715 



The World Health Organization also relies on its Executive Board 

 to implement its recommendations, particularly the findings of its 

 expert commi.'ies. Under regulations governing expert panels, the 

 Fourth Assembly instructed the Board "to consider and take appro- 

 priate action in regard to recommendations of expert committees and 

 within its discretion to authorize publication of their reports, hence 

 recommendations of expert committees endorsed by the Board become 

 recommendations to governments." ^^ 



The recommendation-information-consensus-persuasion approach to 

 conformity and improvement of global health practices may not in all 

 instances be as effective as a formal international health regulation. 

 At the present time, however, it seems politically wise as well as a 

 more compelling overall strategy to let it be known that health experts 

 of the world have reached a conclusion and to leave the adoption and 

 implementation of that conclusion in the hands of member 

 governments. 



Political Prohlewji Outside of the World IleaHh Organization 



Two distinctly political developments, one relatively recent and the 

 other with a persistent 20-year history, lie outside of WHO's internal 

 organization altogether. 



THE DEVELOPMENT OF POLITICAL BLOCS OUTSIDE WHO 



The recent development is a result of the growth of membership in 

 WPIO in such a way that political blocs have emerged. One of these 

 blocs consists of numerous newly-constitutecl countries, in a section of 

 the African region with common health problems. Depending on the 

 issue before the Health Assembly, this group of countries can produce 

 as many as 30 to 35 votes as compared with one vote for the United 

 States or even some 20 votes for the major, developed nations which 

 supply most of the funds for WHO. Whether or not the question 

 before the Assembly involves WHO's budget, the African group of 

 small developing countries becomes a political force when it votes as a 

 bloc. This would be especially true should it contrive to consolidate 

 on a proposition in its own self-interest without going through the 

 established WHO channels. 



Conversely, a number of the major nations, including the United 

 States, because of their relative lack of voting power in the Health 

 Assembly, have organized themselves outside of the WHO adminis- 

 trative structure into a so-called "Geneva group.'* This group appears 

 to have been established to work out prior agreements on budgetary 

 and program policies in order to exert leadership on the Secretary- 

 General to promote greater economy and efficiency. It is also believed 

 that the Geneva group is striving for a determination of priorities of 

 WHO activities in the interest of the membership generally. A justi- 

 fication for the existence of such a group of developed nations outside 

 of who's formal organizational structure is that the technical and 

 management skills of those nations become lost in the overwhelming 

 131 -Member World Health Assembly. 



Even if the African bloc and the Geneva group are not as cohv;sive 

 as the term "bloc" suggests, a principal argument against this arrange- 

 rs Fourth World Health Assembly, Resolution No. 14. In Ibid. 



