WORLD HEALTH ORGANIZATION (WHO)
The WHO is a specialized agency of the United Nations and is part of the UN Sustainable Development Group. It was established on 7 April 1948, commemorated as World Health Day.
- Objective: The attainment of the highest possible level of health for all peoples.
Functions of WHO
- Core functions
- Providing leadership: On crucial health matters and engaging in partnerships.
- Shaping research agenda: Stimulating the generation, translation, and dissemination of valuable knowledge.
- Setting norms and standards: Promoting and monitoring their implementation.
- Policy options: Articulating ethical and evidence-based policy options.
- Providing technical support: Catalyzing change and building institutional capacity.
- Monitoring: Assessing the health situation and trends.
- Other functions
- Directing and coordinating authority: On international health work.
- Health services: Assisting governments in strengthening health services upon request.
- Work on prevention: Advancing efforts on the prevention and control of epidemic, endemic, and other diseases.
- Cooperation with specialized agencies: Promoting improvements in nutrition, housing, sanitation, and working conditions.
- Research: Coordinating biomedical and health services research.
- Improved standards in teaching and training: In health, medical, and related fields.
- International standards: Establishing standards in biological, pharmaceutical, and diagnostic procedures.
- Recommendations: WHO proposes conventions, agreements, and regulations, making recommendations on international nomenclature of diseases, causes of death, and public health practices.
Role of WHO in dealing with COVID-19 Pandemic
- Advice:
- Guidance documents: WHO published a comprehensive package of guidance documents on topics related to managing outbreaks of new diseases.
- Medical Product Alert: Issued to warn stakeholders about falsified medical products claiming to prevent, detect, treat, or cure COVID-19.
- WHO Academy App: Designed to inform healthcare workers on caring for COVID-19 patients and protecting themselves.
- Augmented Reality Course: For health workers on the use of COVID-19 PPE.
- Vaccines: COVID-19 subcommittee of WHO Global Advisory Committee on Vaccine Safety (GACVS) issued an interim statement on the use of various vaccines.
- Information dissemination: WHO continuously provided updates on the virus, its spread, precautions, vaccine efficacy, and other relevant information.
- Leadership:
- World Health Assembly Resolution: Called for intensified efforts to control the pandemic and equitable access to essential technologies and products.
- Recovery Plan for the World: An event co-hosted to build back better and ensure a healthy recovery from COVID-19.
- Others: Declaration of a public health emergency of international concern (PHEIC) and hosting the first-ever International Day of Epidemic Preparedness.
- Science:
- Global Research and Innovation Forum: Convened by WHO to assess knowledge levels, identify gaps, and accelerate funding for priority research.
- Solidarity trial: An international clinical trial launched to find effective treatments for COVID-19, conducted by WHO and partners.
- Others: WHO released details on the use of medicines, treatment of people with co-morbidities, and the potential effects of post-medication.
- Global Study on the Origin of COVID-19: Conducted by WHO to investigate possible origins of the COVID-19 pandemic.
Issues with World Health Organization
- Criticism during COVID-19 pandemic:
- Chinese bias: WHO correctly opposed calling SARS-CoV-2 the “Chinese virus.” However, it remained silent when China made false claims about SARS-CoV-2 being a CIA operation or calling it a “U.S.A. virus.”
- Delay in acknowledging human-to-human transmission: WHO did not acknowledge human transmission until mid-January 2020, despite warnings from Taiwan and cases in other countries.
- Delay in declaring public health emergency and pandemic: WHO delayed declaring a PHEIC until the end of January and waited until mid-March to declare a pandemic, by which time over 4,000 deaths had been reported in 114 countries.
- Delay in implementing travel restrictions: While many countries imposed air travel restrictions early on, WHO opposed any travel or trade restrictions.
- Funding issues:
- Lack of resources: WHO lacks sufficient resources to take on-the-ground action.
- Excessive reliance on voluntary contributions: The organization relies heavily on voluntary contributions, which may promote vested interests.
- Difficulty in setting priorities: WHO struggles to prioritize effectively because many donors earmark funds for specific projects.
- Reduction in assessed contributions: In the early 2000s, 49% of WHO’s funding came from assessed contributions, but this dropped to 17% by 2018.
- Donor-driven agenda: Challenges due to constrained finances limit WHO’s autonomy in decision-making, favoring a donor-driven agenda.
- Structural issues
- Regional offices: WHO has six regional offices, each with its own director elected by regional member states. Thus, there are effectively seven WHOs whose directors report to their own member states, not the Director-General.
- Semi-autonomous regional offices: For example, the Pan American Health Organization operates semi-autonomously, as it was founded in 1902 (before WHO), leading to communication gaps.
- Thinly stretched: WHO initially focused on infectious diseases, but now handles multiple issues with limited resources.
- Advisory body: WHO mostly serves as an advisory body, unlike UNICEF, which can directly intervene (e.g., vaccinating children).
- Lack of strong sanctions: International Health Regulations (IHR) require governments to report PHEICs and cooperate with WHO, but WHO lacks legal authority to enforce compliance.
- Issues in functioning
- Slow response: WHO has faced criticism for delayed responses, such as during the 2014 West African Ebola outbreak.
- Confusing warnings: For example, WHO’s International Agency for Research on Cancer (IARC) has issued mixed warnings on topics like air quality, meat consumption, and mobile phones.
- Lack of defined functions: WHO’s responsibilities and powers are scattered across documents like IHR, WHA resolutions, and operational guidelines.
- Other issues: WHO’s efficiency is hindered by organizational lethargy, lack of decisive leadership, bureaucratic inertia, underfunded programs, and inability to adapt to modern health needs.
Way forward
- Restructuring: WHO leadership should be independent health professionals capable of resisting external pressure.
- Open governance: WHO governance should include alternative voices (e.g., civil society, private philanthropies) without compromising its democratic focus.
- Strong sanctions: IHR should be reformed to enforce compliance from member countries.
- Narrow mandate: WHO’s role should be clarified, focusing on activities with high impact.
- Untied funds: WHO should explore new financing mechanisms to secure untied funds (e.g., using Gavi’s model or higher taxes on global transactions).
- Broad technical expertise: WHO should involve professionals beyond public health, such as urban designers and legal experts, to address complex health issues.