GENEVA — The World Health Organization (WHO), headquartered in Geneva, is a division of U.N. and the primary organization overlooking global public health. It works closely with national governments and health agencies to control, treat and prevent diseases.
The WHO has been subjected to ongoing censure due to its perceived inadequate response to the Ebola outbreak and underestimation of the scale of the problem. It is blamed for its initial missteps, for not intervening sooner and for overburdening the countries under attack. Several warnings from Doctors Without Borders indicating that local governments were unable or unwilling to deal with the Ebola crisis went unheeded by the WHO until the situation spiraled out of control and was declared a global emergency by director-general Margaret Chan in August 2014.
Critics and supporters of the WHO agree that it has not shown appropriate leadership in responding to epidemics. What follows are three underlying problems potentially weakening the organization’s stance as the global leader in promoting health and effectively:
- The complexity of the structure results in inefficient governance. The World Health Organization has been criticized for its complicated structure. It is the only U.N. body with six regional offices, each with its own director elected independently by regional state members. A consensus exists between donors, health specialists and NGOs that it needs to streamline its processes to better respond to local emergencies and potential pandemics. Regarding the Ebola response, former WHO secretary of public health Charles Clift said the “lack of a direct line of control from Geneva to what was happening at country level was probably one of the main reasons for why they were so slow.”
- There is a lack of adequate financial support and control over resource allocation. The WHO budget was slashed by 13 percent in 2011 as a result of the global financial crisis. Reduced funding from member states potentially played a role in the WHOs slow response to the Ebola crisis. But the overarching obstacle preventing the WHO from executing its directives is its lack of control over the allocation of funds. In the early 2000s, the WHO received 49 percent of funding from member states as assessed contributions and could prioritize programs based on emerging needs. But by 2014, 80 percent of funding came from voluntary contributions from NGOs and charities. Moreover, about 93 percent of the voluntary contributions are tagged by the donors for specific projects, thus restricting allocation for emergency responses and hindering its mandate of combating global health threats.
- WHO is involved in a multitude of global health issues. The WHO was founded in 1948 with the primary goal of combating infectious diseases at a time when disease control was the most important public health issue. Currently, the WHO is invested in a broad spectrum of health aspects ranging from chronic conditions to a plethora of public health issues including car accidents, air pollution and domestic violence; many facets of wellbeing including sunburn and healthy aging now fall within its jurisdiction. Many believe the WHO is overburdened and needs to recalibrate its focus onto vaccinations, pandemic prevention and emergency response.
The World Health Organization plays a vital role in shaping health standards in countries, but critics believe significant reforms are critical towards its success going forward. Director-general Margaret Chan has stated that fundamental reforms are needed in order for the WHO to be prepared for the next crisis.
Chan’s successor will be appointed in July and have the task of stabilizing the organization’s authority as a global health leader. One of three final candidates selected by the 34 member board will take office after a vote of the 194 member states in May.
Though the three candidates differ in their backgrounds and expertise, they are all cognizant of the fundamental fact that change is imperative for the WHO to regain international confidence and fulfill its promises on global health.
– Preeti Yadav