Newsletter Edition #353 [The Files In-Depth]
Readers,
The processes around the annual World Health Assembly has just concluded, including the Executive Board meeting that follows the Assembly. A lot has happened. We are carefully parsing through the various developments including behind-the-scenes diplomacy.
In today's edition, we bring you a guest essay by scholar Habib Benzian, who provides us a framework on how to read power in the proceedings of the Assembly. I loved reading his piece. I hope you find it valuable too.
In the second part, we present The GHF View where I share some initial reflections on the Assembly.
Finally, my fabulous colleague Julia Dötzer, has mapped more than 200 side-events at WHA79. The graphic reveals themes, organizers and more!
We have more analyses on the WHA coming your way later this week. Thank you for your patience with the volumes from us during this month. I promise this will abate. (I think!)
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Priti
Priti Patnaik, Founder & Publisher, Geneva Health Files
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I. GUEST ESSAY: Decoding the WHA
Geneva Rules: Power, Proximity, Priority
The formal and informal diplomacy of the World Health Assembly
By Habib Benzian
Benzian is a global health academic and policy advisor affiliated with universities across Africa, Asia, and Australia, working to advance health equity and systems reform through research, implementation, and global policy engagement. He writes The Global Health Paradox, a blog on the defining tensions and paradoxes shaping global health, where this essay was first published. He can be reached at hbenzian@uwc.ac.za.
The World Health Assembly operates in two diplomatic theatres: the formal Assembly and the ecosystem of side-events around it.
The first has an agenda, rules of procedure, committees, regional consultation groups, and resolutions. It is where Member States speak, negotiate, endorse, delay, soften, and decide.
The second is less formal, but not less consequential. It unfolds through side events, diplomatic breakfasts, donor lunches, closed roundtables, civil society briefings, receptions, corridor conversations, hotel meetings, and quiet bilateral exchanges. It is where issues compete for visibility before they acquire formal standing, where coalitions are built before they are announced, and where proximity to power begins to look like political relevance.
Together, these two theatres tell us something about power, proximity, and priority in global health. Priority is what the official agenda seems to establish. Proximity is what the informal ecosystem makes visible. Power is what determines whether either one changes anything.
The official agenda of the World Health Assembly is a document of prioritisation. Read it as such and it tells a story.
Some issues arrive with the full weight of institutional attention. They have dedicated reports, plenary debate, political momentum, technical machinery, donor interest, and the language of emergency behind them. Others appear as follow-up items, information documents, progress reports, or updates. They are present, but not quite central. They are acknowledged, but not necessarily activated.
This distinction matters. The WHA does not only decide what the world’s health ministers discuss. It also signals what kind of problem a health issue is understood to be. Is it an emergency? A security threat? A financing problem? A human rights question? A long-standing burden that everyone agrees is important but no one treats as politically urgent?
These categories are not neutral. They shape the flow of money, staff time, and the willingness of institutions to move. But the official agenda is only one agenda. During WHA week, Geneva produces another layer of diplomacy. It is more crowded, more fluid, and less formal.
A side event is rarely just a side event. It is a claim to relevance. It says: this issue belongs here. This organisation belongs here. This framing deserves proximity to WHO, Member States, donors, civil society, and the global health press. It is a way of turning concern into visibility and visibility into a form of legitimacy.
To see this hierarchy in practice, just read the invitations. A striking architecture of attention governs WHA side-events: Emergency and pandemic-focused events use verbs of creation and action - they “build,” “launch,” and “forge.” Meanwhile, Non-Communicable Disease (NCD) events are relegated to verbs of maintenance and friction - they “translate,” “navigate,” or “close gaps.” (My own field, oral health, is barely on the map, managing exactly two side-events among the more than 80 events during the WHA week). The language reveals the priority before anyone even takes their seat.
In this ecosystem, physical presence is political currency. The arrival of an Assistant Director-General, a Regional Director, or even the Director-General walks into a room, they not just fill a chair. They confer legitimacy, marking an issue as worthy of attention. The official may not need to take the floor. A brief appearance, a handshake, a nod from the front row, a photograph, or a few minutes of listening can be enough to elevate the room. It signals that the issue has entered WHO’s field of recognition, even if no formal policy position has yet been developed.
This is proximity as power. Not decision-making, but recognition. Not an endorsement, but enough attention to matter. The term “side-event” suggests something almost decorative happening beside the real meeting. But anyone who has spent time around the WHA knows that the room outside the room is often where future official language is rehearsed. Coalitions form there. Ideas are tested there. Neglected issues seek political sponsors there. Well-funded issues consolidate their dominance there.
I have learned this partly by taking part in it. Over the years, I have helped organise and navigate WHA side events myself. I have seen the formal rules, the informal choreography, the careful negotiation over logos, the sequence in which invitations move, and the peculiar meaning of “sponsorship” in the UN system. Here, sponsorship often does not mean paying for the room. It means political recognition. It signals that an issue is not merely an NGO concern, a technical interest, or a professional campaign, but something a Member State is willing to place its name behind.
The system rewards those who understand this choreography, who can absorb the costs, secure the right logos, bring the right speakers, and make an issue appear not only important but governable.
