O n this World Health Day, April 7, the World Health Organization celebrates its 70th anniversary.
Achieved some notable achievements such as efforts to eradicate diseases such as smallpox, a convention on tobacco control and a framework to prevent influenza pandemics. In addition to this, work is coordinated on global standards and guidelines for essential medicines, diagnostics, treatment and health workers.
This year's World Health Day will focus on one of the fundamental principles of WHO: "The enjoyment of the highest possible level of health is one of the fundamental rights of every human being without distinction of race, religion , political belief, economic or social condition ".
This language and the creation of the World Health Organization on April 7, 1948 reflect the postwar times. The leaders, galvanized by the devastation of the years of conflict, were open to building societies again, incorporating basic values such as the right to health.
That same year, the UN adopted the Universal Declaration of Human Rights and the United Kingdom established a National Health Service to meet the needs of its population regardless of income or social access, and the country has reaped the social benefits and economic since then.
Since then, the membership of WHO has tripled to 194 Member States, with the developing countries now in the majority. The organization depends on the interest of states to work together for the common good, prevent infectious diseases such as border crossing, for example, or face common risks such as drug resistance. But great inequalities persist in the provision of health between the richest and the poorest countries. While Europe and America could prioritize health security, for many developing countries, providing fairer access to quality health care must come first.
The challenge of increasing drug resistance highlights the complexity of WHO's role. The organization warned that there are very few antibiotics in preparation to cope with the increase in infections that are not very treatable. While research and development play a role, controlling access to antibiotics is also vital. In the poorest states, health systems are not always available to facilitate that, if the majority of their population does not have reliable access to a doctor or a qualified nurse to prescribe, and therefore would be at risk of dying from an infection due to lack of signature, how can these restrictions be enforced?
The election last year of Dr. Tedros Adhanom Ghebreyesus Ethiopia as WHO Director-General is part of the slow shift towards greater representation for developing countries. Tedros has a very fine line to walk during his five-year term if he wants to maintain the confidence of donors to raise basic funds and maintain the independence of the organization, while fulfilling the founding objectives of the WHO.
The richest countries still use their financial influence. Only 20% of WHO activity is non-conditional basic funding of the Member States. The remaining 80%, a combination of government financing, philanthropy and the private sector, is money earmarked for specific projects. Without major contributions from member states, this seems to be the reality of WHO.
The field of global health has become a more crowded place. The World Bank secured significant funds at the time of the wrong structural adjustment that defends user fees and, therefore, was able to sweeten the councils with loans and donations. More recently, the arrival of the stricter competencies and the more agile decision of the Global Fund (to fight against AIDS, tuberculosis and malaria) and the Gavi vaccine alliance have also attracted significant funds.
The appointment of a health professional, Jim Yong Kim, as president of the World Bank, with invaluable experience in health care in resource-limited settings, was encouraging. However, the Bank can do more. There is an inherent contradiction if another part of the organization advises investing in countries with low tax regimes when it has been demonstrated that public finances are key to the provision of sustainable health services.
Growth will not bring prosperity to countries without guaranteeing the nucleus of citizens health needs are met; Health has a great impact on economic and social development. An international body such as WHO can not provide universal access alone, but must convince national governments to invest in health.
Former Director General, Margaret Chan, found a way to get member states to cooperate again, but as the Ebola crisis demonstrated. some tensions still need to be addressed. Tedros has a diplomatic loose rope to walk. Despite an initial mistake about Mugabe's appointment, there is still goodwill for his term and he will have to deploy all his political skills to ensure that the next 70 years bring us closer to accessing health for all.
Despite all its imperfections, WHO still has a vital role. We need your convening power as much as we did in 1948. Their failures reflect our current global inequality in health and its challenges the policy of correcting this.