Word Health Organization: BRICS Have Less Clout Than They Should

The World Health Organization (WHO) is undergoing an important reform process, started in 2010, which could well alter the priorities, governance, and funding sources behind its activity. In fact, there is a new dynamic at work between traditional donors and emerging economies, the so-called BRICS (Brazil, Russia, India, China, South Africa) Over the last two decades the importance of the latter has grown in the international arena. Today, BRICS account for 25% of world GDP and host 40% of the world population.

Attention has been thus far focused on the economic performance of these countries, neglecting the impact they are having on global health. In a recent study supported by Fondazione Cariplo, Bocconi CERGAS, the University's research center for health economics and management , explored the role of these countries vis-à-vis the WHO and how they affect its reform process. Beyond their formal commitment to sustain and re-legitimize the WHO as coordinating authority and multilateral agency for global health, BRICS have been found wanting in finding a common position over reform of the organization. Only with respect to governance and funding, there has been some agreement among emerging economies. More frequently, BRICS have acted singlehandedly to support the activities of the WHO in health domains that have clear domestic relevance for them. Thus, considered as a group, the influence of BRICS over the WHO reform process has been limited. For instance, the BRICS' preference for keeping a full mandate for the WHO was met with rebuttal during discussions over the 2014-2015 budget, just as their worries over the growing weight of voluntary contributions were downplayed. But there are ad hoc alliance at work within the group. For example, China and Russia have taken a more conciliatory stance with respect to the positions that prevailed, by siding with the current WTO Director General, Dr Margaret Chan. Conversely, Brazil, India, and South Africa have been rather more critical of the existing consensus.

Summing up: governments of the five regional powers acknowledge the importance of banding together to have additional clout, as their official statements over WHO reform prove, but, on the other hand, they don't want their hands tied by formal alliances which could reduce their freedom of action in determining the priorities of national health policy.

However the influence of BRICS over global health policy, either individually or as a group, is bound to grow. Firstly, these countries will have stronger political influence thanks to their growing geo-economic and political soft power assisted by the development of diplomatic strategies. Secondly, the recent revision in the allocation of compulsory contributions made by UN members to the WHO entails a growth in the quotas that are pertinence of BRICS, and thus gives these countries more voice over the definition of international health policy.