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[afro-nets] WHO Reform: Fit for purpose or fit for plucking?

  • From: "David Legge" <D.Legge@latrobe.edu.au>
  • Date: Mon, 2 Jan 2012 01:17:13 -0800

WHO Reform: Fit for purpose or fit for plucking?

The World Health Organisation is a critically important global institution. It has a unique role to play in addressing the health needs of people around the globe, vulnerable populations in particular.

But WHO is today in crisis. For over thirty years the rich countries have sought to control the Organisation by refusing to fund the priorities of the membership as a whole while selectively funding those programs which are consistent with their interests and perspectives. Thus generous funding is supplied to a range of programs which are designed in part to protect the intellectual property rights of European and US pharmaceutical giants while programs directed to the effective and efficient use of medicines or quality of care are seriously underfunded.

Health system development is one of the critical areas of work in developing countries and WHO has taken the lead in promoting universal health care, integrated health systems and primary health care. However, the World Bank promotes a horizontally fragmented model of health care (private for the rich, social insurance for the middle and safety nets for the poor) while the Global Fund for AIDS, TB and Malaria promotes a vertically fragmented model of health care focused solely in three priority diseases. But, adequate funding is not available to WHO to promote unified, universal, publicly funded, PHC based health care.

In a Catch 22 twist, the funding crisis has contributed to inefficiencies and distortions in the work of WHO which are then taken as the reason for not untying its funding.

WHO is currently going through a complex reform process. Different parties with different agendas are driving the reform in different directions.

The next stage in the WHO Reform process will be at the January meeting of WHO's Executive Board in Geneva from 16-23 January 2012. The EB will consider a range of issues including finance, staffing, governance, evaluation, stakeholder relations and others. PHM's WHO Watch website (http://www.ghwatch.org/who-watch/eb130/whoreform) provides a detailed overview of these issues with critical commentary.

Many of the suggestions to be considered are sensible but some are very worrying. Most worrying is the proposed pledging conference at which donors will be asked to choose what they will support from across WHO's range of programs. Read more<http://www.ghwatch.org/who-watch/eb130/whoreform#add5>

David Legge