who

Context:

  • The World Health Organization (WHO) announced “sweeping reforms” on March 6, 2019 to “modernize and strengthen” itself. 
  • WHO’s new director-general Tedros Adhanom Ghebreyesus had promised the reforms during its first-ever open election campaign, in which the director-general was selected in a vote by the WHO’s member states.

About WHO:

  • WHO was set up on April 7, 1948 after its constitution was signed by 61 countries on July 22, 1946 at the first meeting of the World Health Assembly. 
  • The Geneva-headquartered organisation has six regional offices and 194 members currently.
  • Its primary role is to direct and coordinate international health within the United Nations system.

Its main areas of work are health systems; health through the life-course; noncommunicable and communicable diseases; preparedness, surveillance and response; and corporate services.

WHO’s functions are

  • To act as the directing and co-ordinating authority on international health work; 
  • to establish and maintain effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups and such other organizations as may be deemed appropriate; 
  • to assist Governments, upon request, in strengthening health services; 
  • to furnish appropriate technical assistance and, in emergencies, necessary aid upon the request or acceptance of Governments; 

Membership:

  • Members of the United Nations may become Members of the Organization by signing or otherwise accepting WHO’s Constitution in accordance with the provisions of Chapter XIX and in accordance with their constitutional processes.
  • Territories or groups of territories which are not responsible for the conduct of their international relations may be admitted as Associate Members by the Health Assembly.

WHO’s funding comes from two sources

  1. Regular budgetary funds (RBFs), which are the membership dues assessed to each state, and 
  2. extrabudgetary funds (EBFs), which states and other organizations voluntarily give to WHO for specific projects. 
  • WHO has complete control over how it allocates its RBFs, but donors have control over the allocation of EBFs.

Organs of WHO

  • The World Health Assembly (herein called the Health Assembly)
    • The Health Assembly shall be composed of delegates representing Members.
  • The functions of the Health Assembly shall be: 

(a) to determine the policies of the Organization; 

(b) to name the Members entitled to designate a person to serve on the Board; 

(c) to appoint the Director-General; 

(d) to review and approve reports and activities of the Board and of the Director-General and to instruct the Board in regard to matters upon which action, study, investigation or report may be considered desirable; 

  • The Executive Board 
    • The Board consists of thirty-four persons designated by as many Members. The Health Assembly, taking into account an equitable geographical distribution, shall elect the Members entitled to designate a person to serve on the Board.
    • The functions of the Board shall be: 
      • to give effect to the decisions and policies of the Health Assembly; 
      • to act as the executive organ of the Health Assembly; 
      • to perform any other functions entrusted to it by the Health Assembly; 
      • to advise the Health Assembly on questions referred to it by that body and on matters assigned to the Organization by conventions, agreements and regulations; 
      • to submit advice or proposals to the Health Assembly on its own initiative; 
      • to prepare the agenda of meetings of the Health Assembly;
  • The Secretariat
    • The Secretariat shall comprise the Director-General and such technical and administrative staff as the Organization may require.
    • The Director-General shall be appointed by the Health Assembly on the nomination of the Board on such terms as the Health Assembly may determine.

Need for reforms

  • Poor response to the Ebola outbreak in West Africa : Its Ebola Interim Assessment Panel urged the WHO to “re-establish its pre-eminence as the guardian of global public health” and to “undergo significant transformation in order to better perform.”

What are the reforms?

  • Triple-billion targets : WHO would align its “processes and structures” with :
    • One billion more people benefitting from universal health coverage
    • One billion more people better protected from health emergencies
    • One billion more people enjoying better health and well-being
  • Aligning with UN Sustainable Development Goals (SDG): WHO’s new structure and operating model would also align with the UN Sustainable Development Goals (SDG). Among 17 SDGs set by the UN in 2015, at No.3 was ‘Good Health and Well-being’.
  • What are the new structures?
  • A division of the chief scientist
  • A department of digital health
  • A division of data
  • A division of emergency preparedness
  • The organisation proposed a new “state-of-the-art” WHO Academy for its staff and public health professionals globally and said it would streamline recruitment. 
  • It also said the focus would be new fund-raising initiatives to increase its base of funders.

Four new structural pillars:

  • Programmes — to back universal health coverage and healthier populations
  • Emergencies — for critical health security (to respond to crises and help countries prepare)
  • External Relations and Governance — to centralise and harmonise resource mobilisation and communication
  • Business Operations — to ensure more “professionalized” delivery of budgeting, finance, human resources and supply chain

WHO & India

  • India became a party to the WHO Constitution on 12 January 1948.
  • India is a Member State of the WHO South East Asia Region.
  • India is seen as a natural leader for the cause of the global South.

WHO India Country Cooperation Strategy 2019–2023: 

  • It has been jointly developed by the Ministry of Health and Family Welfare (MoH&FW) of the Government of India (GoI) and the WHO Country Office for India. 
  • The Country Cooperation Strategy (CCS), provides a strategic roadmap for WHO to work with the GoI towards achieving its health sector goals, improving the health of its population and bringing in transformative changes in the health sector.
  • Concerns for India
    • WHO’s role in access to medicines by addressing trade and intellectual property barriers, 
    • Pressing for technology transfer and capacity building in areas where the South remains deficient
    • Measures that curb the interests of mainly multinational corporations from the North in industries related to medicines, food and beverages, alcohol and tobacco.

Way forward:

  • Increased public funding of WHO: A key requirement for the revival of WHO’s leadership role in global health is the need to progressively increase untied flexible contributions by member countries. Countries such as India have the opportunity to take the lead in funding the organisation so that the global public organisation can be largely public funded. 
  • India’s leadership to the global South: India can possibly provide leadership to the South in pressing for decisions at the WHO that promote the interests of the South.
  • Indian Health reforms: To reach the 2025 target of spending 2.5% of GDP on health, the National Health Policy mandated Indian states to increase their health spending on primary care by at least 10% every year.
  • If WHO reforms succeed, it would be Tedros’ signature accomplishment. If they fail, though, they could further damage the WHO’s standing within the global community.