Via Stat, Helen Branswell writes: World Health Organization should be overhauled, panel urges. Excerpt:
Quick action will be critical to reforming the WHO, outside experts watching the process said. Effecting change is difficult and if reform is to flow from the aftermath of the Ebola crisis, the WHO will need to move swiftly to embrace a few key recommendations that can be pushed through, suggested Dr. Jeremy Farrar, director of the Wellcome Trust, a British charity that funds biomedical research.
Infectious diseases expert Michael Osterholm concurred. Osterholm, who heads the University of Minnesota’s Center for Infectious Diseases Research and Policy, said the momentum for reform will stall if the various groups critiquing the Ebola response draw up long wish lists. “There can’t be a list of 110 recommendations,” he said flatly.
This panel issued 10, though several were made up of multiple parts. A number were aimed at strengthening the WHO’s emergency response capacity. While the panel demurred from advising the WHO on what programs it should cut, it did state firmly that responding to global health crises is one of the reasons the agency exists.
Dr. Peter Piot, one of the panel’s cochairs and director of the London School of Hygiene and Tropical Medicine, said the head of the proposed center for emergency preparedness and response should report directly to the WHO director general and should be shielded from political pressure.
The panel said countries that report disease outbreaks promptly should be publicly praised. Those that hold back information that puts the world at risk should be “named and shamed,” Piot said.
The report also advises the WHO to publicly criticize countries that impose unwarranted trade and travel restrictions during outbreaks; the fear of those kinds of reprisals encourages affected countries to hide rather than disclose.
The report does not directly criticize Chan, who declared Ebola a global emergency two months after Doctors Without Borders warned the situation was out of control. Three members of the panel interviewed by STAT sidestepped the question of whether the report’s multiple references to the need for a strong WHO leader was an indictment of the current director general. They said the panel wanted to look forward, not back.
“Member states should insist on a director general with the character and capacity to challenge even the most powerful governments when necessary to protect public health,” the panel wrote. Internal emails obtained by the Associated Press suggested that the WHO was reluctant to declare the outbreak an emergency, fearing it would antagonize the affected countries.
The WHO knows it bears the brunt of the criticism for the inadequate Ebola response. Chan has acknowledged the agency was overwhelmed and said at its annual general meeting in May that the outbreak shook the WHO to its core.
“I have heard what the world expects from WHO,” Chan said in her speech opening the World Health Assembly. “As director general of WHO, I am committed to building an organization with the culture, systems, and resources to lead the response to outbreaks and other health emergencies.”
Chan’s second and final term ends on June 30, 2017, and would-be successors are likely already positioning themselves. Whether WHO member states will want an assertive and proactive director general remains to be seen, though recent history provides some cause for doubt.
Dr. Gro Harlem Brundtland headed the WHO during the 2003 SARS crisis. A former Norwegian prime minister, Brundtland made tough calls; under her, the WHO warned against unnecessary travel to China, Toronto, and other SARS-affected locations. The travel advisories were loathed by the countries named and won Brundtland no friends in their capitals. That tool has never been used since.