World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with
international public health. It was established on 7 April 1948, headquartered in Geneva, Switzerland. The
WHO is a member of the United Nations Development Group. Its predecessor, the Health Organization, was
an agency of theLeague of Nations.
The constitution of the World Health Organization had been signed by 61 countries on 22 July 1946, with the
first meeting of the World Health Assembly finishing on 24 July 1948. It incorporated the Office international
d'hygine publique and the League of Nations Health Organization. Since its creation, it has played a leading
role in theeradication of smallpox. Its current priorities include communicable diseases, in
particular HIV/AIDS, Ebola, malaria andtuberculosis; the mitigation of the effects of non-communicable
diseases; sexual and reproductive health, development, and ageing; nutrition, food security and healthy eating;
occupational health; substance abuse; and driving the development of reporting, publications, and networking.
The WHO is responsible for the World Health Report, the worldwide World Health Survey, and World Health
Day. The Director-General of WHO is Tedros Adhanom who started his five-year term on 1 July 2017.
History
Establishment
During the 1945 United Nations Conference on International Organization, Szeming Sze, a delegate from
China, conferred with Norwegian and Brazilian delegates on creating an international health organization
under the auspices of the new United Nations. After failing to get a resolution passed on the subject, Alger
Hiss, the Secretary General of the conference, recommended using a declaration to establish such an
organisation. Sze and other delegates lobbied and a declaration passed calling for an international conference
on health.[2] The use of the word "world", rather than "international", emphasised the truly global nature of
what the organisation was seeking to achieve.[3] The constitution of the World Health Organization was signed
by all 51 countries of the United Nations, and by 10 other countries, on 22 July 1946.
Operational history
Three former directors of the Global Smallpox Eradication Programme read the news that smallpox had
been globally eradicated, 1980
In 1947 the WHO established an epidemiological information service via telex, and by 1950 a
mass tuberculosis inoculation drive using the BCG vaccine was under way. In 1955, the malaria eradication
programme was launched, although it was later altered in objective. 1965 saw the first report on diabetes
mellitus and the creation of the International Agency for Research on Cancer.[7]
In 1958, Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to
undertake a global initiative to eradicate smallpox, resulting in Resolution WHA11.54. At this point, 2 million
people were dying from smallpox every year.
Overall focus
The WHO's Constitution states that its objective "is the attainment by all people of the highest possible level of
health".
WHO fulfills its objective through its functions as defined in its Constitution: (a) to act as the directing and co-
ordinating authority on international health work (b) to establish and maintain effective collaboration with the
United Nations, specialised agencies, governmental health administrations, professional groups and such other
organisations as may be deemed appropriate (c) to assist Governments, upon request, in strengthening health
services (d) to furnish appropriate technical assistance and, in emergencies, necessary aid upon the request or
acceptance of Governments (e) to provide or assist in providing, upon the request of the United Nations, health
services and facilities to special groups, such as the peoples of trust territories (f) to establish and maintain
such administrative and technical services as may be required, including epidemiological and statistical
services (g) to stimulate and advance work to eradicate epidemic, endemic and other diseases (h) to promote,
in co-operation with other specialised agencies where necessary, the prevention of accidental injuries (i) to
promote, in co-operation with other specialised agencies where necessary, the improvement of nutrition,
housing, sanitation, recreation, economic or working conditions and other aspects of environmental hygiene (j)
to promote co-operation among scientific and professional groups which contribute to the advancement of
health (k) to propose conventions, agreements and regulations, and make recommendations with respect to
international health matters and to perform.
As of 2012 WHO has defined its role in public health as follows:
providing leadership on matters critical to health and engaging in partnerships where joint action is
needed;
shaping the research agenda and stimulating the generation, translation and dissemination of valuable
knowledge;
setting norms and standards and promoting and monitoring their implementation;
articulating ethical and evidence-based policy options;
providing technical support, catalysing change, and building sustainable institutional capacity; and
monitoring the health situation and assessing health trends.
Communicable diseases
The 20122013 WHO budget identified 5 areas among which funding was distributed. Two of those five areas
related to communicable diseases: the first, to reduce the "health, social and economic burden" of
communicable diseases in general; the second to combat HIV/AIDS, malaria and tuberculosis in particular.
