New York Times
http://www.nytimes.com/
Accessed 11 August 2012

(WHO) HEALTH AGENCY OVERSHADOWED BUT VITAL
By YANZHONG HUANG
http://nytweekly.com/columns/intelarchives/08-03-12/

Extract
“…Historically, the organization has undertaken a wide range of campaigns against major disease threats, which culminated in the successful eradication of smallpox in the 1970s. Beginning in the 1980s, the complex challenges posed by H.I.V./AIDS called into question the W.H.O.’s lead role in global health governance. The organization’s failed 3 by 5 Initiative, which aimed to provide the three million people living with H.I.V./AIDS in low- and middle-income countries with life-prolonging antiretroviral drugs by the end of 2005, was a setback in its efforts to play a major role in tackling pressing global health problems. It is no coincidence that the director general of the W.H.O., Margaret Chan, was not one of the “prominent voices” to address the 2012 International AIDS Conference in Washington last month, even though the W.H.O. initiated the world’s most attended conference on H.I.V./AIDS 17 years ago.

In the 21st century, while the rise of noncommunicable diseases expands the discrepancy between the organization’s mandate and its capacity, the W.H.O. finds it hard to adapt to a world that is focused on the “bottom line” and “value for money.” As its budget and influence erode in a time of austerity, the W.H.O. is overshadowed by other health organizations and initiatives like the World Bank, which has substantial lending power, and the Gates Foundation, whose global health budget is about twice the size of W.H.O.’s core budget. Yet the W.H.O. is the organization that facilitates access to medicines for H.I.V./AIDS, malaria and tuberculosis; it rapidly mobilized an alert and response network in response to the 2003 SARS outbreak; and used its treaty-making power to negotiate the Framework Convention on Tobacco Control, one of the most widely and rapidly ratified of United Nations treaties. Any serious W.H.O. reform efforts should reflect its advantages.

During the H1N1 flu pandemic in 2009, the developing world did not look to the World Bank for information on how to respond to the spread of the unknown virus, nor did it go to the Gates Foundation for coordinating distribution of limited vaccines. In the wake of the swine flu pandemic, it was the W.H.O. that sponsored the landmark agreement to pave the way for virus sharing and access to affordable vaccines for Indonesia and the rest of the developing world. Like it or not, the W.H.O. is still the chief reference body for support in handling global health threats. To paraphrase Voltaire: If the W.H.O. didn’t exist, it would be necessary to invent it.

Unfortunately, the W.H.O. is underfunded and overstretched, limiting its ability to respond effectively to health challenges. For the past two decades, the organization has seen zero nominal growth in contributions from its member states. The organization has to rely on voluntary contributions. Today, 75 percent of its funding is from voluntary contributions, which are usually set aside for specific diseases, sectors or regions. The lack of predictable, flexible and sustainable funding has seriously compromised its ability to fulfill its core functions. For example, a mere 3 percent of its 2012-13 budget is for addressing noncommunicable diseases…”

(Yanzhong Huang is a Senior Fellow for Global Health at the Council on Foreign Relations and associate professor at the John C. Whitehead School of Diplomacy and International Relations, Seton Hall University in New Jersey.)