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The World Health Organization was formally established in 1948.
When the World Health Organization (WHO) was formally established in 1948 by ratification of the United Nations, its Member States pledged to finance it to achieve their main – and ideal – goal: “That all peoples achieve the highest level of health possible.”
Although there are many actors in global health today, WHO main coordinating body for international health workIt can provide governments with technical assistance to provide medical care and emergency care during times of crisis.
Over its history, the organization has developed and supported, in particular, very important programs in the field of public health, maternal health, baby food, but is best known for its eradication, prevention and control of epidemics, including the current coronavirus pandemic.
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But WHO has been criticized for extremely bureaucraticslowly in their decisions and frommotherLPolitics communicationHe also suffered from setbacks that made him the subject of serious accusations.
The final blow came in a statement by Donald Trump that his government was suspending US funding. organizations for the “poor” pandemic management.
This move has been challenged by several world leaders and health experts, especially in the current crisis.
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WHO headquarters in Geneva, Switzerland.
Structural issues
“WHO is the most important global player in maintaining the ideal of health as a public and collective good,” said Joao Nunez, professor of international affairs at York University in the UK, BBC Mundo.
While there are other important actors in global health, Dr. Nunez says the underlying principles Who lets youN play a leading rolenot only providing technical knowledge, but also mobilizing and motivating cooperation to contain, control, monitor and monitor outbreaks.
“WHO performs its functions with varying degrees of effectiveness. We all know that, like any complex institution, it susceptible of to make mistakes“But it’s difficult to call an organization a single entity, because it consists of different departments and divisions,” said an expert on global health policy.
The institution consists of regional offices around the world, such as Pan American Health Organization (PAHO),and they themselves are divided into the offices of the countries where they work.
“When we talk about WHO, we must ask ourselves:“ What is WHO? “. WHO headquarters has various departments and divisions with their own functions, which do not always act as a single force and never follow a single program of action, ”explained Nunez. ,
It helps explain how difficult is it organization,
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WHO is an organization with 194 Member States and a complex bureaucratic structure.
3 key issues
“WHO has three key issues,” said Clare Wenham, a professor of global health policy at the London School of Economics (LSE), who has experience in the epidemiology of infectious diseases.
They are related to institution financing, his position in his EMember States and policies related to their managementAccording to the expert.
Regarding the first, each Member State makes a specific contribution each year, which is only 20% of the annual budget, explains Dr. Weham. The remainder comes from other contributions, such as charitable foundations or private individuals.
In addition, it is the Member States that direct the funds, which generally coincides with the priorities or agenda of the donor and that subtracts autonomy from the organization,
“WHO depends on what every government does,” says Professor Wenham. “Therefore, if you are not going to finance it properly, you cannot expect a comprehensive, comprehensive, and functional organization.”
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Secondly, his position is in the service of member states. “This can create tension every time you watch your members, when you serve them, how you work with them, or when you appeal to diplomacy,” Wenham explained.
This situation was clearly visible this year in relation to WHO’s relationship with China and how it was criticized for allegedly missing a “strong hand” with the Beijing government in the fight against the coronavirus pandemic.
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WHO Director-General Tedros Adhan Ghebreesus has been criticized for accepting WHO to confirm human-to-human transmission of coronavirus.
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However, Joao Nunez claims that “WHO does not have the power to demand anything from anyone.” All you can do is recommend what steps to take in particular.
Which brings us to the third issue that Claire Wenham mentions. “The mandate of WHO is to issue guidelines, but this mission is completely confused in politics, about who and for what reason lobbying, and which other participants are on the world stage,” says the professor. It should focus not only on relations with its 194 member states, but also with the various administrative sectors that comprise it.
“He works with his hands tied many times,” because of these factors and structures, says Juan Nunez. However, he says that he continues to do his job – not always efficiently – but with achievements that often go beyond impressive press headlines,
Famous success
Perhaps WHO’s greatest success was in 1977 when it announced that it had achieved its goal of eradicating smallpox on the planet.
“Impressive Achievement”according to Dr. Wenham. “This was one of the main infectious diseases, and its success (in eradicating) was related to the timing of the incident, the persons involved and the nature of the threat. It was not one thing. ”
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The eradication of smallpox is considered the greatest achievement of WHO.
Regarding polio, although the organization was not liquidated, as expected, “gigantic steps were taken and it was almost liquidated,” says Dr. Juan Nunez.
York University professor says the same thing happened in control of other diseases that were distributed in many parts of the world and now they are an exception,
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In the case of Chagas disease and leprosy – both present in Latin America – they are at the top of the organization’s goals list.
However, Dr. Nunez emphasizes that “the perspective that WHO devotes to the eradication of disease is simplified.”
“There is ongoing and daily work related to the promotion of primary care, maternal health, baby nutrition, rehydration therapy for children suffering from rotavirus or diarrhea,” she says, adding that “all this has a huge impact on the conditions for alleviating the burden on health systems countries. “
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Primary care, maternal and child health programs are important.
However, he notes that the media prefers to focus on serious diseases such as malaria, tuberculosis and HIV/ AIDS,
Errors and criticism
Such a diverse and extremely bureaucratic institution can’t escape of no mistakes of that their units sometimes work in opposite directionsBoth Juan Nunez and Claire Wenham acknowledge that WHO can respond slowly or awkwardly.
In this sense, they agree that organization strategy against the N1H1 outbreak (swine flu) in 2009 and then Ebola outbreak in West Africa between 2014 and 2016. was not adequate.
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WHO’s late response to the Ebola pandemic claimed many lives.
Firstly, because he had announced a pandemic in advance and recommended that governments keep antiviral drugs at a high price, and the outbreak was not so serious.
Then came Ebola in West Africa. In this case, almost nine months have passed since the confirmation of the first case, until WHO announced that it was an epidemic of international proportions. By that time, the outbreak was already out of control.
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Joao Nunez claims WHO doesn’t respond quickly enough because he has too many “clients” or interests that he has to answer,
For her part, Claire Wenham notes that “there is a difference between what the world expects from him (WHO) and what he is capable of doing.” He argues that the reactions and results of an organization should be seen as a continuum.
“This is a dynamic organization that moves and changes depending on what is happening,” he explains. “There was a SARS that they did very well. Then H1N1 announced a pandemic … and accused her of false alarm. Therefore, when Ebola arrives, she is too cautious and does not want to announce the epidemic too quickly. ”
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WHO has applied the lessons learned to its strategy against Zika.
He learned from there, the teacher says, and “together with Zika, they announced an epidemic in less than a month in response to what happened to Ebola,” he said. “I don’t think it can be criticized for how they dealt with this issue.”
“On the run”
In this sense, says Dr. Nunez, WHO is learning on the go. A new situation arises with coronavirus, surrounded by a certain uncertainty and an ever-changing panorama.
“WHO issues a series of recommendations based on the latest scientific information, and then considers and updated“That’s why he is changing his mind, for example, regarding the use of masks to not only respond to the latest data, but also to adapt to the reality of the pandemic itself,” said Nunez.
“I do not understand how WHO could do something significantly different from what it did, with its resources and limitations. Obviously, the retrospective will analyze in detail what happened, what was done and what could be done, ”he insisted.
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Dr. Wenham believes Trump is “trying to use WHO as a scapegoat.”
“He can only respond to the most relevant scientific information.”
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Meanwhile, Dr. Wenham believes President Trump is “trying to use WHO as scapegoat for his government’s own setbacks in the fight against this pandemic. “
Although both experts agree that institutional reform processes can be completed, it is difficult for WHO to replace its potential. coordinate global health programs,
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