As of 2015 WHO has worked within the UNAIDS network and strived to involve sections of society other
than health to help deal with the economic and social effects of HIV/AIDS. In line with UNAIDS, WHO has
set itself the interim task between 2009 and 2015 of reducing the number of those aged 1524 years who are
infected by 50%; reducing new HIV infections in children by 90%; and reducing HIV-related deaths by 25%.
Health policy
WHO addresses government health policy with two aims: firstly, "to address the underlying social and
economic determinants of health through policies and programmes that enhance health equity and integrate
pro-poor, gender-responsive, and human rights-based approaches" and secondly "to promote a healthier
environment, intensify primary prevention and influence public policies in all sectors so as to address the root
causes of environmental threats to health".
Governance and support
The remaining two of WHO's thirteen identified policy areas relate to the role of WHO itself:[19]
"to provide leadership, strengthen governance and foster partnership and collaboration with countries, the
United Nations system, and other stakeholders in order to fulfill the mandate of WHO in advancing the
global health agenda"; and
"to develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate
more efficiently and effectively".
Partnerships
The WHO along with the World Bank constitute the core team responsible for administering the International
Health Partnership (IHP+). The IHP+ is a group of partner governments, development agencies, civil society
and others committed to improving the health of citizens in developing countries. Partners work together to put
international principles for aid effectiveness and development co-operation into practice in the health sector.
The organisation relies on contributions from renowned scientists and professionals to inform its work, such as
the WHO Expert Committee on Biological Standardization,[43] the WHO Expert Committee on Leprosy,[44] and
the WHO Study Group on Interprofessional Education & Collaborative Practice.
WHO runs the Alliance for Health Policy and Systems Research, targeted at improving health
policy and systems.
WHO also aims to improve access to health research and literature in developing countries such as through
the HINARI network.
Public health education and action
Each year, the organisation marks World Health Day and other observances focusing on a specific health
promotion topic. World Health Day falls on 7 April each year, timed to match the anniversary of WHO's
founding. Recent themes have been vector-borne diseases (2014), healthy ageing (2012) and drug
resistance(2011).
The other official global public health campaigns marked by WHO are World Tuberculosis Day, World
Immunization Week, World Malaria Day, World No Tobacco Day, World Blood Donor Day, World Hepatitis
Day, and World AIDS Day.
Financing and partnerships
The WHO is financed by contributions from member states and outside donors. As of 2012, the largest annual
assessed contributions from member states came from the United States ($110 million), Japan ($58 million),
Germany ($37 million), United Kingdom ($31 million) and France ($31 million). The combined 20122013
budget has proposed a total expenditure of $3,959 million, of which $944 million (24%) will come from
assessed contributions. This represented a significant fall in outlay compared to the previous 20092010
budget, adjusting to take account of previous underspends. Assessed contributions were kept the same.
Voluntary contributions will account for $3,015 million (76%), of which $800 million is regarded as highly or
moderately flexible funding, with the remainder tied to particular programmes or objectives.
In recent years, the WHO's work has involved increasing collaboration with external bodies.[94] As of 2002, a
total of 473 non-governmental organisations (NGO) had some form of partnership with WHO. There were 189
partnerships with international NGOs in formal "official relations" the rest being considered informal in
character. Partners include the Bill and Melinda Gates Foundation[96] and the Rockefeller Foundation.
Controversies
IAEA Agreement WHA 1240
Alexey Yablokov (left) and Vassili Nesterenko (farthest right) protesting in front of the World Health
Organization headquarters in Geneva, Switzerland in 2008.
Demonstration on Chernobyl disaster day near WHO in Geneva
In 1959, the WHO signed Agreement WHA 1240 with the International Atomic Energy Agency (IAEA). The
agreement states that the WHO recognises the IAEA as having responsibility for peaceful nuclear energy
without prejudice to the roles of the WHO of promoting health. However, the following paragraph adds that
"whenever either organization proposes to initiate a programme or activity on a subject in which the other
organization has or may have a substantial interest, the first party shall consult the other with a view to
adjusting the matter by mutual agreement". The nature of this statement has led some pressure groups and
activists (including Women in Europe for a Common Future) to believe that the WHO is restricted in its ability
to investigate the effects on human health of radiation caused by the use of nuclear power and the continuing
effects of nuclear disasters in Chernobyl and Fukushima. They believe WHO must regain what they see as
"independence".
