Last week, the World Health Organization’s Executive Board met in Geneva to set the year’s agenda for global health.
As the United Nations agency responsible for global health, the WHO has a full in-tray.
The current crisis with the Chinese coronavirus, coming on the back of recent outbreaks of Ebola and Zika, shows that new and deadly diseases can emerge without warning and that global coordination is key. Work needs to be done to tackle the looming crisis of drug resistant bacteria that stand to makes today’s antibiotics ineffective. And too few people have access to basic healthcare, despite significant increases in global prosperity.
With its technical expertise and global mandate, the WHO is central to solving these problems. But it has limited resources. At around $450 million, its annual core budget is like that of large hospital in a developed country. It should therefore focus on the few areas where it has unique expertise and influence — tackling transnational diseases, preparing for international pandemics and advising countries on healthcare reform.
WHO’s leader, Dr Tedros Adhanom Ghebreyesus, deserves credit for increasing spending on health emergencies since his election in 2017. This makes the world better prepared to deal with the current outbreak as it evolves.
But WHO continues to spread itself too thinly, involving itself in dozens of peripheral areas, many of which are best left to national or local governments.
Alongside tropical diseases and immunisation, WHO busies itself publishing recommendations on subjects ranging from traffic safety, prison violence to school health and sunburn.
It is this piecemeal approach that undermines the WHO, according to Jeremy Farrar, director of the UK-based global health research charity the Welcome Trust.
“It's so thinly stretched,” he told Reuters. “There's arguably no organisation on earth that could cover all those (topics) at sufficient depth to be authoritative.”
At its executive board meeting, the agenda covers global health staples such as pandemic preparedness and increasing access to vaccines. As it should.
However, the board will also be distracted by discussions on how to weaken the intellectual property (IP) rights that drive discovery of new health technologies. Some within the WHO believe that diluting patent rights will make medicines cheaper to the benefit of all.
The WHO should not waste its valuable time and resources on this topic. The vast majority of treatments prescribed in both developing are off-patent and therefore unaffected by IP rules. Yet far too many still do not have reliable access to them.
The reasons why have been long known, and they have little to do with IP.
According to WHO, the world is currently short of 7.2 million healthcare workers, rising to 12.9 million by 2035. Thanks to a lack of healthcare insurance, 150 million people each year suffer financial catastrophe due to paying for healthcare directly themselves.
Philip Stevens is director of Geneva Network, a UK-based research organisation working on innovation, development and trade policy issues