World Health Organization (WHO) : History, Funding, Contribution & Challenges

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World Health Organization (WHO) : History, Funding, Contribution & Challenges

• The World Health Organisation (WHO), which is the UN’s health body, was set up in 1948.

• Its main office is in Geneva, which is in Switzerland.

• There are 194 Member States, 150 country offices, and six regional offices.

• It is a group of governments that work together, usually through the Ministries of Health, to help people in the countries that are part of it.

• The WHO is in charge of global health issues. It sets the agenda for health research, makes rules and standards, comes up with evidence-based policy choices, gives technical help to countries, and watches and evaluates health trends.

• It started working on April 7, 1948, which is now known as World Health Day and is marked every year.

Objectives

• To be in charge of directing and organising health work around the world.

• To work well with the United Nations, specialised agencies, government health departments, professional groups, and any other organisations that may be needed.

• To help governments improve their health services when they ask for help.

• To encourage science and professional groups that work to improve health to work together more.

How is it Governed?

World Health Assembly

• The World Health Assembly (WHA) is WHO’s body for making decisions. Delegations from all of WHO’s member states attend this meeting.

• It is held every year in Geneva, Switzerland, which is where WHO is based.

• The Executive Board’s specific health plan is still the main focus of this assembly.

• The 2022 gathering is the first in-person meeting since the Covid-19 pandemic began.

• In May 2022, the 75th meeting of the World Health Assembly took place at the World Health Organisation (WHO).

Functions

• The Organization’s policies are set by the Health Assembly.

• It looks over the Organization’s financial policies and looks over and accepts the budget.

• It reports to the Economic and Social Council based on any deal between the Organisation and the United Nations.

The Administration

• The Director-General and as many technical and administrative people as the Organisation may need are part of the Secretariat.

• The Director-General is chosen by the Health Assembly based on a recommendation from the Board. The terms of the appointment are up to the Health Assembly.

Associate Membership and Membership

• Anyone who is a member of the United Nations can join the Organisation.

• The Health Assembly can let territories or groups of territories join as Associate Members if they are not in charge of their foreign relations.

Contributions of WHO to the world

• The WHO’s main point of contact with states is through its country offices.

They give technical help on health issues, share important global standards and guidelines, and tell other levels of WHO what the government wants and needs.

They also tell the host government about disease breakouts outside the country and check on them.

They give help and direction to other UN agency offices in the country about public health.

• WHO works with other UN agencies, donors, non-governmental organisations (NGOs), and the business sector. It also works with governments.

• All countries, even the most developed ones, profit from the work WHO does to improve health around the world.

For example, all countries have gotten something out of their payments to WHO programmes that helped get rid of smallpox and find better, cheaper ways to control tuberculosis.

• The group thinks that all children who need it should be able to get immunisations, which protect against the six most common childhood diseases that can be spread: diphtheria, measles, poliomyelitis, tetanus, tuberculosis, and whooping cough.

Together with the United Nations Children’s Fund (UNICEF), WHO is leading a global effort to get all children immunised in a way that works.

• From 1948 to 1958, the WHO paid a lot of attention to certain infectious diseases that affected a lot of people in poor countries.

Malaria, yaws, tuberculosis, and illnesses spread through sexual contact were among these.

Services for mothers and children, cleanliness (especially safe water), and making sure that drugs and vaccines were all the same were also very important.

During this time, WHO got to know and work closely with other UN organisations.

• The independence of several former countries in Africa, which became voting members of the Organisation, had a big impact on the years 1958–1968.

In 1960, when almost all foreign doctors left the Democratic Republic of the Congo, which had just become independent, a huge emergency happened.

Working with the international Red Cross, WHO hired 200 doctors and other health workers and set up a new fellowship programme to help many Congolese “medical assistants” become fully trained doctors.

During this time, fellowships for developing health workers became an important WHO policy in almost every country.

In the 1960s, WHO encouraged and even worked with the world’s chemical industry to make new poisons to fight the bugs that spread onchocerciasis (also known as “river blindness”) and to treat schistosomiasis.

In the late 1950s, a big step forward was made when it was shown that tuberculosis could be treated without expensive hospital care.

Even something as simple as standardising the names of diseases and causes of death was a big step forward for international health messaging thanks to WHO.

• During WHO’s third decade, from 1968 to 1978, the world’s smallpox was finally wiped out.

In 1967, smallpox was still common in 31 countries, where it affected 10–15 million people.

Teams of public health workers in each affected country did the work, with WHO as the head, coordinator, and source of ideas.

Millions of dollars were saved around the world because of this success, which was made possible despite different national rivalries and fears.

With the help of this great effort, there was a push to vaccinate more children around the world against six diseases that used to kill a lot of people: diphtheria, tetanus, whooping cough, measles, poliomyelitis, and tuberculosis (with the BCG vaccine).

