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WHO resolves to improve response to public health emergencies
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The WHO Executive Board unanimously adopted a resolution recently that would overhaul and strengthen the organization’s capacity to respond to disease outbreaks worldwide.
The resolution, which was proposed as a result of WHO’s response to the Ebola outbreak in West Africa, recognizes “the urgent need for an improved and more effective and coordinated response capacity for the international community and especially for WHO and Member States in responding to health-related emergencies.”
In a speech to the board during a special session on Ebola, WHO Director-General Margaret Chan, MD, said the outbreak drew attention to some shortcomings in WHO’s infrastructure. To address those shortcomings, the resolution includes a number of proposed reforms.
Margaret Chan
“Ebola is a tragedy that has taught the world, including WHO, many lessons about how to prevent similar events in the future,” Chan said during her speech in Switzerland. “The Ebola outbreak points to the need for urgent change in three main areas: to rebuild and strengthen national and international emergency preparedness and response, to address the way new medical products are brought to market, and to strengthen the way WHO operates during emergencies.”
Chan highlighted a report from 2010 in which a review committee convened by the World Health Assembly evaluated the response to the 2009 influenza pandemic. The committee warned that the world was not prepared to respond to a threatening global public health emergency, and that WHO did not have the capacity to respond to long-term, severe outbreaks.
The proposals call for more international support to enhance WHO’s ability to respond to outbreaks and for improvement in communication between WHO and other partners. They also call on member states to promote strengthening health care system capacities and for more training and resources to protect health care workers. Additionally, they propose that appropriate funds be allocated and disbursed quickly to areas in need.
Perspective
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Stephen S. Morse, PhD
Responding to this Ebola outbreak, by far the largest and most extensive known to date, has been a tremendous effort. Non-governmental organizations such as Médecins Sans Frontières (Doctors Without Borders) were among the earliest responders. For a number of months, they were asking for help from the international community, including WHO. In general, the response has been very slow, although in the last few months perhaps the international response compensated with magnitude of funding for what it initially lacked in timeliness. However, I find it hard to understand why the initial reaction to these requests was so weak.
Many people think that public health surveillance and response is the WHO’s job, but WHO leadership in this has varied over time. During some periods, WHO has been at the forefront, as it should be, in terms of mobilizing response to infectious disease outbreaks. But at other times, such as during the 1980s and early 1990s, WHO was not as involved as most of us, laypeople and specialists alike, believed it should be. WHO has shown very effective leadership when it does mobilize, and has been doing much better in the past few years. WHO took leadership, quite effectively, in the response to SARS in 2003. It was a step in the right direction, but many think WHO hasn’t done that recently. Part of the problem is that WHO is vastly under-resourced.
The current Ebola response was taken out of the WHO’s hands and given to the larger United Nations system. The same thing had been done before with HIV/AIDS and with avian and pandemic influenza. During those earlier events, WHO had assumed a somewhat lower profile and had taken a more passive stance. That, plus their limited funding, which was never nearly enough to begin with, led to a vicious cycle, and people began to feel less confident in WHO. Donors began to withhold money. It has become worse over the years, leading WHO to have neither the resources nor the capacity to respond as it should.
With these steps by the WHO Executive Board, we hope there will now be more funds to help the WHO. We hope that the proposed reforms will lead to a much stronger WHO, and allow it to embrace the necessity of being the world’s public health agency. It was necessary for them to do some soul searching. Hopefully, there will be more resources for WHO, but also, the organization needs to rededicate itself.
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