Dear Director-General Dr. Tedros

Dear Dr. TedrosDear Director-General Dr. Tedros,

September 6, 2017
Congratulations on your appointment as the new WHO Director-General. We recognize the mighty responsibility of your office, with its tremendous potential for bringing better health to the world’s people – and above all, to the poor, marginalized, and discriminated against, to whom you have long voiced your commitment. We were heartened to hear you state so powerfully upon your appointment that WHO must “put the right to health at the core of its functions, and be the global vanguard to champion them.”

One powerful tool to do just that is a proposed Framework Convention on Global Health (FCGH), which would be a global treaty based on the right to health and aimed at national and global health equity. It could help put the right to health not only at the core of WHO’s functions, but also at the core of the global policy agenda, with WHO in the lead. The treaty would contribute to priorities that you have articulated in your vision for WHO, including universal health coverage, the rights of women and other marginalized populations, the Sustainable Development Goals, and health emergencies, along with a reinvigorated WHO (please see the Annex).

As a first step, we urge you to use your legal and moral authority to establish a process, such as a WHO FCGH Working Group, to explore the potential benefits, principles, and parameters of the FCGH. It could also propose the basic structure the FCGH might take. The Framework Convention on Tobacco Control is one model to learn from. The FCGH could also draw from other recent treaties, like the Paris Agreement on climate change, with nationally developed commitments backed by global accountability, and the Convention on the Rights of People with Disabilities, with its inclusive negotiating process and powerful vision of equality.

We would leave to your good judgment whether to establish this WHO process through your own initiative or to bring the proposal to the WHO Executive Board. In any case, we believe that states, civil society, and affected communities should all participate in any process.

We would be happy to provide assistance in this groundbreaking process, and look forward to further discussing the FCGH with you in the very near future. We wish you well in your vitally important work as Director-General.

Sincerely,

Action for Global Health (Europe)
Action for Humane Hospitals (Cameroon)
Action Group for Health, Human Rights and HIV/AIDS (Uganda)
Africa Japan Forum
African Development and Advocacy Centre (UK/Nigeria)
AMREF Health Africa
Association des Journalistes Africains pour l’Environnement (Cameroon)
Bangladesh Legal Aid and Services Trust
BRAC (Bangladesh)
CARE (United States)
Center for Health, Human Rights and Development (Uganda)
Centro de Estudios para la Equidad y Gobernanza en los Sistemas de Salud (Guatemala)
CHESTRAD International (Nigeria) Communication for Development Centre (Nigeria)
Community Working Group on Health (Zimbabwe)
Le Consortium Panafricain des Droits de l’Homme et de lutte Contre la Toxicomanie (Republic of Congo)
Doctors of the World
FUNDEPS (Foundation for the Development of Sustainable Policies) (Argentina)
Ghana Coalition of NGOs in Health
Global Health South
Global Oncology
Handicap International (UK)
Helen Keller International
I Will Give – Africa
IMAXI Cooperative (France/India)
Incentives for Global Health (United States)
International Agency for the Prevention of Blindness
International Council of Nurses
International HIV/AIDS Alliance
International Network of Women Against Tobacco
International Rescue Committee
International Union Against Tuberculosis and Lung Disease (France)
IntraHealth International
Kenya Ethical and Legal Issues Network on HIV and AIDS (KELIN)
Management Sciences for Health (USA)
O’Neill Institute for National and Global Health Law, Georgetown University Law Center (United States)
The Oswaldo Cruz Foundation (Brazil)
Partners In Health
 (USA)
Partners in Population and Development
Population Services International
Prayas (India)
SECTION27 (South Africa)
Socioeconomic Rights Initiative (Nigeria)
Southeast Asia Tobacco Control Alliance
Sustainable Resources Foundation (Pakistan)
Transparency International’s Pharmaceuticals and Healthcare Programme Treatment Action Campaign (South Africa)
Volunteer Health Services (Ethiopia)
Wemos (Netherlands)
WIPGG Nigeria
World Federation of Public Health Associations