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After hesitating for a long time because of politics, WHO finally got involved in family planning during this time by encouraging study and development around the world on human reproduction.

Malaria and leprosy were also fought against in a new way.

WHO also pushed for the training of people who help with health care, like the “barefoot doctors” in China and the traditional birth helpers in India.

o This kind of training was a better investment in most developing countries than teaching doctors to work mostly in cities.

• A big world meeting of WHO and UNICEF was held in Alma Ata, a city in the Asian part of the Soviet Union, at the start of the fourth decade (1978–1988).

As a way to avoid focusing too much on high technology, the Alma Ata conference emphasised the value of both preventative and curative primary health care as the best way to run a national health policy.

This method, which focuses on community involvement, using the right technology, and working with people from different fields, became the central pillar of world health policy.

Thirty years after the WHO was founded, 134 member states reaffirmed their pledge to equality, which is summed up in the slogan “Health for All.”

The International Drinking Water Supply and Sanitation Decade (1981–1990) was started by the UN General Assembly and backed by WHO. Its goals were to make sure everyone had safe drinking water and a good way to get rid of waste.

During this time, every country was urged to make a list of “essential drugs” that would be used in all public facilities instead of the thousands of brand-name products sold on world markets.

A lot of people also paid attention to the WHO’s criticism of the marketing of artificial infant formula goods in developing countries.

Oral rehydration therapy was used to stop diarrhoea in babies all over the world. This was another great step forward that was based on very easy ideas.

• Networks: When the Ebola virus broke out in the Congo in 1995 and went on for three months without WHO knowing about it, it showed that there were no global public health monitoring and notification systems.

So, in 1997, WHO and Canada created the Global Public Health Intelligence Network (GPHIN), which used information from the Internet to act as an early warning system for possible outbreaks.

The WHO added the Global Outbreak Alert Response Network (GOARN) to this (GPHIN) in 2000 so that events could be looked at once they were found.

o GOARN connected 120 networks and institutes that had the information, labs, skills, and experience to move quickly in a crisis.

• According to the WHO, most of the about 500,000 maternal deaths that happen each year can be avoided by using family planning to avoid illegal abortions and teaching traditional birth helpers about hygiene.

• The WHO is also doing more to fight cancer, which now kills as many people in poor countries as it does in rich countries.

• The WHO is working in every country to stop smoking, which is the single most preventable cause of death for both men and women.

• One of the main goals of health education in WHO is to spread easy rules about diet, exercise, not smoking, drinking alcohol in moderation, and having clean places to work.

• The worldwide spread of AIDS (acquired immune deficiency syndrome) has given WHO another task as it tries to stop the spread of this deadly virus disease that is spread through sexual contact.

The WHO is trying to get people to be able to test themselves for HIV so that more people who have it can find out and get treatment.

• In 2021, Covid-19 was called a pandemic by the World Health Organisation (WHO).

• A pandemic is called by the WHO when a new disease that people don’t have protection to spreads around the world faster than expected.

• An epidemic, on the other hand, is a large outbreak that spreads through a population or area. It’s not as bad as an outbreak because it’s only in a small area.

India and WHO

• India joined the WHO on January 12, 1948.

• The South East Asia regional office is in New Delhi.

• Smallpox

In 1967, almost 65% of all smallpox cases in the world were found in India. Of these, 26,225 people died, which showed how hard the fight was going to be.

The Intensified Smallpox Eradication Programme was started by the WHO in 1967.

The Indian government and the World Health Organisation (WHO) worked together to get rid of smallpox in 1977.

• Polio

In reaction to the WHO’s 1988 Global Polio Eradication Initiative, India started fighting the disease with financial and technical help from the World Bank.

Polio Campaign-2012: The Indian government, along with UNICEF, the World Health Organisation (WHO), the Bill & Melinda Gates Foundation, Rotary International, and the Centres for Disease Control and Prevention, helped almost everyone know that all children under five need to be vaccinated against polio.

Because of these measures, India was taken off the list of countries where the disease is common in 2014.

• The Prime Minister recently spoke at the Second Global Covid Virtual Summit of the World Health Organisation (WHO). In his speech, he talked about WHO Reforms.

Reforms Suggested by India

• Making the process for declaring a public health emergency of international concern (PHEIC) stronger:

It’s important to come up with clear, objective rules for how to declare PHEIC.

In the statement process, the focus should be on being open and quick.

A PHEIC refers to an event that is:

o Serious, quick, strange, or out of the blue;

o Has effects on public health that go beyond the borders of the harmed state; and

o May need world action right away.

• Funding:

Most of the money for the WHO’s programmatic activities comes from extra budgetary payments, which are usually set aside even though they are voluntary. The WHO doesn’t have much freedom in how it spends these funds.

