World Health Organization Director General Margaret Chan today made a strident pitch to WHO member governments to invest in the well-known United Nations agency, citing several unique and essential aspects of the organisation. The WHO Executive Board is meeting this week to address major reform of the WHO, in part due to a severe funding shortage but reaching into the broader question of its place in the global public health spectrum.

“First, as I have been told repeatedly by ministers of health, as I have seen with my own eyes, WHO has staying power,” Chan said in remarks delivered today. “The developing world is littered with the debris of short-lived projects. But not from this organisation, not from your WHO.”

“Second, WHO has respect. Our name carries clout,” she said. “The world’s top scientific, medical and health experts give us their time and their wisdom with pride. The WHO logo on a technical document is a stamp of trustworthy authority. If we publish a treatment guideline, countries can introduce this guidance with confidence.”

“Third,” said Chan, “we fight for prevention, and this includes population-wide prevention, and we fight for equity, across the board, because this is the right thing to do. Prevention is the heart of public health. But equity is its soul.”

Chan went further in declaring the critical independent nature of the WHO. “In the interest of safeguarding public health, we are not afraid to speak out against entities that are far richer, more powerful, and better connected politically than health will ever be. In addition, we need to maintain vigilance against any real or perceived conflicts of interest. We will speak out to make sure that developing countries, and health, get a square deal in international negotiations.”

“Finally, our functions, taken in their entirety, are genuinely unique,” she said. “The world needs a global health guardian, a custodian of values, a protector and defender of health, including the right to health.”

The WHO Executive Board is meeting in a special session from 1-3 November to address organisational reform, as called for by the annual World Health Assembly in May (IPW, WHO, 24 May 2011).

The Executive Board is discussing a report entitled, “WHO Reforms for a Healthy Future” [pdf] that Chan sent to member states on 15 October.

Chan’s plea was made to the Board as it conducts its review. The secretariat presented an overview of the three components of the review including programmatic priorities, governance and managerial reform. Executive Board delegates will detail proposals in the three areas as well as WHO plans moving forward.

At a 27 October press conference, the organisation’s Director of Strategy, Andrew Cassels, provided some insight into the need for reform. He explained that although its financial crisis is a big part of the issue – with member state contributions dropping and expenditures rising – it is not whole picture. “The idea of reform, making WHO fit for purpose for the 21st century, was well underway, the financial issue has made it more urgent,” he said. “It hasn’t provided the primary rationale.”

He said the world is a very different place since the organisation’s founding in 1948, with new health challenges and a new, more crowded, global health environment. In this context, he said there is a real need for the WHO to focus on its strengths and priorities, and to clearly define how it fits in today’s global health landscape.

Brazil Lends its View

Brazil, in its statement to the meeting today, posted by Knowledge Ecology International here, offered strong support for the continued leadership of the WHO, and had several suggestions for ways the WHO could improve.

Brazil raised concern that most of WHO’s funds are voluntary contributions, and that these are usually earmarked for specific projects. It said WHO members “should make a collective effort to change the perception that this is a donor-driven organization. WHO cannot and should never act as a rubber-stamping agency for national projects.”

Brazil also was critical of WHO’s cutting of programmes for budgetary reasons without consultation with member states, noting that the reform process could examine such decisions.