Power enters when proximity becomes consequence.
The question is not just whether an issue gets a room. The question is what that room changes. Does it attract a Member State champion? Does it help move an issue from a technical concern into a formal decision point?
Sometimes the answer is yes. A room can open space for a neglected issue, connect actors who need each other, and generate momentum before formal politics is ready. But sometimes the answer is no. The room fills, the photographs circulate, the speeches are posted, the words “high-level” and “timely” appear in the summary, and nothing shifts. The issue achieves visibility without authority.
This is why the World Health Assembly is such a revealing moment. The formal Assembly cannot do everything, and the informal ecosystem is not merely decorative. It is a way of managing competing demands, allowing issues to be seen without forcing the institution to act. And for the issues that do move forward, this informal theatre is the first step in the machinery of consensus - the process that takes all this raw political friction and eventually flattens it into agreed-upon text, a machine more closely observed in the next essay.
For one week, the formal and informal layers of global health governance are compressed into the same city. The agenda shows what has been authorised. The corridors show what is being attempted. The closed rooms show where alignment is being tested. None of this is accidental. It is how diplomacy works when the problems are global, the authority is fragmented, and the political costs of direct conflict are high.
Geneva has its own image for this. At La Jonction, the clear blue river Rhone leaving the lake meets the sediment-heavy Arve descending from the Alps. For a stretch, the two rivers run side by side, visibly separate, before merging and flowing onward toward France and, eventually, the Mediterranean.
The formal Assembly and the Assembly around it work in much the same way. They arrive from different places, carry different kinds of authority, and remain briefly distinguishable. But in Geneva they enter the same channel.
The official World Health Assembly is where global health speaks in resolutions. The Assembly around the Assembly is where it tests which issues, actors, and framings are ready to be recognised.
This essay is part of Geneva Rules, a short series on the World Health Assembly (WHA). It is not a live blog, but an attempt to read global health governance while it performs itself: in the assembly halls, the corridors, the side events, the hotel rooms, and the spaces where power becomes language.
II. THE GHF VIEW: REFLECTIONS WHA79
By Priti Patnaik
Some initial thoughts on the WHA proceedings this year:
- The fragmentation in global health was too literal. The fragmentation in the venues of the 79th World Health Assembly, between the Palais des Nations in Geneva, and the Headquarters of the WHO, was never going to be easy. This meant that at least some of the agenda items got a short shrift including the discussion on budget and finances, as Switzerland mentioned in a formal statement at the Executive Board earlier this week.
- The splintering of the venues meant that there were far too fewer serendipitous encounters among attendees. While global health is certainly not a one big happy family, the expansive layout of the Serpentine café - now under renovation at the Palais des Nations - was conducive for countless conversations on-the-go. This was not the case this year. Hundreds of great ideas may never see the light of the day, since they did not get a chance to be formulated in the rich diversity that the attendees of the WHA represent.
- There were numerous intersecting themes not only in corridor conversations, but also in the formal statements by member states. The concerns on the Ebola emergency merged with the negotiations of the Pathogen Access Benefit Sharing System under the Pandemic Agreement, which merged with the reforms discussions. This is just one example.
- Also happening in parallel, were conjectures on the candidatures for the election of a new Director-General of the WHO. It was fascinating to witness the pitches by at least some of the more certain candidates across different forums. Naturally, we will have plenty to track and follow including on the visions that the candidates will have for WHO, and for global health, in the coming year.
- The near-dozen political votes sucked the oxygen in the room. The technical discussions were boxed into the remainder of the timeline. Perhaps the time has come to consider a political arm of the Assembly to conduct these charged discussions that will certainly not go away given the harsh geopolitics. Some developed country diplomats had previously suggested a dedicated forum for political discussions where foreign ministries can treat their agendas, while leaving the technical deliberations at the Assembly to the health experts. But as we know it is near impossible to separate both. So we learn to witness the fractures of the world, unfold at the WHA.
- We need more straight-talking in Geneva. Several statements stand out, among many, including the speech by Ghanaian President, John Dramani Mahama; and the address by Spanish Prime Minister Pedro Sánchez. Also precise, were statements, among others, by John-Arne Røttingen, CEO of the Wellcome Trust sharing his views on the reforms of the global health architecture.
- The attendance at the official proceedings including by non-state actors and the press, definitely suffered - as per casual visual inspection and empirical evidence. Some attendees were of the view that the spaces meant for NSAs at the Palais, were poorly designed and were too uncomfortable for meaningful participation.
- There were way too many side-events (see mapping below). This detracts from the official proceedings. (We are guilty too. We launched a book on the Pandemic Agreement, and had the only side-event with a discussion on the Pathogen Access Benefit Sharing System).
- The time for speeches are now over. And we have a fast spreading health emergency at hand.
III. A MAPPING OF SIDE-EVENTS OF WHA79: A REVELATION
By Julia Dötzer
We analysed more than 200 listed side-events at the WHA79. Most of them were multistakeholder events with private sector participation. There were more than ten different themes. Read to know more.
This analysis is for our core supporters. GHF Plus, our premium product offers policy intelligence for our readers who work in global health.