Intermittent preventive therapy
The aggressive support of the Bill & Melinda Gates Foundation for intermittent preventive
therapy of malaria triggered a memo from the former WHO malaria chief Akira Kochi.[105]
Diet and sugar intake
Some of the research undertaken or supported by WHO to determine how people's lifestyles and environments
are influencing whether they live in better or worse health can be controversial, as illustrated by a 2003 joint
WHO/FAO report on nutrition and the prevention of chronic non-communicable disease,[106] which
recommended that sugar should form no more than 10% of a healthy diet. The report led to lobbying by the
sugar industry against the recommendation, to which the WHO/FAO responded by including in the report this
statement: "The Consultation recognized that a population goal for free sugars of less than 10% of total energy
is controversial". It also stood by its recommendation based upon its own analysis of scientific studies. In
2014, WHO reduced recommended sugar levels by half and said that sugar should make up no more than 5%
of a healthy diet.
2009 swine flu pandemic
In 2007, the WHO organised work on pandemic influenza vaccine development through clinical trials in
collaboration with many experts. A pandemic involving theH1N1 influenza virus was declared by the then
Director-General Margaret Chan in April 2009.
By the post-pandemic period critics claimed the WHO had exaggerated the danger, spreading "fear and
confusion" rather than "immediate information".[109] Industry experts countered that the 2009 pandemic had led
to "unprecedented collaboration between global health authorities, scientists and manufacturers, resulting in
the most comprehensive pandemic response ever undertaken, with a number of vaccines approved for use three
months after the pandemic declaration. This response was only possible because of the extensive preparations
undertaken during the last decade".
201316 Ebola outbreak and reform efforts
Following the 2014 Ebola outbreak in West Africa, the organisation was heavily criticised for its bureaucracy,
insufficient financing, regional structure, and staffing profile.
An internal WHO report on the Ebola response pointed to underfunding and lack of "core capacity" in health
systems in developing countries as the primary weaknesses of the existing system. At the annual World Health
Assembly in 2015, Director-General Margaret Chan announced a $100 million Contingency Fund for rapid
response to future emergencies,[112][113] of which it had received $26.9 million by April 2016 (for 2017
disbursement). WHO has budgeted an additional $494 million for its Health Emergencies Programme in 2016
17, for which it had received $140 million by April 2016.
FCTC implementation database
The WHO has a Framework Convention on Tobacco implementation database which is one of the only
mechanisms to help enforce compliance with the FCTC. However, there has been reports of numerous
discrepancies between it and national implementation reports on which it was built. As researchers Hoffman
and Rizvi report "As of July 4, 2012, 361 (327%) of 1104 countries' responses were misreported: 33 (30%)
were clear errors (eg, database indicated yes when report indicated no), 270 (245%) were missing despite
countries having submitted responses, and 58 (53%) were, in our opinion, misinterpreted by WHO staff".
IARC controversies
The World Health Organization sub-department, the International Agency for Research on Cancer (IARC), has
been criticised for the way it analyses the tendency of certain substances and activities to cause cancer and for
having politically motivated bias when it selects studies for its analysis. Ed Yong, a British science journalist,
has criticized the agency and its "confusing" category system for misleading the public.[118] Marcel Kuntz, a
French director of research at the French National Centre for Scientific Research, criticized the agency for its
classification of potentially carcinogenic substances. He claimed that this classification did not take into
account the extent of exposure: for example, red meat is qualified as probably carcinogenic, but the quantity of
consumed red meat at which it could become dangerous is not specified.
Controversies have erupted multiple times when the IARC has classified many things as Class 2a (probable
carcinogens), including cell phone signals, glyphosate, drinking hot beverages, and working as a barber.
Block of Taiwanese participation
China has barred Taiwan from membership of the WHO and other UN-affiliated organizations, and in 2017
refused to allow Taiwanese delegates to attend the WHO annual assembly.
Travel expenses
According to The Associated Press, WHO routinely spends about $200 million a year on travel expenses, more
than it spends to tackle mental health problems,HIV/AIDS, Tuberculosis and Malaria combined. In
2016, Margaret Chan, Director-General of WHO from November 2006 to June 2017, stayed in a $1000 per
night hotel room while visiting West Africa.
World headquarters
The seat of the organisation is in Geneva, Switzerland. It was dedicated and opened in 1966.
About WHO India
World Health Organization (WHO) is the United Nations specialized agency for Health. It is
an inter-governmental organization and works in collaboration with its member states usually
through the Ministries of Health. The World Health Organization is responsible for providing
leadership on global health matters, shaping the health research agenda, setting norms and
standards, articulating evidence-based policy options, providing technical support to
countries and monitoring and assessing health trends.
India became a party to the WHO Constitution on 12 January 1948. The first session of the
WHO Regional Committee for South-East Asia was held on 4-5 October 1948 in the office
of the Indian Minister of Health. It was inaugurated by Pandit Jawaharlal Nehru, Prime
Minister of India and was addressed by the WHO Director-General, Dr Brock Chisholm.
India is a Member State of the WHO South East Asia Region.
Dr Henk Bekedam is the WHO Representative to India.
The WHO Country Office for India is headquartered in Delhi with country-wide presence.
The WHO Country Office for Indias areas of work are enshrined in its new Country
Cooperation Strategy (CCS) 2012-2017.
WHO is staffed by health professionals, other experts and support staff working at
headquarters in Geneva, six regional offices and country offices. In carrying out its activities
and fulfilling its objectives, WHO's secretariat focuses its work on the following six core
functions:
providing leadership on matters critical to health and engaging in partnerships where joint
action is needed;
shaping the research agenda and stimulating the generation, translation and dissemination of
valuable knowledge;
setting norms and standards and promoting and monitoring their implementation;
articulating ethical and evidence-based policy options;
providing technical support, catalysing change, and building sustainable institutional
capacity; and
monitoring the health situation and assessing health trends.
These core functions are set out in the 11th General Programme of Work, which provides the
framework for organization-wide programme of work, budget, resources and results. Entitled
"Engaging for health", it covers the 10-year period from 2006 to 2015.
Country Cooperation Strategy (CCS) 2012-2017
The WHO Country Cooperation Strategy India (2012-2017) has been jointly developed by
the Ministry of Health and Family Welfare (MoH&FW) of the Government of India (GoI)
and the WHO Country Office for India (WCO). Its key aim is to contribute to improving
health and equity in India. It distinguishes and addresses both the challenges to unleashing
Indias potential globally and the challenges to solving long-standing health and health
service delivery problems internally.
The CCS incorporates the valuable recommendations of key stakeholders garnered through
extensive consultations. It balances country priorities with WHOs strategic orientations and
comparative advantages in order to contribute optimally to national health development. It
includes work on inter-sectoral actions, regulations and reform of the provision of
(personal and population) health services that impact on the health system outcomes health
status, financial protection, responsiveness and performance.
To contribute meaningfully to the national health policy processes and governments health
agenda, the CCS has identified three strategic priorities and the focus areas under each
priority:
Strategic priority 1: Supporting an improved role of the Government of India in global
health
International Health Regulations: Ensuring the implementation of International Health
Regulations and similar commitments.
Pharmaceuticals: Strengthening the pharmaceutical sector including drug regulatory capacity
and, trade and health.
Stewardship: Improving the stewardship capacity of the entire Indian health system
Strategic priority 2: Promoting access to and utilization of affordable, efficiently
networked and sustainable quality services by the entire population
Financial Protection: Providing universal health service coverage so that every individual
would achieve health gain from a health intervention when needed.
Quality: Properly accrediting service delivery institutions (primary health care facilities and
hospitals) to deliver the agreed service package.
Strategic priority 3: Helping to confront the new epidemiological reality of India
Health of Mothers and Children: Scaling up reproductive, maternal, newborn, child and
adolescent health services.
Combined Morbidity: Addressing increased combinations of communicable and
noncommunicable diseases.
Transitioning Services: Gradual, phased transfer strategy of WHO services to the national,
state and local authorities without erosion of effectiveness during the transition period.
Achievement of the CCS objectives calls for major adaptations in the way the WCO plans,
works, organizes and delivers measurable results towards the goal of ensuring better health
for all Indians in collaboration with the government and other partners.
The critical challenge for the WCO will be to adjust and scale up its capacity to provide
support for the required technical excellence that would enable meaningful contributions to
national health policy processes, and the governments health agenda. The CCS
implementation will be based on two-year Action Plans developed by the WCO in
consultation with the MoHFW taking due consideration of the health priorities envisaged by
the 12th Five Year Plan.
