In December 2020, as the world was still in the midst of the Covid-19 pandemic crisis, the World Health Organization released a “Private Sector Engagement Strategy Report”. The document was produced by the Universal Health Coverage Partnership, one of WHO’s largest platforms for international cooperation on universal health coverage and primary health care.

In May 2021, on the first day of the WHO’s World Health Assembly, Public Services International (PSI) and eight civil society allies (Global Initiative for Economic, Social and Cultural Rights, Global Justice Now, Initiative for, Social and Economic Rights, OXFAM, People’s Health Movement, Public Services International, STOPAIDS, WEMOS) sent an open letter to Zsuzsanna Jakab, Deputy Director-General of WHO, to raise concerns about this report that “could be encouraging the commercialisation and privatisation of healthcare”.

“The landscape of the work has changed. Universal Health Coverage (UHC) cannot be achieved without the private sector. It is essential to re-frame public and private sector engagement as a partnership in health for shared health outcomes”, says Peter Salama, former Executive Director of Universal Health Coverage, in this report released in December 2020. “The strategy report is intended to set the norms and goals for private sector engagement and provide evidenced support for WHO and Member States to invest appropriate resources in private sector health service delivery governance. For the strategy to be effective, it requires WHO to support Member States to move towards real action and engagement with the private sector”, the report goes on.

“The Strategy Report starts from the premise that private sector provision of healthcare is considerable across different regions and socioeconomic groups; that without an effective engagement strategy with the private sector it will not be possible to achieve Universal Health Coverage (UHC); that the demand for private health services will increase, also as a result of the COVID-19 pandemic; and that private sector engagement was necessary in many countries for the COVID-19 response”, say the civil society organisations in a common analysis on the report. They add : “We agree that an international WHO vision and strategy regarding the role of private actors in healthcare, including the regulation of private healthcare provision, is relevant and necessary to be able to achieve UHC and health security. We also believe that the engagement of the private healthcare sector requires a nuanced analysis that considers the potential risks that commercialisation and privatisation pose to equity and accessibility of healthcare services”.

The Strategy Report is not an official WHO strategy. It contains a disclaimer that it was produced by “the Universal Health Coverage Partnership and does not necessarily represent the decisions or policies of WHO”. “Nevertheless, there remains ambiguity about the status of the document”, warn the organisations. Because “it spells out implementation steps over the next seven years. This implies that the WHO has already established an agreed position on the underlying values and positions behind these steps, which is a major undertaking.”

The report praises the private sector’s positive role without pointing out controversies. "It becomes even more worrisome that it is issued during the Covid-19 pandemic, which has shown that well-financed public healthcare is the only bulwark for realising the right to health”, Baba Aye, Health & Social Services Officer at Public Services International, wrote in a statement on May, 27th, 2021.

The civil society organisations looked for the list of the stakeholders that were consulted or contributed to the discussion on the Strategy Report, but could not receive the information. “We think that it is important that the actors consulted are transparently listed, and that written contributions are made public, as it is common practice in many international organisations, and especially on such an issue where there is always a risk that large multinational corporations use their weight and resources to conduct lobbying to promote their interests”, commented PSI and its allies.