An independent report has heavily criticised the World Health Organisation over the Ebola crisis as lacking the ‘capacity and culture’ to deal with such an emergency. The report, which was commissioned by the WHO itself, said the organisation waited too long to declare the situation a Public Health Emergency of International Concern.
Clearly there were major failings, and as the guardian of global public health WHO is an obvious target for criticism. And while it has admitted to a range of faults and is already making changes to correct them, not all the blame can be laid at its door.
The International Health Regulations (2005) are the essential vehicle to prevent, protect against, control and respond to the international spread of disease, yet ‘Member States have largely failed to implement the core capacities, particularly under surveillance and data collection’, says the report, and nearly a quarter of them violated the regulations by putting in place travel bans and other measures not called for by WHO, which caused negative political, economic and social consequences for the affected countries.
The report also points out that currently less than 25% of WHO’s Programme budget comes from ‘assessed contributions’. There are no core funds for emergency response. ‘The longstanding policy of zero nominal growth for assessed contributions has dangerously eroded the purchasing power of WHO’s resources,’ it says. Among the report’s recommendations are that Member States should increase assessed contributions by 5%. They should also contribute immediately to the contingency fund in support of outbreak response, with a target capitalisation of US$100m fully funded by voluntary contributions.
To be able to deal with health crises on a global basis requires all sovereign countries to play their part. It would be good to think that the fundamental reorganisation that is already taking place internally within WHO will be matched by a renewed commitment by its Member States to fulfill their legal obligations.
