The WHO We Need for the Next Pandemic
Governance

The WHO We Need for the Next Pandemic

The World Health Organization should be more independent, collaborate with NGOs, and increase emphasis on human rights

Picture shows the girl's shadow on an old wall.
The shadow of a girl receiving an evening meal from a humanitarian service center is cast on a wall in front of her family home in Russeifa, Jordan, April 28, 2020, during the coronavirus pandemic. REUTERS/Muhammad Hamed

The COVID-19 pandemic has exposed how vastly underprepared countries are to address public health emergencies. It has also highlighted the need for better global health coordination and leadership. This can, and should, be achieved by supporting a stronger World Health Organization (WHO). But it also requires the WHO to change—to become a more robust, effective organization. This means that the WHO should increase its independence, its partnerships with civil society organizations, and its focus on human rights.

$5 Billion

The 2020–21 WHO budget is just under $5 billion ($4.8 bn), a figure that compares to the budget of a large hospital

The COVID-19 pandemic illustrates the critical role that the WHO plays in issuing technical guidance on new disease threats, as well as coordinating country responses. Strong guidance and country assistance are key to building resilient health systems. But too often, the WHO lacks the core funding and support needed for its technical and programmatic work. The 202021 WHO budget is $4.8 billion, a figure that has been compared to the budget of a large U.S. hospital. Most of that budget is non-discretionary and earmarked for specific activities, requiring WHO to make special calls during emergencies for countries to contribute additional funds. That is a lot harder to do in the face of a global pandemic and a resulting global economic slowdown.

The photo shows several health workers in protective gear.
Health workers participate in an event supporting the National Health Service at a hospital in Liverpool, England, on May 7, 2020. The WHO budget is often compared to the budget of a large hospital. REUTERS/Phil Noble

Beyond funding challenges, though, the WHO needs to become less constrained by its member states, which limit its independence and ability to speak and act forcefully to advance its mission of protecting and promoting the right to the health for all. Building stronger partnerships with independent organizations and human rights activists should be central to its new organization. The WHO should recognize the critically important role independent organizations play in identifying public health threats and exposing how governments are, or are not, effectively responding to pandemics.

‘The WHO needs to become less constrained by its “member states,” which limit its independence and ability to speak and act forcefully’

Lessons learned from the 201316 Ebola outbreak in West Africa demonstrate the centrality of community engagement and partnership to effective response—for example, to local traditions as basic as burial practices—and to call on local expertise for public health monitoring. Journalists and human rights organizations highlighted when quarantines were poorly implemented and how corruption undermined control efforts. Mobilizing and developing partnerships with community groups and making use of local expertise is also essential for establishing trust within communities to effectively tailor the WHO’s response to a health emergency.  Moreover, the work of civil society organizations strengthens technical knowledge about health issues, as has been seen with the development of HIV/AIDS programs.

The picture shows a charred kapok tree, home to hundreds of bats that may have been hosting the deadly virus.
Etienne Ouamouno, father of Ebola patient zero, stands by the kapok tree where scientists say his two-year-old son might have contracted Ebola from bats in Meliandou, Guinea, on February 4, 2015. REUTERS/Misha Hussain

Nongovernmental organizations (NGOs) can provide complementary information and insights about emerging public health issues. They do so by working closely with communities or operating outside of the political channels that can block notice of disease outbreaks. For instance, the Program for Monitoring Emerging Diseases (ProMED), a website that crowdsources information from public health and medical experts, has consistently been the first to report disease outbreaks, including Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and most recently, COVID-19.

During the cholera outbreak in Haiti, the International Federation of the Red Cross and Red Crescent Societies used a community-based monitoring system to detect outbreaks in rural Haiti. This showed that not only could communities successfully conduct disease monitoring, but that this system detected disease in areas overlooked by formal surveillance.

The photo shows a young child sitting up on a cot inside a tent with several other cots and people moving among them.
An infant at a cholera treatment center in Carrefour, outside Port-au-Prince, Haiti, on June 6, 2011. During the outbreak, community-based monitoring was effective at detecting cases in rural Haiti. REUTERS/Swoan Parker

Alongside stronger partnerships, there is an urgent need for the WHO to increase its commitment to human rights. In response to the COVID-19 pandemic, the world has seen medical professionals, scientists, and journalists silenced or censured for speaking out. It has also seen the overly broad and excessive use of laws and law enforcement practices, in alleged efforts to control the epidemic.

Religious, racial and ethnic minorities, indigenous people, and people of Asian descent have been attacked, while other groups, including people with disabilities and refugees and migrants, have often been excluded from prevention campaigns and access to care. The WHO needs to work more closely with human rights organizations to counter these predictable and counterproductive actions—and to bolster the WHO’s resolve to confront governments that allow or condone them.

‘Ensuring the right to the highest attainable standard of health for all is protected and fulfilled’

Right now, all efforts should focus on addressing the current crisis. But soon there will be discussions, and choices, about preventing future pandemics. In this new era, the global health sector needs to broaden its traditional lens of disease monitoring and technical capacity building to embrace and support a focus on human rights. Health agencies should work in close collaboration with the civil society organizations that have crucial roles in community response to an outbreak and in recovery. Pandemic preparedness requires a well-resourced WHO that is strengthened by partnerships with a broad range of organizations united to see that the WHO’s mandate, ensuring the right to the highest attainable standard of health for all, is protected and fulfilled.

The picture shows a small girl climbing up a brightly colored metal container.
Health standards should extend to everyone, everywhere. An internally displaced Afghan girl plays outside her shelter, amid the spread of coronavirus in Kabul, Afghanistan, on May 7, 2020. REUTERS/Mohammad Ismail

Nina Sun is the Deputy Director of the Jonathan Mann Global Health and Human Rights Initiative at the Drexel University Dornsife School of Public Health. 


Joe Amon is a Clinical Professor and the Director of the Office of Global Health at the Drexel University Dornsife School of Public Health.

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