We Need an International Health Organisation That’s Fit for Purpose – Unlike the WHO!
As humans we commonly consider ourselves, our beliefs and our work of particular importance. It is not surprising, then, that when we form institutions, those within them seek to promote the institution’s relevance, expand their work and centralise decision-making within their own ‘particularly important’ group. Few want to divest power and resources, let alone put themselves and their colleagues out of a job. This fatal flaw infects all bureaucracies, from local through national and regional to international.
It is unsurprising then that the World Health Organisation (WHO), an international health bureaucracy of over 9,000 staff, a quarter of them in Geneva, should suffer the same problems. The WHO was originally intended primarily to transfer capacity to struggling states emerging from colonialism and address their higher burdens of disease but lower administrative and financial capabilities. This prioritised fundamentals like sanitation, good nutrition and competent health services that had brought long life to people of wealthier countries. Its focus now is more on stocking shelves with manufactured commodities. Its budget, staffing and remit expand as actual country need and infectious disease mortality decline.
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