohol Spectrum Disorders Alliance

PALMESINO, Ennio European Mutual help Network for Alcohol related problems (EMNA)

WEBER-SCHOENDORFER, Corinna European Network of Teratology Information Services (ENTIS)

RENSHAW, Nina European Public Health Alliance (EPHA)

GALKUS, Lukas Alcohol Policy Youth Network

MARTIN, Teryy AlcoHelp

COSTELLO, Suzanne Alcohol Action Ireland

DOUGLAS, Alison Alcohol Focus Scotland

DOHERTY, Kieran Alcohol Forum Ireland

GILMORE, Ian Alcohol Health Alliance

LIVINGSTON, Bruce Lee Alcohol Justice

FURBER, Andrew Association of Directors of Public Health

ALEXANDER, Graeme British Association for the Study of the Liver

LANGFORD, Andrew British Liver Trust

MORIARTY, Kieran British Society of Gastroenterology

SCHAABER, Jorg BUKO Pharma-Kampagne

SHEPARD, Jonathan Crime and Security Research Institute, Cardiff University

VAN DALEN, Wim Dutch Institute for Alcohol Policy STAP

BECKER, Gisela FASD Fachzentrum Berlin

BLACK, Diane Fetal Alcohol Syndrome Foundation of the Netherlands

SOMER, Sari Finnish Association on Intellectual and Developmental Disabilities

THORN, Michael Foundation for Alcohol Research & Education (FARE)

PESCE, Davide Forum Savonese del Terzo Settore

CRAWLEY, Helen Frist Steps Nutrition First

DENTICO, Nicoletta Health Innovation in Practice (HIP)

BAULD, Linda Institute for Social Marketing, University of Stirling


MIDTTUN, Nijole Lithuanian Tobacco and Alcohol Control Coalition

GALLOWAY, David Royal College of Physicians and Surgeons of Glasgow

MURRAY, Frank Royal College of Physicians of Ireland

IZUEL, Itziar SAF Group

SCHNEIDER, Helene School of Public Health, University of the Western Cape, Cape Town, South Africa

CARLIN, Eric Scottish Health Action on Alcohol Problems (SHAAP)

UK & European Birth Mother Network – FASD

BAULD, Linda UK Centre for Tobacco and Alcohol Studies (UKCTAS)

CAPEWELL, Simon UK Faculty of Public Health

SHEPARD, Jonathan Violence Prevention Group, Cardiff Partnership

METELSKI, Catherine Vivre avec le SAF


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