Extra budgetary or voluntary gifts should not be set aside, so that the WHO can use them where they are needed most.

• Making sure the funding method and accountability framework are open and clear:

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There is no way for member states to work together to decide on real projects and activities, and there is no review of value for money, whether projects are being done according to member states’ priorities, or if there are unusual delays.

For more responsibility, it is also important to make sure there is a lot of openness about how data is reported and how money is spent.

• Improving the WHO’s and member states’ ability to respond:

When the IHR 2005 was put into place, it showed where member states were missing important parts of their basic health infrastructure. As they’ve dealt with the COVID 19 pandemic, this has become more clear.

It is important that the WHO’s programmatic activities under its General Programme of Work focus on building and strengthening capacities in member states, as required by IHR 2005, which are found to be lacking or insufficient based on the self-reporting that Member States do on IHR 2005.

• Improving the WHO’s way of running things:

WHO is a professional organisation, so most of its work is done by groups of experts who work on their own. Also, the part of the Independent Oversight and Advisory Committee (IOAC), which is in charge of how well the WHO Health Emergencies Programme (WHE) works, becomes very important as the risks of disease outbreaks increase.

It is important that the member states have a bigger say in how the WHO works, since it is up to the states to put the WHO’s technical advice and ideas into action on the ground.

To make sure that member states can keep an eye on things, there needs to be a Standing Committee of the Executive Board or something similar.

• Improvement in IHR Implementation:

IHR (International Health Regulations) 2005 says that Member States have to report on their own. But a study of how IHR is used is not required.

IHR (2005) is an international law agreement that is binding on 196 countries around the world, including all WHO Member States.

o Their goal is to help the international community stop and deal with serious health risks that could cross lines and hurt people all over the world.

Reviewing how the IHR is put into place should still be up to those who want to do it.

It is very important to make improving international cooperation a top goal. This cooperation should be geared towards helping developing countries in areas where they lack the resources to implement the IHR.

• Access to medicines, vaccines, and tests:

People have thought that the Doha Declaration TRIPS flexibilities for public health might not be enough to deal with emergencies like the Covid-19 pandemic.

It’s important to make sure that everyone has fair, reasonable, and equal access to all tools for fighting the Covid-19 pandemic, so there needs to be a plan for how they will be given out.

• Making a global plan for dealing with infectious diseases and pandemics:

There needs to be a way to keep track of the International Health Regulations and help member states with things like infrastructure, people resources, and the testing and surveillance tools they need.

Increasing a country’s ability to prepare for and respond to infectious diseases that could cause a pandemic. This includes giving advice on how to take effective public health and economic measures during health emergencies by using a multidisciplinary approach that includes both health and natural sciences.

• The role of hosted partnerships in the control of pandemics:

New flu viruses that lead to more disease cases pose very real dangers to people.

The world needs to act quickly to solve this problem by taking bold steps and making sure that our health care systems are alert and ready.

The main goal should be to make it easier to prevent, plan for, and respond to global pandemics, and to make it easier to fight back against any future pandemics.

What is the role of WHO in World Health Concerns?

• Climate change and toxins in the air

Every day, nine out of ten people take in dirty air. In 2019, the WHO says that air pollution is the biggest health risk from the climate.

Pollutants in the air can get into the breathing and circulatory systems and hurt the lungs, heart, and brain. Every year, 7 million people die too soon from diseases like cancer, stroke, heart disease, and lung disease that are caused by these pollutants.

Burning fossil fuels is the main cause of air pollution. It is also a major cause of climate change, which affects people’s health in different ways.

o Malnutrition, malaria, diarrhoea, and heat stress are expected to kill an extra 250,000 people each year because of climate change between 2030 and 2050.

• Diseases that don’t spread

Diabetes, cancer, and heart disease are examples of noncommunicable diseases. Together, they kill more than 70% of people around the world, or 41 million people.

The rise of these diseases is due to five major risk factors: smoking, not being active, drinking too much booze, eating poorly, and air pollution.

Mental health problems are also made worse by these risk factors. Suicide is the second most common cause of death for people ages 15 to 19.

• Global Influenza Pandemic

The WHO is always keeping an eye on the spread of flu viruses to look for strains that could cause a pandemic. Global surveillance and response is done by 153 organisations in 114 countries.

• Fragile and Vulnerable Settings

More than 1.6 billion people, or 22% of the world’s population, live in places where they can’t get basic care because of long-lasting disasters like drought, famine, war, and population displacement, as well as weak health services.

• Antimicrobial Resistance

Bacteria, parasites, viruses, and fungi that are resistant to modern medicines could put us back in a time when it was hard to treat diseases like pneumonia, tuberculosis, gonorrhoea, and salmonellosis.

If you can’t stop infections, it could really mess up surgery and treatments like chemotherapy.

