The Center for Reproductive Rights, WHO’s New Partner: States Divided

The Center for Reproductive Rights (CRR), founded in 1992, is a lobby dedicated to legal litigation on abortion and contraception. The CRR has brought numerous lawsuits in countries with pro-life laws. The CRR claims that their work has led 1.7 billion people to live in countries whose laws have become more favorable to abortion. Numerous organizations fund this work, including the Open Society, Fords, and MacArthur Foundations. In May 2024, Melinda Gates also announced a $1 billion grant for feminist organizations, including the CRR.

The CRR is also involved in international organizations and has held Economic and Social Council (ECOSOC) status since 1997. As has already been demonstrated, the CRR has promoted an extreme approach to sex education and gender issues in its submissions to the UN Human Rights Committee (CCPR) and the Women’s Rights Committee (CEDAW). In these submissions, the RRC keeps repeating that legal abortion is necessary to improve maternal health. Numerous figures prove the contrary, and even if this were true, it comes at the cost of the death of the children these women are carrying. 

The Center for Reproductive Rights has also been involved in proceedings at the ECHR against Polish court rulings restricting abortion. In particular, it has intervened with the Federation for Women and Family Planning (Federa) in monitoring the execution of judgments in the Tysiąc, R.R. and P. and S. cases. The Center for Reproductive Rights partly funds Federa.

Last but not least, CRR is deeply involved in the World Health Organization’s (WHO) work. Represented by Christina Zampas, the CRR is involved in the drafting of extreme guidelines on abortion to be published by the WHO in 2022. The latter is Associate Director of Global Advocacy at the Center for Reproductive Rights and, as part of the process of drafting the guidelines, WHO appointed her as a human rights adviser. In order to continue its work at the World Health Organization, CRR asked in 2023 to be included among the organizations maintaining “official relations” with WHO. This request was deeply divisive among the Organization’s Member States.

The framework for collaboration with non-state actors

The aim of the World Health Organization (WHO) is to achieve the highest possible level of health for the population of its Member States. To this end, the World Health Assembly, WHO’s supreme decision-making body, determines the Organization’s policies. Before to its work, the Executive Board, made up of 34 members elected for three-year terms, sets the program for the World Health Assembly and the resolutions to be considered.

Thus, it is up to the Executive Board to decide on the admission of organizations to maintain official relations with WHO. On January 1, 2024, there were 217 such organizations. In most cases, the Executive Board decides on the admission of an organization by consensus, without difficulty. According to the Framework of Engagement with Non-State Actors (FENSA), the aims and activities of all these entities shall be in conformity with the spirit, purposes, and principles of WHO’s Constitution, and they shall contribute significantly to the advancement of public health (Article 50). The text also specifies that engagement must demonstrate a clear benefit to public health, protect WHO from any undue influence, and not compromise WHO’s integrity, independence, credibility, and reputation (Article 5). FENSA also recognizes that such engagement helps to enhance organizations for public health purposes (Article 6). This collaboration can, therefore, entail risks. FENSA cites, in particular, the possible influence exerted by a non-state actor on WHO’s work and the fact that this collaboration reinforces the image and influence of this actor (Article 7).

According to paragraph 60 of the FENSA, in making its choice, the Executive Board relies on the Program, Budget, and Administration Committee of the Executive Board (PBAC), which examines applications and makes recommendations to the Board. PBAC receives requests for collaboration via the WHO Secretariat (Article 27), which conducts an initial review to determine whether the request meets several criteria set out in paragraph 5 of the FENSA. The WHO Director-General, Tedros Ghebreyesus, heads the Secretariat.

Examination of the collaboration request from the Center for Reproductive Rights

In December 2023, after concluding that the organization met the criteria established by FENSA, the Secretariat presented the Center for Reproductive Rights to the Board. The Executive Board was asked to admit the RRC to official relations with the WHO. The PBAC examined the request and “noted the Secretariat’s conclusion that both entities had met the criteria, but given diverging views, no recommendation has been made” (§67). Following this, in January 2024, the Executive Board asked PBAC to continue its discussions with a plan  to issue a recommendation in May 2024. However, after its May meeting, the PBAC had still not found a consensus recommendation to propose (§42). The Committee nevertheless reaffirmed its confidence in the Secretariat’s compliance with the eligibility criteria.

From June 3^rd to 4^th, 2024, the Executive Board held its 155^th session. On this occasion, the debate continued at length, confirming a strong dissensus on the issue. In two opposing blocks, the Board Member States took the floor first. Poland, on behalf of the European Union and its Member States, Brazil, Bulgaria, Barbados, Thailand, Morocco, Israel, Norway, Chile, Switzerland, Canada, Australia, and the United States argued in favor of including the Center for Reproductive Rights in the list of non-state actors in official relations with the WHO. They based this mainly on a technical argument: the Secretariat has judged that the CRR meets the FENSA criteria, so there should be nothing in the way of its inclusion on the list. They were supported in this by 32 other States, represented by Mexico.