Individuals
Dona Anyona
, Regional Policy Project Manger, AMREF Health Africa
Brook Baker
, Senior Policy Analyst, Health GAP (Global Access Project); Professor and Co-Director of the Program on Human Rights and the Global Economy, Northeastern University School of Law, USA; Honorary Research Fellow, University of KwaZulu Natal, South Africa
Adam Bertscher
, University of Cape Town (South Africa)
Mekonnen Jima Biru,
 Ethiopian Civil Societies Health Forum Program Coordinator, Consortium of Christian Relief and Development Organizations
Kent Buse
, Chief, Strategy Policy Directions, UNAIDS
Paulo Buss,
 Director, FIOCRUZ Center for Global Health; Full Member of the Brazilian National Academy of Medicine; Former Brazilian representative to the WHO Executive Board (2004-2007, 2008- 2011); Former President of FIOCRUZ (2001-2008) (Brazil); Former President of the World Federation of Public Health Associations (2008-2010)
Mushtaque Chowdhury
, Vice Chairperson and former interim Executive Director, BRAC; Founding Dean of BRAC University’s James P. Grant School of Public Health, Bangladesh
Andres Constantin, Argentina
Sheila Duffy
, Chief Executive, ASH Scotland
Jonathan Edwin, Epidemiologist, Canada
Ezekwesiri Eluchie
, Executive Director, People Against Drug Dependence and Ignorance (Nigeria); Sub-Saharan Africa Representative, Civil Society Task Force, UN General Assembly Special
Session on Drug Policy (2016)
Case Gordon,
 Coordinator, IMAXI Cooperative
Anand Grover
, Senior Advocate and Executive Director, Lawyers Collective (India); Former UN Special Rapporteur for the right to health (2008-2014)
Leigh Haynes, 
People’s Health Movement-USA
Martin Hevia, 
Dean, School of Law, Universidad Tortcuato di Tella (Argentina)
Joan Holloway, 
Human resources for health consultant; Steering Committee member and Former Acting Director, Frontline Health Workers Coalition; Former Senior Advisor, Human Resources for Health and Health Systems Strengthening, Office of the U.S. Global AIDS Coordinator, U.S. Department of State
Bernard Kadasia
, Chair, Alliance for Health Promotion
Runa Khan, Founder and Executive Director, Friendship (Bangladesh)
Bethany Kois
, Research Director, Health in Harmony (Indonesia)
Gabriel Leung
Dean, Li Ka Shing Faculty of Medicine, University of Hong Kong
Nadja Meisterhans
, Senior Lecturer, Institut für Gesellschaftspolitik und Sozialpolitik, Johannes Kepler Universität Linz (Austria)
Michelle Miller
, Assistant Professor of Legal Studies, Quinnipiac University (United States)
Derejge Moges, 
Legal Consultant, Campaign for Tobacco Free Kids United States
Emmanuel Kabengele Mpinga, 
Professor, Health of Human Rights and Health Division, Insttitue of Global Health, Faculty of Medicine, University of Geneva
Joia Mukherjee
, Chief Medical Officer, Partners In Health; Associate Professor of Medicine, Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital (United States); Associate Professor of Global Health and Social Medicine, Harvard Medical School United States
Gorik Ooms, Professor of Global Health Law and Governance, London School of Hygiene and Tropical Medicine
Indira Paharia, Hillside Family of Agencies, Inc.
H. Paramesh, Chair, Lakeside Center for Health Promotion Pulmonologist and environmentalist India
Joy Phumaphi
, Executive Secretary, African Leaders Malaria Alliance; Chairperson, African Comprehensive HIV/AIDS Partnerships; Former Vice President for Human Development and Head of Human Development Network, World Bank (2007-2009); Former WHO Assistant Director-General for Family and Community Health and WHO Director-General’s Representative on Gender Equality (2003-2007); Former Minister of Health of Botswana (1999-2003); Member of Parliament, Botswana (1994-2003); Former Board member, GAVI; Former Co-chair, Independent Expert Review Group, for Every Woman Every Child; Former member of the UN Reference Group on Economics; Former UN Commissioner on HIV/AIDS and Governance
Thomas Pogge
, Leitner Professor of Philosophy and International Affairs, Yale University; Board Member, Academics Stand Against Poverty; Director, Incentives for Global Health
Leslie Ramsammy
, Columnist at Guyana Times; Former Minister of Health, Guyana (2001-2011); Former Minister of Agriculture, Guyana (2011-2015); Former President of the World Health Assembly 
(61st WHA, 2008)
K. Srinath Reddy
, President, Public Health Foundation of India; Former President of the World Heart Federation (2013-2014)
Mark Rosenberg
, President Emeritus, The Task Force for Global Health; Assistant Surgeon General (Retired), US Public Health Service
Mirta Roses Periago
, National Academy of Medicine, Buenos Aires, Argentina; Neglected Tropical Diseases Special Envoy, Sabin Vaccine Institute; PAHO/WHO AMRO Director Emeritus; Global Fund to Fight AIDS, Tuberculosis and Malaria, LAC Board Member
Gracia Violeta Ross Quiroga, Bolivian Network of People Living with HIV/AIDS
Ana Lorena, Ruano Center for International Health, University of Bergen (Norway); Center for the Study of Equity and Governance in Health Systems (CEGSS) (Guatemala)
Nelson K. Sewankambo
, Professor of Medicine and Principal (Head) of Makerere University College of Health Sciences; Chair, Strengthening Research Capacity in Africa; Director; Medical Education for Equitable Services for All Ugandans (MESAU) – MEPI Consortium; Chair, African Medical Schools Association; Former Dean, Makerere University Medical School (1997-2007)
Neil Sircar , Global Health Masters in Law (LLM) candidate, Georgetown University Law Center (United States)
Gabriella Sozanski, 
Coordinator, Alliance for Health Promotion, Geneva
Oyewale Tomori, 
President, Nigerian Academy of Science; Professor of Virology and former Vice Chancellor (2005-2011), Redeemer’s University (Nigeria)
Miriam Were, 
Chancellor, Moi University (Kenya); Former Chair, AMREF (2003-2013); Former Chair, National AIDS Control Council, Kenya (2003-2009)
Debrework Zewdie
, Distinguished Scholar at the CUNY School of Public Health and Public Policy (United States); Former Director, Global AIDS Program, World Bank (2002-2009); Former Deputy Executive Director (2010-2012) and Deputy General Manger (2012-2013) of the Global Fund to Fight AIDS, Tuberculosis and Malaria
Shamiso P. Zinzombe
, Human Rights and Health Law Policy Researcher

