PHM-Exch> WHO Reform: Fit for purpose or fit for plucking?

[Claudio Schuftan]

From: David Legge <D.Legge at latrobe.edu.au>

WHO Reform: Fit for purpose or fit for plucking?



The World Health Organisation is a critically important global institution.
 It has a unique role to play in addressing the health needs of people
around the globe, vulnerable populations in particular.



But WHO is today in crisis. For over thirty years the rich countries have
sought to control the Organisation by refusing to fund the priorities of
the membership as a whole while selectively funding those programs which
are consistent with their interests and perspectives.  Thus generous
funding is supplied to a range of programs which are designed in part to
protect the intellectual property rights of European and US pharmaceutical
giants while programs directed to the effective and efficient use of
medicines or quality of care are seriously underfunded.



Health system development is one of the critical areas of work in
developing countries and WHO has taken the lead in promoting universal
health care, integrated health systems and primary health care. However,
the World Bank promotes a horizontally fragmented model of health care
(private for the rich, social insurance for the middle and safety nets for
the poor) while the Global Fund for AIDS, TB and Malaria promotes a
vertically fragmented model of health care focused solely in three priority
diseases.  But, adequate funding is not available to WHO to promote
unified, universal, publicly funded, PHC based health care.



In a Catch 22 twist, the funding crisis has contributed to inefficiencies
and distortions in the work of WHO which are then taken as the reason for
not untying its funding.



WHO is currently going through a complex reform process. Different parties
with different agendas are driving the reform in different directions.



The next stage in the WHO Reform process will be at the January meeting of
WHO's Executive Board in Geneva from 16-23 January 2012.  The EB will
consider a range of issues including finance, staffing, governance,
evaluation, stakeholder relations and others.  PHM's WHO Watch website (
http://www.ghwatch.org/who-watch/eb130/whoreform) provides a detailed
overview of these issues with critical commentary.



Many of the suggestions to be considered are sensible but some are very
worrying.  Most worrying is the proposed pledging conference at which
donors will be asked to choose what they will support from across WHO's
range of programs.  Read
more<http://www.ghwatch.org/who-watch/eb130/whoreform#add5>
.
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