1 The Lancet 2008; 371 :1483-1486 DOI:10.1016/S0140-6736(08)60634-0 Comment Creating a committee C of the World Health Assembly Gaudenz Silberschmidt a , Don Matheson b and Ilona Kickbusch c The global-health landscape has changed radically in recent years. Key factors are the substantial increase in the number of donors and in funding. Agencies, such as the Global Fund for AIDS, Tuberculosis and Malaria, the Bill & Melinda Gates Foundation, and the World Bank, now contribute more to global-health programmes than WHO. Although this growth of resources and interest is a positive development, its lack of global coordination and strategic direction is problematic. 1 The weakness of global coordination is apparent in the response to recent global emergencies. A UN review of events such as the Indian Ocean tsunami illustrated that, despite an unprecedented level of resources, the response fell short because of poor coordination. 2 Various tracking initiatives—particularly of financial streams—are underway. 3 The International Health Partnership, which coordinates the H8—the Gates Foundation, the GAVI Alliance, the Global Fund, UNAIDS, UN Population Fund, UNICEF, WHO, and the World Bank—and the debates4 within the G8 are pointing in the right direction. There are other useful coordination efforts focusing vertically on specific diseases. However, there is no overall, democratic, transparent coordination on all aspects of international health. There have been no suggestions of how to achieve a more regular and structured debate between the broad range of the many key partners. We think that such a forum is urgently needed, and that it should be established under the auspices of WHO with mechanisms already at the organisation's disposal that have not yet been used for this purpose. WHO has a constitutional mandate to address global-health issues in general and not only the governance of WHO itself. 5 Article 2 of its constitution stipulates that the central activity is to act as the directing and coordinating authority on international health work, and to establish and maintain effective collaboration with the UN, specialised agencies, governmental health administrations, professional groups, and other organisations. Since 1946, when the constitution was signed, the other organisations have grown enormously in power, influence, and resources. So WHO should now respond to this changed environment to ensure that its functions are effective. Until now, the global-coordinating function of WHO has not been recognised by many of the new partners—indeed, several maintain that they have come into existence precisely because the WHO system does not work well enough to meet global-health challenges. However, few of these partners can work without a link with WHO, particularly those at the country level. WHO has not been proactive enough in searching for mechanisms that allow for better exchange and transparency between the many global-health organisations and the member states. The challenge is to find a workable mechanism to improve consistency of global-health action and coordination between many partners while respecting their independence and decision-making structure. Any decisions taken by a coordination mechanism are only as effective as the legitimacy given to them by those affected by the decisions. Coordination only works if it is accepted by those being coordinated. A distinction has to be made between coordination with other intergovernmental organisations (such as the World Trade Organization, the World Bank, the UN, and other UN agencies) and other bodies that operate without governance of member states. In intergovernmental organisations, the very same governments of member states take decisions that are often not coordinated with decisions taken by WHO. Other organisations (such as foundations, non-governmental organisations, public–private partnerships, and industry) are independent of the intergovernmental system and have other forms of governance. We are convinced that—in line with WHO's constitution—the overall coordination of global-health action should be the task of the World Health Assembly (WHA) and thereby be approved by the delegations representing all governments of the world. The WHA meets once a year and is attended by delegations from all of WHO's 193 member states. The assembly mostly takes its decisions by debating and adopting resolutions (which are usually non-binding in nature—ie, soft law) but it also has the authority to adopt binding international health law, such as the Framework Convention on Tobacco Control 6 and the International Health Regulations. 7 Currently the WHA prepares its resolutions and the decisions to be taken by its plenary in two main committees: committee A dealing with programme matters, and