Is the WHO over-extended?
Following the advent of highly pathogenic avian influenza in Asia during the early 2000s, the World Health Organization emerged as the lead agency in the attempted eradication and control of the infection. Based on the dire predictions of an imminent human influenza pandemic, WHO “experts” first mandated an eradication policy. When this proved ineffective, the advisors to national governments accepted the inevitability of endemnicity with control by biosecurity and vaccination.
The WHO along with some other agencies was instrumental in obtaining (read “extorting”) large sums from donor nations including the U.S. to mount programs for the diagnosis, control and research on influenza. Although considerable progress has been made in the molecular biology of influenza and novel immunogens, vast stockpiles of vaccines and antiviral drugs which were amassed have since been destroyed following their expiration.
In a critical evaluation of her Agency, the WHO Director General Dr. Margaret Chen has called for a reevaluation of objectives and priorities since the organization is obviously over extended. Chen has highlighted fiscal excesses including high administrative costs and the need to concentrate on initiatives to combat tuberculosis and malaria as well as the ongoing campaign against AIDS. It is evident that there is considerable duplication of WHO functions with private charities, foundations, donor governments and NGOs participating in programs to combat disease.
Change in attitude
An experienced physician and epidemiologist responsible for combating H1N1 influenza and SARS outbreaks in Hong Kong, Dr. Chen has advanced a radical departure from WHO traditions to focus on health problems where she considers that the Agency has a chance of making an impact. It is evident that she is attempting to engineer a complete overhaul of the culture of the WHO, although as a diplomat she must take into account the views of member states. This is exemplified in her statement “in some areas, our engagement should be that of a watchdog.”
The change in attitude is in part influenced by the global financial crisis, which has limited resources and donations creating an environment in which expediency and practicality should prevail.
The bottom line is that the WHO may retract its horns and become less involved in zoonotic diseases to concentrate on infections of human populations where the WHO can effect improvements. This will allow the OIE (World Organization for Animal Health) to emerge from the shadow of the WHO and become more influential in the control and eradication of livestock and poultry diseases.