Chan: WHO Embarking On “Most Extensive” Reforms In Its History

World Health Organization Director General Margaret Chan today presented her broad vision of a reformed WHO at the opening of the annual assembly of the organisation, and said the WHO was clear of suspicion of alleged pharmaceutical industry influence on the management of the H1N1 pandemic.

The World Health Assembly (WHA) meeting from 16-24 May will address diverse health-related issues, such as the future financing of the organisation, pandemic influenza preparedness, AIDS, fake medicines, communicable and noncommunicable disease, and reforms of the organisation.

Chan said the WHO is facing financial difficulties, and having to cut back on “some of our traditional areas of work,” but, she said, “We are most definitely not bankrupt.”

However, times have changed, she said. “When WHO was dealing mainly with germs, hygiene, medicines, vaccines and sister sectors, like water supply and sanitation, our job was much more straightforward. But that job has changed, gradually over time and then dramatically within the past decade,” she said, making reform essential.

WHO is “embarking on the most extensive administrative, managerial, and financial reforms, especially financial accountability, in its 63-year history,” she said.

“I have a vision,” Chan said, “of a WHO that gives a bigger voice to the many partners working on health, but encourages them to speak with a coherent voice that responds, first and foremost, to the needs and priorities as defined by recipient countries.”

“On this journey of reaffirmation, remembrance, reform and revitalisation,” that Chan called on countries to join, Chan said her vision included “a WHO that pursues excellence,” an efficient, responsive, objective, transparent and accountable organisation. She also called for effective development aid that builds capacities for countries. “Countries want a hand up, not a hand-out,” she said.

Chan’s vision is laid out in her report on the future of financing for WHO [pdf].

Chan’s opening speech was punctuated with the chorus phrase “remember the people,” as she commended advances in vaccines and in the improved accessibility of treatments in developing countries, such as a vaccine preventing meningitis in Africa. The vaccine, she said, was coordinated by WHO and PATH, a non-profit organisation, funded by the Bill and Melinda Gates Foundation. The vaccine was developed in record time, ant at about “one-tenth of the cost usually need to bring a product through development to the market.”

She also said that innovative financing mechanisms from the GAVI Alliance had helped issue new vaccines against diarrhoea and pneumonia.

A new diagnostic test for tuberculosis was also developed and “WHO endorsement of the test brought an immediate price reduction of 75 percent for developing countries,” Chan said. She also praised the “massive drug donations from both traditional and newly supportive pharmaceutical companies” of treatment of neglected tropical diseases.

“The purchasing power of development dollars has expanded, and this means expanded access to medical products for the poor,” she said, adding that all the achievements were the result of good collaboration with countries, other UN agencies, global health initiatives and funding mechanisms, civil society, foundations, and the private sector.

WHO’s Clean Hands in H1N1 Pandemic

Chan said that the report of the Review Committee on the Functioning of the International Health Regulations (2005) in relation to Pandemic (H1N1) 2009 had cleared the WHO of the allegation of possible undue influence by the pharmaceutical industry in the management of the H1N1 pandemic. Concerns after it became apparent that the virus turned out to be relatively mild and industry received a substantial financial benefit from the declaration of pandemic.

According to Chan, the report answers the two main questions about the pandemic: Was WHO right about declaring a pandemic, and were WHO decisions shaped by ties with the pharmaceutical industry. “In other words, did WHO declare a fake pandemic in order to line the pockets of industry?” she said.

Chan said that the 180-page report [pdf] “exonerates WHO on both counts.” The report offers some constructive criticism, and gives a number of specific recommendations to better prepare for the next global public health emergency.

WHO Having Identity Crisis, NGO Says

The People´s Health Movement issued a press release [pdf], saying that the WHO is facing a financial crisis, but “is also suffering from a crisis of identity and legitimacy.

WHO’s “role and mandate have been diluted and usurped by the proliferation of new actors in the field of global health,” it said.

“The driver of the reforms foreshadowed in the DG’s report [pdf] is the financial crisis in which the WHO finds itself,” the NGO said. “In accordance with the demands of the donors, the report simply addresses issues of effectiveness, efficiency, responsiveness, objectivity, transparency and accountability. However, while the report sets out broad directions for the WHO, it has few concrete recommendations and inadequate analysis of the financial crisis.”

US Backs WHO

United States Health and Human Services Secretary Kathleen Sibelius, in her address to the plenary today, committed to supporting Chan’s agenda for reform.

Sibelius also said that progress has been made on infectious diseases, “but we must remain vigilant.” She highlighted the smallpox virus, and said the Assembly should not set an immediate date for the destruction of the last known samples of the virus.

“Today, most of the world’s population has no immunity to the disease, and it is quite possible that undisclosed or forgotten stocks of smallpox exist,” she said in prepared remarks, adding that the virus’ genetic code is available on the internet and the technology exists to wrongfully create a new smallpox virus in a laboratory.

The US has effective vaccines, but global supplies are limited. “We have more work to do before these safe and highly effective vaccines and antiviral treatments are fully developed and approved for use,” she said. “Once they are ready, we intend to share the fruits of this research with the world.”