Declaration of Interests for WHO Experts

DECLARATION OF INTERESTS FOR WHO EXPERTS
WHO's work on global health issues requires the assistance of external experts who may have interests related to
their expertise. To ensure the highest in tegrity and pub lic confiden ce in its activities, WHO requires that ex perts serving in an
advisory role disclose any circumstances that could give rise to a potential conflict of interest related to the subject of the
activity in which th ey will be involved .
All experts serving in an advisory role must disclose any circumstances that could represent a potential conflict of
interest (i.e., any interest that may affect, or may reasonably be perceived to affect, the expert's objectivity and independence).
You must disclose on this Declaration of Interest (DOI) form any financial, professional or other interest relevant to the subject
of the work or meeting in which you have been asked to participate in or contribute towards and
any interest that could be
affected by the outcome of the meeting or work. You must also declare relevant interests of your immediate family members
(see definition below) and, if you are aware of it, relevant interests of other parties with whom you have substantial common
interests and which may be perceived as unduly influencing your judgement (e.g. employer, close professional associates,
administrative unit or department).
Please complete this form and submit it to WHO Secretariat if possible at least 4 weeks but no later than 2 weeks
before the meeting or work. You must also promptly inform the Secretariat if there is any change in this information prior to,
or during the course of, the meeting or work. All experts must complete this form before participation in a WHO activity can
be confirmed.
Answering "Yes" to a question on this form does not automatically disqualify you or limit your participation in a
WHO activity. Your answers will be reviewed by the Secretariat to determine whether you have a conflict of interest relevant
to the subject at hand. One of the outcomes listed in the next paragraph can occur depending on the circumstances (e.g, nature
and magnitude of the interest, timeframe and duration of the interest).
The Secretariat may conclude that no potential conflict exists or that the interest is irrelevant or insignificant. If,
however, a declared interest is determined to be potentially or clearly significant, one or more of the following three measures
for managing the conflict of interest may be applied. Th e Secretariat (i) allows full participation, with public disclosure o f your
interest; (ii) mandates partial exclusion (i.e., you will be excluded from that portion of the meeting or work related to the
declared interest and from the corresponding decision making process); or (iii) mandates total exclusion (i.e., you will not be
able to participate in any part of the meeting or work).
All poten tially significant interests will be disclosed to the other participants at the start of the activity an d you will be
asked if there have been any changes. A summary of all declarations and actions taken to manage any declared interests will
be published in resulting reports and work products. Furthermore, if the objectivity of the work or meeting in which you are
involved is subsequently questioned, the contents of your DOI form may be made available by the Secretariat to persons
outside WHO if the Director-General considers such disclosure to be in the best interest of the Organization, after consulting
with you. Completing this DOI form means that you agree to th ese conditio ns.
If you are unable or unwilling to d isclose the de tails of an interest that may pose a real or pe rceived conflict, you must
disclose that a conflict of interest may exist and the Secretariat may decide that you be totally recused from the meeting or
work concerned, after consulting with you.
Name:
Institution:
Email:
Date and title of meeting or work, including description of subject matte r to be considered (if a number of
substances or processes are to be evaluated, a list should be attached by the organizer of the activity):
Member of Guidelines Developing Group on Nanohealth 2011
Please answer each of the questions below. If the answer to any of the questions is "yes", briefly describe
the circumstances on the last page of the form.
The term "you
" refers to yourself and your immediate family members (i.e., spouse (or partner with whom
you have a similar close personal relationship) and your children). "Commercial entity
" includes any commercial
business, an industry association, research institution or other enterprise whose funding is significantly derived
from commercial sources with an interest related to the subject of the meeting or work. "Organization
" includes a
governmental, international or non-profit organization. "Meeting
" includes a series or cycle of meetings.
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