Time to rally behind the World Health Organization

The unprecedented outbreak of the new coronavirus once again places the WHO at the centre of global public action for health.  Independent global health experts in countries around the world have highlighted the importance of the WHO in the response to this global public health crisis both in terms of transparency and timeliness of recommendations and decisions. This is no small feat given heavy critique of its handling of the Ebola Crisis in West Africa in 2014/15, the H1N1 Influenza Pandemic in 2009, and the SARS outbreak of 2003. It shows that this unique UN Organization has taken a big step forward in the performance as the coordinating agency in global health.

US President Donald Trump’s serious accusations, disgraceful campaigning and threats of withholding WHO funding can only be understood as a blame-game by a government that scapegoats others for its own lack of responsibility and failure to prevent and manage the crisis. We condemn this tirade against WHO as baseless and unacceptable, particularly in such a critical situation that requires solidarity.

We are of the opinion that governments, including that of the United States, should be more concerned with ensuring that all health workers and others on the frontline delivering services to the public at these trying times are provided with personal protective equipment. The worrisome state of the public health system in the United States has absolutely nothing to do with the phantom allegations now being raised against the WHO by the country’s president.

The WHO is not perfect, and its scientific, normative and policy-orientation functions need to be strengthened. Too often, geopolitical conflicts mute what should be a strong autonomous WHO denouncing failures of member states to follow its science based advice and recommendations. Since WHO relies on only “soft power” and diplomatic skills to bring member states to the table to share crucial information in epidemics and public health emergencies of international concern, cooperation is basically voluntary and unenforceable. The responsibilities and rights of national governments dealing with a public health emergency are outlined in the International Health Regulations (IHR, 2005). Once the pandemic is over, the IHR may need revision based on the experience and evaluation of how WHO and its member states handled the Covid-19 public health emergency.

It is high time all WHO member states acknowledge and support the immense value of the organization in comprehensively tackling the health challenges ahead of us due to climate change, and other threats, instead of using their own mistakes as an excuse to further weaken the organization’s leading role in safeguarding global health.

In 2017, during the election of a new WHO Director-General, the Geneva Global Health Hub (G2H2) facilitated the drafting and publication of a joint civil society message “The WHO we want and the leadership WHO needs”. We then stated the following:

The WHO we want

• Has a strong and credible leadership in global health, takes a human rights-based approach, and promotes comprehensive primary care;
• Is a leading voice for Health for All among international and multilateral actors and takes a bold pro-public health stand vis-à-vis potentially harmful actions pursued by other entities, such as in the field of Access to Essential Medicines and Intellectual Property Rights;
• Is well governed across the three levels of the organization, with clear and coherent processes of transversal interaction across relevant departments on specific topics, and with rigorous procedural transparency;
• Sets priorities and decides on strategy implementation from a global public health perspective, rather than being guided by individual donor interests and priorities.
• Reinvigorates Member States’ protagonism and commitment to public health, including by providing sufficient non-earmarked contributions and adequately protecting the organization from the influence of private interests;
• Has the capacity to play its fundamental norm setting role by harnessing solid scientific and biomedical research and providing sound guidance to Member States in detecting potential health risks, using contextually effective tools and strategies;
• Affirms the relevance of its status as the world’s highest health authority and policy setting body, using this unique prerogative through its resolutions and binding instruments to fulfil Article 19 of its Constitution. WHO must be prepared to support governments to implement key WHO decisions and priorities as binding legislation, and, where necessary, to stipulate that certain standards must prevail over trade rules or other commercial/financial interests;
• Recognizes and embraces public-interest civil society organizations, recognizing the value of their role in fulfilling Article 1 of its Constitution (the “attainment by all peoples of the highest possible level of health”) in their interaction with Member States at various levels.

This is all still valid, the same as our statement about “the leadership WHO needs” in the same document. Since the election of Dr Tedros, the members of G2H2 and other public interest civil society organizations have critically followed and commented on the work of the new WHO leadership. We have fully supported WHO as the people’s international health authority, and equally strongly criticized WHO when needed. And we will continue to do so.

Today, with the Coronavirus crisis in full swing, and seeing the WHO and its staff at all levels taking the lead in the global public health response in an absolutely dedicated and credible way, our message to civil society colleagues, to the global public health community and to all political leaders is a simple one:

This is the time to insist on multilateralism, solidarity, and science based health policy making at global and national level. This is the time to rally behind WHO.

Geneva, 9 April 2020
Members of the Geneva Global Health Hub
and some civil society colleagues