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We need reform at the WHO if we actually care about global health issues


The World Health Organization (WHO) has served as a wall against global pandemics for more than 70 years, fighting smallpox, polio and HIV/AIDS among its key accomplishments. Working collaboratively with a broad range of stakeholders, the WHO’s efforts have had incalculable benefits to global health and economic development.

This is why recent WHO moves away from its core mission and inclusive approaches toward narrow, exclusive health initiatives are so worrying. These approaches could consign millions to otherwise-preventable health problems. The WHO urgently needs a serious course correction, and this week’s World Health Assembly (WHA) in Geneva offers the perfect opportunity.

{mosads}U.S. Secretary of Health and Human Services Alex Azar will play a key role in his first WHA, where he should make clear that the WHO must return to its core mission and longstanding approach — emphasizing that the United States stands ready to support the WHO’s critical mission but cannot support initiatives that undermine its core foreign policy, economic and health interests.

 

Here’s why: For decades, the WHO has partnered with universities, nonprofits and businesses to advance global health initiatives, leveraging their resources and expertise. Innovative partnerships, such as the Global Polio Eradication Initiative, have tackled global health crisis through constructive, collaborative programs.

But recently, the WHO has moved away from that approach, expanding its mandate while shrinking the number of partners it is willing to engage.

These efforts drain the WHO’s limited resources, make its efforts less effective and allow initiatives to be driven by narrow special interests, not by member states. These initiatives are exclusionary, ignoring international best practices for transparency, the need for science and evidence-based approaches and inclusive stakeholder engagement.

The growing anti-innovation agenda exemplifies this. Instead of working with all parties to create the cures of tomorrow, the WHO has adopted troubling actions, from undermining innovative new cures for once-incurable diseases, such as hepatitis and tuberculosis.

Efforts to combat noncommunicable diseases are another clear example. While the 2018 Montevideo Roadmap rightly sounds the alarm on the need to address these issues, the WHO has lobbied member states to adopt counterproductive recommendations, such as imposing onerous taxes and regulations that undermine their own economies and workers without definitive proof that they improve public health. These efforts stigmatize the private sector as a problem, rather than a partner, in the effort to improve health outcomes. Sidelining the private sector removes a critical expertise and resources that the WHO should mobilize in the fight to improve public health.

All of this is harming global health and the world’s most vulnerable populations. It must stop — and quickly. Sec. Azar has a unique opportunity at this week’s WHA to shine a light on these issues and call for immediate reform.

Rather than further overextend an overextended mandate, the WHO must rededicate itself to its core mission and focus on activities where it has the expertise and ability to make an impact. Rather than shutting out critical players, it must return to the tried-and-true approach of building bridges and platforms to engage with all public and private-sector stakeholders.

The WHO already faces resource constraints as it confronts an unprecedented number of global health challenges, from new global pandemics to the risk of less effective cures due to antibiotic resistance. It will be unable to tackle any of these issues effectively without refocusing on its core mission and reforming its approaches.

Thus, it is critical that Azar and all who care about global health issue a clear, strong call for reform. The WHO has been essential in improving public health and welfare around the world. With reform, the WHO can continue improving global, public health. To do so going forward, it must start reforming now.

Kenneth E. Thorpe, PhD. is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease.