Bloated and bureaucratic, the institution has lost its way
The World Health Organization turns 75 today, on World Health Day. It’s a good opportunity to do a health check on an organisation which has had a catastrophic pandemic — and which, like many 75-year-olds, finds that its gilded youth is at risk of turning corrupt in its old age.
WHO’s failings in the pandemic are vast. A brief summary would include: recommending that all nations follow a lockdown model in February 2020, when its own report on pandemic mitigations from three months earlier had not mentioned the word lockdown once; ignoring studies on previous lockdown trials during the Ebola outbreak in West Africa, which concluded that they had failed; appointing Peter Daszak, with strong commercial and research ties to the Wuhan Institute of Virology, as American representative in its initial investigation into the origins of Covid-19; using advertising material from pharmaceutical giant Merck in a campaign in India against low-cost treatments, when Merck had its own alternative treatment Molnupiravir about to receive a $1.2 billion contract from the US government; and attempting to redefine core concepts such as “herd immunity”.
The last three items on the list underline what is wrong with WHO today. Conflicts of interest grounded in corporate profit have sucked the life out of the old internationalist organisation. While WHO was originally funded primarily by nation states, private contributions now comprise 80% of funding. Donations from the Bill and Melinda Gates Foundation, for instance, now nearly match those of the American government. This has major policy implications, with the previous W.H.O. Director-General Margaret Chan complaining about the role of private interests in directing strategy.
All this is anathema to WHO’s founding principles. These enshrined a bottom-up community healthcare model, defining health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Yet WHO is now embarked on a mission of transnational governance – built around new pandemic treaties imposing unilateral responses, and a rewriting of the international health regulations.
It’s no coincidence that the retreat from the community-led healthcare model into top-down transnational global health governance has coincided with this shift in funding. Expanding corporate funding further will also expand the harmful global health model which saw WHO rolling out policies destroying the lives and livelihoods of poor people around the world.
But that also makes it clear what WHO must do. Like many 75-year-olds, it needs to become leaner. This involves recognising that the people best equipped to make decisions about their healthcare are not well-paid public health officials in Geneva and New York — but the communities who are affected themselves. Empowering communities again, all around the world, must become WHO’s mission if it is to redeem itself.