Other States opposed this inclusion, such as Senegal, on behalf of the 47 member States of the WHO African region, accompanied by Togo. Other States not members of the Board supported them, such as Qatar, on behalf of the EMRO region (21 States); Pakistan, on behalf of the Organization of Islamic Cooperation - OIC (57 States); Russia; Egypt; Yemen; Iran; and Somalia. These States have argued that their legalizations counter the concepts and notions promoted by the CRR. 105 out of 194 WHO Member States have thus expressed their opposition (EMRO states being mostly OIC members).

WHO Director-General’s pro-abortion activism

Following these discussions, delegates were invited to take note of the Director-General’s report presenting RRC’s candidacy. In the absence of a consensus, they took this decision with a show of hands. The meeting chairman invited them to study the draft decision admitting RRC to official relations with WHO. Qatar was the first to take the floor in opposition, explaining that the Center for Reproductive Rights’ activity is opposed to the laws and customs of many States, and Senegal joined this position. Conversely, the United States and Norway called for the debate not to be politicized, considering that the CRR complies with the FENSA criteria, and that the decision should be adopted.

Then, WHO Director-General Tedros Ghebreyesus took the floor to politicize the debate. He immediately began by explaining that the crux of the debate was abortion. For him, on this issue, “WHO should […] take [the] side with science and evidence”. Taking a personal anecdote as an example, he recalled that when he was Minister of Health in Ethiopia, a 2005 law in favor of abortion reduced maternal mortality. So, for him, based on“evidence-based science”, decriminalizing abortion helps to reduce this mortality rate. States were then subjected to a veritable plea in favor of decriminalizing abortion. Finally, he concluded by promising that the RRC would not influence the WHO or take over from the States on this issue: “We won’t do anything that you are afraid of”.

Egypt immediately reacted to this highly inappropriate pedagogical intervention vis-à-vis Member States. The Egyptian delegate explained that the problem was not that the RRC wanted to save the lives of pregnant women but that it was an organization that went much further, promoting abortion on demand and gender reassignment. The French delegate, Amélie Schmitt, then immediately took the floor to express her regret at the Egyptian intervention, wishing that the Board had stuck to the intervention of the WHO Director General. She went on to accuse the States opposed to the RRC of politicizing the situation in favor of implementing the FENSA procedure, even though Tedros Ghebreyesus had just made a political plea defending the RRC in the name of abortion.

The vote in favor of the Center for Reproductive Rights 

When the Executive Board could not   reach a consensus on the initial draft decision, Norway proposed a new compromise resolution. This new compromise recognized the context and legislation of Member States. It also recognized that the FENSA framework applies between the WHO Secretariat and non-state actors and does not apply to collaboration between WHO and Member States. With these clarifications in mind, the RRC was admitted to official relations with the WHO.

Several States have lent their support to this alternative decision. These include Costa Rica, the United States, Brazil, Barbados, Chile, Ukraine, Slovakia, Canada, Australia, Poland, Mexico, Thailand, Micronesia, Bulgaria, the Netherlands, and the Dominican Republic. Some of these States also argued that this decision only grants the RRC collaboration, not decision-making power. Mexico pointed out that the RRC has ECOSOC status, which means it is already included in the United Nations system, so it did not understand the blockage. Finally, Ukraine spoke on the merits, saying it would find collaboration with the RRC useful to propose reproductive technologies to improve their demography, which is suffering as a result of the war.

Senegal, Somalia, Lesotho (on behalf of the African region), Zimbabwe, China, Yemen, and Russia expressed their opposition. Several of these States, led by Somalia, requested that the item be postponed until the January 2025 Executive Board session and that consideration be given to continuing these discussions at the 2025 World Health Assembly.

The Executive Board could not reach a consensus, so they held a vote. Several options were available: the initial text, the Norwegian text, a vote on part of the text, and postponement of the decision. For regulatory reasons, the first text to be put to the vote had to be the initial draft decision. The French delegate, Amélie Schmitt, then took the floor for the second time to make an outrageous request for a secret ballot so that delegates could vote according to their conscience and perhaps against the instructions of their capital. Despite opposition from Qatar, Senegal, Yemen, and Egypt, a vote approved this proposal. The draft decision was adopted with 17 votes in favor, 13 against, and 4 abstentions.

The reaction of countries opposed to the Center for Reproductive Rights.

Following the vote, several States took the floor. Senegal, Qatar, Togo, Yemen, Somalia, Kuwait (on behalf of the EMRO region), Indonesia, Russia, Egypt, Pakistan (on behalf of the OIC), Bangladesh, Iran, Algeria, and Ethiopia (on behalf of the 47 Member States of the African Region) announced that they would only accept the implementation of this text if it was compatible with their values and traditions. These States want their customs and traditions to take precedence and refuse to collaborate with the Center for Reproductive Rights, whose practices they consider contrary to their laws, cultures, and religions. Several of these States have called for the issue to be reopened at the forthcoming World Health Assembly in 2025.