Think Tanks et al
Council on Foreign Relations
Accessed 3 June 2017
A Change of Guard at the WHO
Expert Brief by Laurie Garrett
| 25 May 2017
With the United States likely to pull back on global health funding, the World Health Organization, under its new director-general, will need to undertake serious structural and administrative changes.
GENEVA—For the first time in its seventy-year history, the World Health Organization (WHO) will, effective July 1, be led by a non-physician, an African, and a person from the global South. Tedros Adhanom Ghebreyesus of Ethiopia campaigned in an unprecedented election that gave 186 nations equal voice and saw three globetrotting candidates plead their cases. In the past, the director-general of the WHO was selected in a secretive and elite process by the thirty-four members of its executive committee. This year, the entire World Health Assembly voted in three rounds of written, secret ballots; Tedros, as he prefers to be called, emerged victorious on May 23 carrying two-thirds of the votes.
Tedros has a PhD in community health and has served as his nation’s minister of health and of foreign affairs, as well as a central committee member of the ruling Ethiopian People’s Revolutionary Democratic Front party…
The Polio Paradox
According to documents released by the WHO [PDF], the agency has long been using polio money for everything from salaries throughout its own infrastructure to literally funding the entire health budgets of some desperate countries, such as the Democratic Republic of Congo (DRC). Salaries for about one out of every seven of the WHO’s seven-thousand-strong workforce come from polio funds. A whopping 74 percent of all salaried WHO employees in its Africa region are salaried thru polio funds, regardless of what they actually work on. According to a WHO document released to Assembly states, the WHO has used polio funds to pay for half of all government health staff in Angola, Chad, the DRC, Nigeria, Pakistan, and even countries that have been certified free of polio for more than a decade. Moreover, polio eradication infrastructure has been used this year to stop outbreaks of yellow fever, cholera, and meningitis, to supply lifesaving Vitamin A to kids all over the world, and even to combat cancer and heart disease in poor countries. The polio infrastructure has, since 1988, become the bedrock of the WHO. If it disappears, the future of the organization is quite uncertain.
Tedros will proudly take over the reins of the WHO in July 2017, but within two years, unless he proves to be a maestro of fundraising, he will witness a house of cards fall. Polio eradication funds and, consequently, the salaries of one-seventh of its employees will dry up; everything from maternal mortality and cervical cancer screening programs will collapse. The effort most closely allied with polio eradication, the Expanded Program of Immunization (EPI), is already appearing to weaken as countries, confident that polio will soon disappear, are becoming lax in their support for vaccine programs more generally. In Africa, more than 90 percent of EPI funding comes from the polio program; take polio away and, in theory, children across the region could stop getting every type of immunization. The main vaccination organization, the Global Alliance of Vaccinators and Immunizers (GAVI), warned the Assembly that a ripple effect is already being felt across the full range of child immunization and health programs as rates of vaccination decline…
If the U.S. government retreats from funding global health, as the president’s proposed budget indicates, and the Gates Foundation cannot step in to plug the breach, pressure will mount on the G20, the private sector, and many of the world’s top charities. Without their support, the WHO, under its first African leader, could face an existential threat.