World Health Organisation needs an enforcer, not a diplomat

PUBLISHED : Friday, 10 July, 2015, 1:41am
UPDATED : Thursday, 28 September, 2017, 5:47pm

The World Health Organisation ought to be the world's doctor, but it often falls short of fulfilling that role.

By its very composition, it resembles the United Nations General Assembly. Its 194 member states typically bicker and politick over narrow national self-interests. This means the WHO's top leadership, headed by our own former health director Dr Margaret Chan Fung Fu-chun, has to play politics and diplomacy as much as to contain disease outbreaks.

After almost a decade at the helm, Chan has proved to be more a diplomat than a doctor. A new damning report has again directed criticism at her leadership as well as the way the WHO is organised. It says WHO leadership lacked "the independent and courageous decision-making" necessary to deal with the deadly Ebola outbreak last year in Africa.

"The panel considers that WHO does not currently possess the capacity or organisational culture to deliver a full emergency public health response," the report said.

The WHO leadership is beholden to its member states, and African nations and developing countries make up powerful voting blocs. Instead of perceiving this as an inherent weakness, Chan has taken it as a mandate to define her modus operandi. Thus when polio broke out in war-torn Syria in late 2013, or when Middle East respiratory syndrome appeared in Saudi Arabia, the WHO accepted at face value that their governments had the problems under control. In 2010, after a short visit to Pyongyang, Chan said North Korea's national health care service was something "most other developing countries would envy". In the case of Ebola, early warnings were ignored on the say-so of local officials.

Chan got her job at China's insistence, so perhaps she was following Beijing's diplomatic doctrine of non-interference. If there is a silver lining, it's that the WHO's executive board now recognises stronger leadership and swifter action is needed in future cases of dangerous outbreaks and has already started to implement changes such as fielding rapid-response medical teams to deal with emergencies.

Chan's tenure ends in 2017. In a world of emerging dangerous diseases, her successor needs to be more a health enforcer than a diplomat.