—————————————————————-

Annex: Links between your vision for WHO and the FCGH

* Universal health coverage: The FCGH would offer mechanisms, from standards, benchmarks, and timelines to catalyzing the use of tools to help ensure meaningful and progressively deepening health coverage for all people. These would include national health equity strategies to address the physical and mental health needs of all marginalized populations. The treaty’s financing dimensions, such as a domestic and global financing framework and closely monitored national strategies for equitable financing, would contribute to overcoming the financing challenges of universal health coverage (UHC) and of developing the resilient and secure public health systems that UHC requires. The FCGH could include creative and comprehensive approaches to improve accountability and participation, from rigorous assessments of current accountability mechanisms to new possibilities, including through social media and technology and processes that open up new democratic spaces for marginalized populations to engage. FCGH standards to ensure people’s meaningful participation in the decisions that affect their health would be key to empowering those whose needs, preferences, and rights are often neglected.

* The rights of women and other marginalized populations: Ensuring the health rights of women, children, and the entire range of marginalized and vulnerable communities is at the heart of the FCGH, which would reinforce human rights requirements on non-discrimination and equality – for all people, including migrants, people with living disabilities, and others frequently subject to discrimination. The treaty could include measures to protect the rights of women and children, from protections against gender-based violence, sex trafficking, and harmful cultural practices to ensuring sexual and reproductive health services.
* Sustainable Development Goals: The FCGH equity, financing, and accountability dimensions would help fill gaps in the SDGs. Currently, SDG financing needs far exceed the current resource commitments, the mandate to leave no one behind lacks clear mechanisms to change the power dimensions needed to realize that promise, and follow-up and review processes lack independent accountability mechanisms. Further, the FCGH could provide clear standards on respecting the right to health in all actions and on conducting health impact assessments using participatory approaches, ensuring that health is promoted in all sectors and throughout the SDGs. The FCGH would also provide a robust framework for ensuring the centrality of health and human rights in the post-2030 era.

* Health emergencies: The same measures that contribute to UHC and building strong, equitable health systems are critical for addressing emerging and other infectious diseases, including AIDS, TB, and malaria, and the urgent challenge of antimicrobial resistance. Moreover, the FCGH will help ensure truly people-centered health systems, as called for in WHO’s 2016 Framework, through the treaty’s emphasis on participatory approaches. These should strengthen community involvement – including with the community-based health services that you have long championed – and help build the trust and local leadership that, as the West African Ebola crisis demonstrated, is vital to effective responses to disease outbreaks.

* Reinvigorating WHO: The FCGH can help reinvigorate WHO. The engagement of civil society and affected communities has been central to the vitality of such institutions as UNAIDS and the Global Fund to Fight AIDS, TB and Malaria, yet WHO’s governing and other processes have not adequately benefitted from the participation of civil society and affected communities, often left sidelined. WHO’s leadership on an initiative that demands extensive civil society and community participation and that holds the promise of increasing participation in health-related decisions from local through global levels would enhance WHO’s relevance to the communities it aims to serve. Leadership on the FCGH will also ensure that WHO is carrying out its normative functions to the fullest as it leads a process to carve paths to global health equity and the right to health.