PHA-Exchange> PHA 2 media coverage: BRITISH MEDICAL JOURNAL - STORY 4: WHO needs more money to deliver better health care to poor people

[UNNIKRISHNAN P.V. (Dr)]

BMJ  2005;331:180 (23 July), doi:10.1136/bmj.331.7510.180-c 


 

 

 
 

 
 

 
 

 
 

 
 

 

 

 

 
 

 
 

 
 

 
 

 
 

 

 

 

 
 

 
 

 

 

 

 
 

News extra


WHO needs more money to deliver better health care to poor people

London Owen Dyer 
The World Health Organization is under-resourced, lacks direction, and
is run by staff who are jaded and poorly managed, says a highly critical
report from an independent health charity. To deliver the basic health
needs lacking in the developing world WHO needs to re-examine its
structure and policies and call for better funding, it says. 
The report is produced by the charity Medact and the People’s Health
Movement, the umbrella group that organised the first People’s Health
Assembly in Savar, Bangladesh, in December 2000. 
It says that resources devoted to WHO’s international programmes are far
smaller than most people believe. The global WHO budget for 2002 and
2003, for example, was equivalent to about 0.5% of the NHS budget over
the same period. The annual budget of the entire United Nations, with
all its agencies and peacekeeping operations, is $12bn (£7bn;
€10bn)—less than the annual budget of New York city’s Board of
Education. WHO’s funding arrangements leave the organisation susceptible
to outside pressure, the report concludes. 
The report, which states that it set out to "explore this decline in
WHO’s fortunes from the perspective of a critical friend," concludes
that the organisation suffers from poor morale, declining influence, and
lack of direction—and that these problems stem from the top. Senior
levels are "dominated by white men from developed countries." Its
management is perceived as "top-heavy, hierarchical, overpaid and
centralized" and "is beset by rumours of corruption and nepotism." 
Interviews conducted for the report among more junior staff found that
"a pattern of apathy, anger, cynicism and despair emerged" and that "the
pervasively depressed but frantic mood inside WHO is a cause for huge
concern." 
Mike Rowson, managing editor of the report, said: "We are calling on
donors to resource WHO much better and for a more rational allocation of
those funds. We are also calling on WHO to open a public debate on its
future direction, to cut down on ‘priorities,’ and re-inspire its
staff." 
The report depicts a world in which international cooperation on public
health issues is only skin deep and in which many of the most
influential voices are compromised by vested interests or undue
pressure. 
The World Bank and World Trade Organization are singled out for
particular criticism. The reforms demanded by the World Bank in poor
countries have often hindered the development of public health services
and overridden the priorities of the weaker WHO, the report argues.
"Some of these institutions, the [World] Bank in particular, now operate
in direct competition with WHO as the leading influence on health sector
policy," it says. 
The World Trade Organization has too often been guided by pressure from
the pharmaceutical industry, says the report. One issue where this is
most notable is in the negotiations over the TRIPS (trade related
aspects of intellectual property rights) agreement, which limits the
right of developing countries to issue compulsory licences permitting
generic manufacturers to ignore patents. 
* The second People’s Health Assembly was held this week in Cuenca,
Ecuador, ending on 22 July. 
Global Health Watch is available at http://
<http://medact.org/hpd_global_health_watch.php>
medact.org/hpd_global_health_watch.php 
 
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