In 2017, about 600,000 cases of tuberculosis were resistant to rifampicin, the most effective first-line drug, and 82% of these people had multidrug-resistant TB.

People and animals, especially those used to make food, use too many antimicrobials, which leads to drug tolerance. Antimicrobials are also used too much in the environment.

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WHO is working with these industries to implement a global action plan to fight antimicrobial resistance by raising awareness and knowledge, reducing infections, and encouraging the careful use of antimicrobials.

• Ebola and other dangerous diseases

In 2018, there were two different Ebola outbreaks in the Democratic Republic of the Congo. Both of them spread to cities with more than 1 million people. One of the areas that has been hit is also in a place where there is a current war.

In WHO’s R&D Blueprint, diseases and pathogens that could cause a public health problem but don’t have good treatments or vaccines are listed.

o This watchlist for priority research and development includes Ebola, several other haemorrhagic fevers, Zika, Nipah, Middle East respiratory syndrome coronavirus (MERS-CoV), and Severe Acute Respiratory Syndrome (SARS). It also includes disease X, which stands for the need to prepare for an unknown pathogen that could cause a serious epidemic.

• Poor care at the start

Primary health care is usually the first time a person interacts with their health care system. It should provide complete, reasonable, community-based care for the whole person’s life.

Still, many countries don’t have basic health care facilities that are up to par. This may be because low- and middle-income countries don’t have enough money or because, in the past few decades, more attention has been paid to single disease schemes.

• Vaccine Hesitancy

Even though vaccines are available, some people still don’t want to get them. This could set back efforts to stop diseases that can be prevented by vaccines.

For example, there have been 30% more cases of measles around the world. There are a lot of reasons for this rise, and not all of these cases are caused by people not getting vaccinated.

But the disease has come back in some countries that were close to getting rid of it.

The WHO says that reluctance is caused by being too comfortable, finding it hard to get vaccines, and not having enough faith.

• Dengue

Dengue is a disease spread by mosquitoes that makes people feel like they have the flu. It can be fatal, killing up to 20% of people who have it in its worst form, and it has been a growing threat for decades.

During the rainy season in places like Bangladesh and India, there are a lot of cases.

The goal of the WHO’s plan to control Dengue is to cut deaths by 50% by 2020.

• HIV

Huge progress has been made against HIV in terms of getting people tested, giving them antiretrovirals (22 million are on treatment), and giving them access to preventive measures like pre-exposure prophylaxis (PrEP), which is when people who are at risk of getting HIV take antiretrovirals to stop them from getting sick.

About 37 million people around the world have HIV right now.

It is very hard to reach people like sex workers, people in prison, guys who have sex with other men, and transgender people. Most of the time, these groups can’t get health care.

Young girls and women (ages 15–24) are at a high risk of getting HIV. Even though they only make up 10% of the population, they account for 1 in 4 HIV cases in sub-Saharan Africa.

The WHO is working with countries to help them support self-testing so that more HIV-positive people can find out their status and get treatment (or preventive steps if the test is negative).

• Covid-19

In 2021, the WHO said that Covid-19 would be a pandemic.

The coronavirus (Covid-19) outbreak was discovered when China told the World Health Organisation on December 31, 2019, that Wuhan City in Hubei province had a cluster of pneumonia cases with unknown causes.

o After that, the disease spread to more areas in China and the rest of the world. The WHO called it a global health emergency. The name of the virus is now SARS-CoV-2, and the name of the disease is now COVID-19.

Test for Covid-19: The polymerase chain reaction (PCR) test is the first one done on samples from people who might have Covid-19.

o If that is true, the sample is sent to the National Institute of Virology in Pune, which is the only government lab that does genome sequencing right now, for final confirmation.

• Monkeypox

In July 2022, the WHO declared a global health emergency because of the monkeypox virus and sounded the highest warning.

o The virus has spread to places where it is not common. This virus has quickly spread to many places where it has never been seen before.

Monkeypox is a virus disease that can spread to humans. It has symptoms that are similar to those of smallpox, but they are less severe.

The infection was first found in 1958, after two outbreaks of a pox-like disease in research groups of monkeys. This is how the name “monkeypox” came about.

WHOs’ Organisational Challenges

• Instead of getting support from countries, the WHO has relied on donations, mostly from rich countries and foundations like the Bill and Melinda Gates Foundation.

Because of this, 80% of WHO’s funding is currently tied to programmes that donors choose. Work programmes that are important to WHO’s mission but don’t get enough money because they conflict with the goals of big donors, especially those from rich and developed countries, aren’t supported enough.

Because of this, the WHO’s role as a leader in global health has been taken over by organisations like the World Bank and, more and more, by big charities.

The organization’s effectiveness has been called into question, especially after it failed to stop the 2014 ebola outbreak in West Africa.

It was because WHO didn’t have enough money, structure, people, or bureaucracy.