Shortcuts / 07 May 2020

The World Health Organisation

The World Health Organisation really is in the spotlight at the moment. Get the backstory to how it operates, the guy in charge, and some of the criticisms centred at it.

What does the World Health Organisation have to do with the United Nations?
The WHO was launched on 7 April 1948, that was just a couple of years after the founding of the United Nations in 1945. The World Health Organisation is an agency of the United Nations. The UN has a broad remit focused on sustainable development, security and humanitarian disasters amongst other things, so you can see how a dedicated health agency within the sprawling UN supports that work.

What is the WHO’s main purpose?
According to the WHO website is to “work worldwide to promote health, keep the world safe, and serve the vulnerable”. More specifically, at a top level they work to combat diseases. That includes communicable diseases like influenza and HIV, and noncommunicable diseases like cancer and heart disease. They have a focus on maternal health, particularly in developing nations. And they also do a lot of work on safe food and water supplies – and providing vulnerable populations with medicines and vaccines.

Who is involved in the WHO?
The WHO is a member organisation, which means it is made up of member states, which are basically countries and territories. When it was founded it had 55 member states, it now it has 194. Each of these member states is able to appoint a delegate to the World Health Assembly, the WHO’s top decision-making body (Australia’s Chief Medical Officer Professor Brendan Murphy is our delegate).They meet annually in Geneva, Switzerland to vote on policy matters brought to the Assembly and determine how money is spent. The Assembly also appoint the Executive Board, as well as the Director General of the WHO. The executive board is made up of 34 health experts from member nations, they’re there for a 3-year term. The main functions of the Board is to implement the decisions and policies of the Health Assembly, and advise and generally to facilitate its work. Australia actually sits on that board at the moment.

Who is the Director General of the WHO?
Dr Tedros Adhanom Ghebreyesus (or Dr Tedros for short…) is an Ethiopian, and also the first African head of the WHO, taking office two-and-a-half years ago. As far as his career, he has PHD in Community Health and Masters of Science in Immunology of Infectious Diseases, his work has been mainly political. He was Ethiopias Health Minister, and then Foreign Minister before his successful campaign to lead the WHO.

Why is Dr Tedros facing criticism?
There’s criticism that the WHO missed opportunities to contain the virus to China. China first put up its hand on 31 December that there was a problem. And by 20 January, the first cases arose outside China. So critics say there was almost three weeks there to stop it in its tracks. A global health emergency was declared on 30 January, and it was labeled a pandemic on 11 March. It might sound like semantics, but each level has meaning in terms of what the WHO can do to step up its response. For example, the world’s governments and scientific community looks to the UN to classify health risks, and that determine local efforts like screening at airports and monitoring of outbreaks. It also determines the level of global cooperation on issues such as funding and drug development – and the more severe the warning and widespread the disease outbreak, the more funding and cooperation required.

How has he responded?
In response to the criticism, Dr Tedros has hit back recently saying that the organisation’s role was to offer science-based advice then it was up to countries whether or not they implemented that advice. And given the scale of what’s happened since the start of this, there are a lot of people, countries and organisations ducking for cover and pointing fingers, not just at Dr Tedros. Some countries, like the US, are also taking issues with how he has dealt with where the coronavirus crisis started, in China. US President Donald Trump has accused the WHO of being too quick to accept the information China provided in the early days of the pandemic. Trump praised China in the early days of the crisis, but he now says he’s not happy that the WHO have praised China for its response. And the US is looking at accusations that China initially covered up the existence of the virus. Also, they’re not happy with the funding arrangement.

How is the WHO funded?
The WHO’s budgets are biennial, spanning over two years. Its 2020-2021 budget is nearly US$5 billion (AU$7.6 billion), up 9% from the previous budget. Much of that money comes from mandatory funding from its member states, the amounts of which are assessed based on each country’s income and population. The US is by far the biggest contributor to the funding of WHO. It contributed more than US$400 million (AU$610 million) in 2019 in both baseline and voluntary contributions. Just for comparison, Australia contributed about $AUD63million in 2018. Member states can make voluntary donations, as can private donors. In fact the Bill and Melinda Gates Foundation is the second largest donor to the WHO, pledging US$531 million (AU$808 million) over 2018 and 2019. That foundation has a big focus on public health and disease eradication and they see the WHO as the best partner for that. During a crisis such as this, the WHO can also effectively raise money, and are at the moment trying to raise an additional $675 million USD to tackle coronavirus, and they’re about half way there.

What’s US President Donald Trump’s problem with WHO funding?
Critics say he’s trying to deflect from the disaster that’s unfolded in the US – it has by far the largest number of coronavirus deaths and cases in the world, so theres some political pressure there. But Trump has made the point that the US, with its population of 330 million people covers 22% of the WHO’s overall mandatory contributions. Meanwhile China, with its 1.4 billion people, will stump up 12% in the next couple of years. Trump thinks China has too much influence in forums like the WHO, and given the US is the main funder of these forums, he wants the sidelined. And he sees insult to injury here because the virus kicked off in China. So the US has suspended its funding for three months and will conduct a review. And for Australia’s part, whilst we haven’t been as direct in our criticism of the WHO, or China, our government has said there should be an international inquiry into the origins of the coronavirus. PM Scott Morrison has worn the wrath of China when he made what he says is a “reasonable and sensible” call for a big independent inquiry into the crisis. That would involved a look at China’s and the WHO’s handling of it – something China has taken exception to. The Chinese ambassador in Canberra has suggested that Beijing could stop tourists and students coming to Australia and that the Chinese public would boycott Australian beef and wine. Chinese state media called Australia ‘gum stuck to China’s shoe’. But Morrison hasn’t backed down and US Secretary of State said “Who in the world wouldn’t want an investigation of how this happened to the world?”

Squiz Recommends:
Inside Bill’s Brain
Time Magazine “Dr Tedros”

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