Need For WHO Reforms

In News

• Recently, while addressing the heads of countries at the second global COVID-19 summit, the Indian PM once again brought up the issue of reforming the World Health Organisation.
  • First Global COVID virtual Summit hosted by President Biden in 2021.

World Health Organisation (WHO)

• It is a specialised agency of the United Nations with a mandate to act as a coordinating authority on international health issues.
• It was founded in 1948 and has headquarters at Geneva, Switzerland. 
• It has 194 Member States, 150 country offices, six regional offices.
• It works in collaboration with its member states usually through the Ministries of Health.

India’s Role in Fighting Pandemic

• India adopted a people centric strategy to combat the pandemic and has made the highest ever allocation for its health budget this year.
• India was running the largest vaccination campaign in the world and had vaccinated close to ninety percent of its adult population and more than fifty million children.
• India is working to extend its genomic surveillance consortium. 
• India has used traditional medicine extensively and has laid the foundation for a WHO Centre for Traditional Medicine in India to make this knowledge available to the world.
• India would continue to play an active role by sharing its low cost indigenous COVID mitigation technologies, vaccines and therapeutics with other countries.

Need for WHO Reforms

• Lack of funding: Any attempt to build a stronger WHO must first begin with increased mandatory funding by member states.
  • For several years, the mandatory contribution has accounted for less than a fourth of the total budget, thus reducing the level of predictability in WHO’s responses; the bulk of the funding is through voluntary contribution.
• Providing more powers: It is time to provide the agency with more powers to demand that member states comply with the norms and to alert WHO in case of disease outbreaks that could cause global harm.
• Lack of information sharing: The long delay and the reluctance of China to readily and quickly share vital information regarding the novel coronavirus, including the viral outbreak in Wuhan.
• Member states do not face penalties for non-compliance: This has to change for any meaningful protection from future disease outbreaks.
• Vaccine approval: Demand for a review of the health agency’s processes on vaccine approvals is a long time pending issue.  
  • The demand for a review of the vaccine approval process is based on the assumption that the emergency use listing (EUL) of COVAXIN was intentionally delayed by the health agency, which has no basis.

India submits 9-point plan for WHO reforms

• International Health Regulations (IHR) Emergency Committee: the current decision-making mechanism of the WHO largely relies on the recommendation of the International Health Regulations (IHR) Emergency Committee.
  • It has called for strengthening the Public Health Emergency of International Concern (PHEIC) declaration process to enable the WHO Director-General to declare a global public health emergency without the need for overarching consensus among the IHR Emergency Committee but just a broad agreement.
• Extra-budgetary contributions: The proposal also notes that the Programmatic Activities of the WHO are currently funded by earmarked voluntary extra-budgetary contributions.
  • It calls for the unearmarking of these voluntary contributions reasoning that this would provide greater flexibility across financing enabling the WHO to use these sums where they are most required.
• It also calls for expanding the WHO’s regular budget to allow the body to cater to its core activities thereby relieving the added burden on developing nations.
• Solidarity Response Fund or the Foundation and Strategic Preparedness Response Plan (SPRP): The government has also acknowledged the lack of transparency within the funding mechanism of the WHO, advocating for strong and robust financial accountability frameworks that will enable maintaining integrity in financial flows.
  • SPRP are monitored at a micro level while calling for a quarterly review of the WHO’s activities by member states.
• It has recommended increased support from the medical body to improve technical and core competencies in each country so as to facilitate broad uniformity in country responses.
  • Noting that member states have a self-reporting obligation under the IHR 2005, it has cautioned that since the public health infrastructure in many developing countries remains under-developed, a complete implementation of the IHR may be unrealistic.
• Independent Oversight and Advisory Committee (IOAC): The proposal has criticised the policy making framework of the WHO that currently sees the World Health Assembly and Executive Board play only a peripheral role.
  • Citing the rising risk of outbreaks like the one we are currently witnessing, it advocates for the constitution of a Standing Committee of the Executive Board to supervise member states’ implementation of the WHO’s recommendations.
  • It also recommends expanding the role of the Independent Oversight and Advisory Committee (IOAC) and greater representation from developing nations with high disease burdens.
• The proposal also champions the fair and equitable access to vaccines and diagnostic tools acknowledging the growing wave of vaccine nationalism taking place. It warns that with several larger countries striking bilateral deals with vaccine manufacturers, developing countries may be greatly disadvantaged in the race to rid the world of the COVID-19 virus.
• Pan world surveillance: It has also called for the enhancement of capacities of countries in preparation for and response to infectious diseases of pandemic potential, noting that there was a need to set up “pan world surveillance” by leveraging the latest technology.
• Hosted Partnerships: The proposal recommends improving pandemic prevention, preparedness and response through the development of Hosted Partnerships that enable developing nations to leverage the technical and academic expertise of other member states. 

Way Forward/ Suggestions

• Under the legally binding international health regulations, member states are expected to have in place core capacities to identify, report and respond to public health emergencies.
• The timeline for granting a EUL for a vaccine depends 99% on manufacturers, the speed, and the completeness of the data.
• Build global solidarity for worldwide health security: WHO will work with countries to improve their own preparedness for pandemics and health emergencies. But for this to be effective, we will ensure that countries work together.
• Advance health for all: WHO will work across all three levels of the Organisation and with partners worldwide to help countries strengthen systems so that they can respond to COVID-19 and deliver all the essential health services required to keep people of all ages healthy close to home and without falling into poverty.
• Tackling health inequities: The COVID-19 pandemic has drawn attention to the deep disparities that persist between and within countries, some of which are being exacerbated and risk widening even further. 
• Provide global leadership on science and data: WHO will monitor and evaluate the latest scientific developments around COVID-19 and beyond, identifying opportunities to harness those advances to improve global health.
• Revitalise efforts to tackle communicable diseases: WHO and partners have worked resolutely to end the scourge of polio, HIV, tuberculosis and malaria, and to avert epidemics of diseases like measles and yellow fever.
• Build back better: Manifesto for a Healthy Recovery from COVID-19, with its goals of addressing climate change and health, reducing air pollution and improving air quality, can play a major role in making this happen.

Source: TH