WHO’s Chan Outlines New Response Capabilities

World Health Organization (WHO) Director-General Margaret Chan outlined Monday a series of measures aimed at improving the organization’s ability to respond to health emergencies. While WHO has been involved in a lengthy reform agenda over several years, the Ebola outbreak highlighted the organization’s shortfalls, particularly in the areas of rapid reaction, accountability, and communications, and at all levels. Its ability to quickly transform itself into a more nimble, action oriented agency capable of identifying health emergencies and coordinating an effective response will be critical to securing public support for WHO in the coming years.

The reforms were fueled in part by criticisms leveled by an independent panel convened to assess the organization’s reaction to the Ebola epidemic. The panel’s preliminary report was presented at the World Health Assembly May 19 and a final version is due in July. The group of international experts said WHO’s emergency capacities were weak and lacked effective coordination with other potential responders. In addition to restructuring at WHO, they called for greater member state investment in the organization.

Change is definitely needed. Many at the WHA expressed concern over the response and the organization’s future. In discussions on WHO’s broader reform efforts, country representatives called for stronger, more accountable WHO country offices, better coordination among the various levels of WHO, and “corporate management” structures.  With the complexity of the world’s health situation, WHO is more important than ever, but the Ebola response has led some to lose faith in the organization, a representative from Germany said. He added that the WHO’s future will be decided in next two years depending on how it adapts to recent lessons learned. Jimmy Kolker, U.S. Department of Health and Human Services Assistant Secretary for Global Affairs, noted that while there have been some advancements in the organization under reform efforts, “giant steps” still are needed to make WHO more effective.

The initiatives outlined in Chan’s opening remarks at the WHA focused on response capabilities she says she plans to have in place by the end of the year. They include formation of a single new program for health emergencies that would unite all outbreak and response resources from the country, regional, and global level, reporting to her. “The new program is designed for speed, flexibility, and rapid impact,” Chan said. Among goals of the initiative is strengthening national response capacity and improving coordination among other responders including UN agencies, the International Federation of Red Cross and Red Crescent Societies, and Doctors without Borders.

In addition, the program would coordinate a new global health emergency workforce. Chan also proposes adding logisticians, medical anthropologists, and experts in risk communication to her emergency staff. The program would be held to clear performance measures and guided by new business processes. To support the changes, Chan is requesting a new $100 million contingency fund.

“I do not ever again want to see this organization faced with a situation it is not prepared, staffed, funded, or administratively set up to manage,” Chan said. Several of the proposals require WHA approval and will be considered as part of a decision document on the Ebola outbreak now being drafted and expected to be considered by the full assembly Monday.

Despite concerns about the organization, WHA participants emphasized WHO’s importance. Lancet editor Richard Horton called WHO the preeminent institution for promotion of international cooperation in health and called on the global health community to rally around the organization. In her speech before the assembly, German Chancellor Angela Merkel said, “WHO is the only international organization that has universal political legitimacy on global health.”

The world expects a lot from the World Health Organization and recently, it hasn’t delivered. The next few months will tell whether countries and WHO officials are willing to provide the resources and make the changes necessary so that it can be the organization the world needs it to be.