Reforming the World Health Organization | Opinion – analysis
The spread and scale of coronavirus disease (Covid-19) have called for strengthening international cooperation in the area of public health, both regionally and multilaterally. The Group of Twenty (G20) video summit on March 26 decided for better data sharing and greater cooperation.
Prime Minister Narendra Modi addressed the call for cooperation at Covid-19 within the South Asia Regional Cooperation Association, and urged the G20 on the need for reforms at the World Health Organization (WHO). This is essential as WHO is the leading global and United Nations (UN) public health agency. Its institutional arrangements must be able to strongly boost global cooperation in public health and support developing countries in real time.
The last major global crisis was the 2008 financial crisis. At that time, the major economies came together in the G20. The response then required the larger players to take concerted action. Global public health emergencies involve people from all over the world. The voices of developing countries must be part of the decision-making process.
As an intergovernmental body, the WHO is not immune to the global power play, as witnessed by reports by the director-general that he avoided naming the virus after the country of origin, China, and delayed the declaration of a pandemic. Furthermore, only a quarter of its budget comes from contributions from UN member states, and the real money to drive its work comes from voluntary funding from countries and organizations.
WHO, as the global convenor, plays a key role in public health standard setting. This is a matter of great importance to the “wealthy” in the global economy, especially those with a vibrant pharmaceutical industry. The United States is the largest contributor, but the Chinese have also recognized the importance of WHO, and the previous director-general was its candidate.
WHO’s main decision-making body is the annual World Health Assembly (WHA), which is attended by all Member States. Then there is the Executive Board (JE) made up of technically qualified people from 34 countries, chosen based on geographic representation from around the world. With WHO’s demands for a better real-time response, the EB must become a permanent body with the elected countries that have permanent representatives in Geneva. The EB should meet when necessary and the direct action of WHO.
EB must also go beyond geographic representation and ensure that key stakeholders, such as the largest economies and those with the largest populations, are always present. At the UN, there is a precedent for this in the composition of the UN Women board which, in addition to representing different regions, also has representation from major donors.
And then there are the problems that revolve around drugs and medical science. This is a huge and lucrative industry where intellectual property rights (IPRs) count most, and there is little provision for collaborative research even in times of crisis. Neither WHO nor any multilateral organization is involved in drug research. They must participate in the launch of new drugs in developed countries.
Affordability will be a key, and past history is not exemplary. WHO, along with others like the World Trade Organization, must find ways to make affordable access to these key drugs possible at critical moments.
It is time to use the crisis to launch much-needed and expected reforms and review the WHO.
Manjeev Singh Puri is former Deputy Permanent Representative of India to the UN
The opinions expressed are personal.