Lets start with The World Health Organisation (called WHO)

The current outbreak in West Africa of Ebola has brought it into public view.

Formed by the United Nations in 1948, (76 years ago) it is still trying to be an efficient and effective organisation.

In the 76 years of its existence the agency has promulgated only two major treaties: The International Health Regulations and the Framework Convention on Tobacco Control.

It has declare two global health emergencies. The 2009 swine flu (H1N1) epidemic, and in reaction to a reversal of progress in eradicating polio in May 2014.  

A deeply political organisation, it remains the undoubted leader in global health.

With its incomparable expertise, global influence, and normative powers it has no substitute. There is no other show in town. So it survives as a global health agency within the United Nations, the question is.

“If we try to improve it, will it fall to pieces?”“

At the moment it resembles nothing so much as a dinosaur on the edge of the Ice Age, only in this case it will be the Age of Global Warming and the age of the lifestyle-associated non-communicable pandemics that cannot be stopped by an immunizing needle, quarantine or medicine that is going to test it in the future.

What exactly is it?

It comprises of six regional offices that are uniquely independent within the UN system, with each regional office having full power over regional personnel, including appointment of country representatives, all administered by 147 country offices.

It is controlled by delegates from its 194 member states, each of which has an equal vote on the direction of agency policies.

So what we really have is six separate WHOs in six different regions – Africa, the Americas, South-East Asia, Europe, the Eastern Mediterranean and the Western Pacific governed by 194 governing member states.  An Organisation that is plagued by ossified structures that prevent it from exercising the flexibility it needs.

It’s no wonder it has problems and in need of reform.

Few would dispute that a stronger, more effective World Health Organisation would benefit all.

THIS CANNOT BE ACHIEVED BY AN Agency whose work and policies ultimately reflective of its wealthiest donors, leaving it scant margin to set its own.

It simply is not sustainable to have wealthy states and foundations control some 80% of WHO’s budget.

Don’t be surprised that it is now pointing its finger at the lack of contribution it is getting to manage the current outbreak of Ebola.

However it can not be excused for using the voluntary funds it does receive primarily for infectious diseases (60%), with negligible allocations for non-communicable diseases (3.9%) and injuries (3.4%). Yet, non-communicable diseases account for 62% of all deaths worldwide, and injuries constitute 17% of the global burden of disease.

Just three years ago, the World Health Organization (WHO) was in deep financial trouble, with a US$300-million deficit. More importantly, its extra-budgetary expenditure rose from 48.8% to 77.3% from 1998/99 to 2008/09.

The $3.98-billion budget approved by the assembly for 2014–15 shows zero growth on the WHO’s $3.96-billion budget for 2012–13,

Its income from member dues has stagnated since the 1990s. WHO is probably funded at about 10% of what it needs.

However it is not to be blamed for its inability to tackle infectious diseases such as Malaria because over 80% of its budget is voluntary. The agency has long been plagued by the fact that it has total control of only a small part of its budget:

77% — of the 2014–15 budget comes from voluntary contributions from member states and other donors.

Budget cuts at the WHO have severely hobbled the agency’s ability to respond to the Ebola epidemic.

So what are we going to do?”

We see over and over again with disasters. It’s the money that flows after something happens – after Hurricane Sandy, or Katrina or, in this case, Ebola.

The world of global health is rapidly changing if WHO is to offer leadership for urgent challenges facing the global health, such as emerging infectious diseases and noncommunicable diseases (cardiovascular diseases, diabetes and cancer) it must have its Financing changed from voluntary to fully funded.

Mandatory contributions are more aligned with the actual global burden of disease than voluntary funding. The ideal solution for this is to set higher member state mandatory contributions. Member states must become genuine shareholders in the World Health Organisation’s future, act collectively, and refrain from exerting narrow political interests.

The World Health Organisation is presently financed through two main streams. First, member-states pledge a set amount based on each country’s wealth and population. The second stream is through voluntary contributions often earmarked for specific diseases.  This has to change

Extra-budgetary funding would transform the WHO from a donor-driven organization, restricting its ability to direct and coordinate the global health agenda into some thing worth while.

Organizations like the U.S. Centers for Disease Control (CDC); Doctors Without Borders (MSF); the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the Gavi Alliance; and the Bill and Melinda Gates Foundation are important actors, often with more money and visibility than the WHO. There’s an obvious need for a higher degree of inter agency coordination and collaboration embracing the WHO, Food and Agriculture Organization, International Labour Organization,UNICEF and UNHCR.

Preparedness is a constant battle. It’s not like you can just make an investment and walk away. It’s something that needs to be kept up. And quickly, once the crisis passes and the headlines aren’t there anymore, that money dries up.

The organisation could take a more active role in regulating key global health issues, including counterfeit medicines, food safety, and nutrition. It could be more engaged and influential in international regimes with powerful health impacts, such as trade, intellectual property, arms control, and climate change.

The WHO must undergo fundamental reform if it’s to retain its rightful place as the leader in global health. While remaining true to its normative and bold vision of health-for-all, the organisation must adapt to a new political climate, demonstrate global leadership, and deliver results. The Gatekeeper of the planet’s health must publishing more about where its money goes and what it achieves.

Can any of this actual happen?  Of course not.

The only way to funds these organisations it to cap Greed at it source. (See Previous Posts)  Once the funding is there then we can HAVE MEANINGFUL WORLD ORGANISATIONS.

We all know that World Organisations end up as bickering, skint, power, shops.

Next Post we will look at the World Bank.

 

Name of the organisation Headquarter Head:

UN Security Council New York The presidentship is held for one month by member countries in alphabetical order.
UN General Assembly New York Huke Jeremic; 2013-John William Ashe
UN Secretariat New York Ban Ki Moon
International Court of justice The Hague, Netherlands Peter Tomka
International Criminal Court Lyons, France Song Sang-Hyun
Economic and Social Council New york Milos koterek
Food and Agriculture organisation Rome Jose Graziano da Silva
International civil Aviation organisation Montreal, Canada Raymond Benjamin
International Labour organisation Geneva Juan Somavia
International Monetary Fund Washington DC Christian Lagarde (former head Dominique Strauss Kahn was involved in a sex scandal)
International Atomic Energy Agency Vienna, Austria Yukiyo Amano
International Maritime Organisation London, U.K. Koji SekimizuUnited nations Educational Cultural and Social organisation Paris Irina Bokova (1st woman to have become director-general)
Internatioonal labour organization Geneva Juan Somavia
International fund for Agriculture Development Rome Kanayo F. Nwanze
World Bank New York Jim Yong kim
World health Organisation Geneva Dr. Margaret Chan
World intellectual property organisation Geneva Francis Gurry
World trade Organisation Geneva Pascal Lamy
United nations International Children and Women Fund New York Anthony Lake