JAMA
April 20, 2011, Vol 305, No. 15, pp 1511-1610
http://jama.ama-assn.org/current.dtl
Commentary
Medicine and Law
ONLINE FIRST
JAMA. 2011;305(15):1585-1586. Published online March 29, 2011. doi: 10.1001/jama.2011.418
Reforming the World Health Organization
Devi Sridhar, DPhil; Lawrence O. Gostin, JD
In December 2010, Jack Chow,1 the former World Health Organization (WHO) assistant director-general, asked, “Is the WHO becoming irrelevant?” A month later, the WHO’s executive board considered the agency’s future within global health governance. After a year-long consultation with member states on its financing, Director-General Margaret Chan called the WHO overextended and unable to respond with speed and agility to today’s global health challenges.2
The crisis in leadership is not surprising to those familiar with the WHO. As its first specialized agency, the United Nations (UN) endowed the WHO with extensive normative powers to act as the directing and coordinating authority on international health. Yet modern global health initiatives (eg, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance [formerly the Global Alliance for Vaccines and Immunisation]), bilateral programs (eg, US President’s Emergency Plan for AIDS Relief [PEPFAR]), and well-funded philanthropies (eg, the Bill & Melinda Gates Foundation) often overshadow the agency. The WHO can be subject to political pressure, and its relationship with industry and civil society is uncertain.3
Given the importance of global health cooperation, few would dispute that a stronger, more effective WHO would benefit all. The WHO’s internal reform agenda must be bold to ensure its future. In this Commentary, we offer 5 proposals for reestablishing the agency’s leadership….
vaccines and global health :: ethics and policy 