World Health Organization (WHO), the United Nations specialised agency for health, was founded in 1948. It is headquartered in Geneva, Switzerland. It is an intergovernmental organisation and works in collaboration with its member states. The governance of the WHO is carried out through the World Health Assembly and the Executive Board.
The Health Assembly is the WHO’s decision-making body and consists of 194 Member States.
The Executive Board is composed of 34 members technically qualified in the field of health, with members being elected for three-year terms. The Board chairman’s post is held by rotation for one year by each of the WHO’s six regional groups: African Region, Region of the Americas, South-East Asia Region, European Region, Eastern Mediterranean Region, and Western Pacific Region.
The WHO’s emergency work is governed by a legal framework known as the International Health Regulations, the current version of which has been in force since 2005.
India became a party to the WHO Constitution on 12 January 1948. Since 2019, Dr Soumya Swaminathan has been the WHO’s, Chief Scientist. India was also elected to the Chairmanship of the WHO Board for one year – May 2020 to May 2021. Dr Harsh Vardhan, Union Minister of Health and Welfare, represented India there.
Overdependence on funding and other drawbacks
The organisation has been in the news because of the global pandemic and its role in handling it. It has been criticised for its failure to mount a robust response. This can be attributed to the following factors:
The WHO is intended to be an international leader in public health by alerting the world to threats, fighting diseases, developing policy and improving access to care during emergencies like the coronavirus. The organisation is meant to serve as a central coordinating body — guiding containment, declaring emergencies and making recommendations — with countries sharing information to help scientists address outbreaks. However, it has no direct authority over member nations. It lacks meaningful enforcement authority and is under budgetary and political pressures, especially from powerful governments and private funders.
In this particular pandemic, it has also been criticised for responding too slowly and not being critical enough of China – appearing to appease a significant donor and an influential member. It also delayed declaring covid as a PHEIC (Public Health Emergency of International Concern) and advised against travel restrictions stating that they were ineffective, disrupted essential supplies and caused economic harm.
WHO was severely criticised for its poor handling of the Ebola outbreak in 2014 as well. Consequently, the relevance of the health agency has been fading. It is perceived to be reduced to a coordinating body, beholden to the interests of rich member states. Its functional efficiency has been disadvantaged with organisational lethargy, absence of decisive leadership, bureaucratic indolence, underfunded programmes, and inability to evolve to meet the needs of the 21st century.
One of the major reasons cited for this is the over-dependence on voluntary funding from affluent member states. This over-reliance on voluntary contributions was brought to the fore by the ongoing pandemic and the last US president threatening to cut off funding and leave the organisation.
WHO is funded through assessed contributions made by the member states and voluntary contributions from member states and private donors. While assessed contributions can be spent as per the organisation’s priorities approved at the World Health Assembly, the irregular voluntary contributions are allocated in consultation with the donors. While voluntary contributions accounted for nearly 80% of the budget in 2018-19, assessed contributions merely constituted 17% of the total budgetary support. Thus, such overdependence on voluntary contributions leads to prioritisation of a donor-driven agenda and encumber the autonomous working of the organisation.
India’s approach
As a growing world power, India has a pivotal role in navigating the international pandemic response.
First and foremost, equitable vaccine deployment and countering vaccine hesitancy must be a priority for the organisation. The WHO has an important role to play in ensuring accessibility, affordability and availability of vaccines worldwide. This is also in line with India’s vaccine diplomacy.
Secondly, it must ensure a fair and consensual enquiry into the source, causes and spread of the current pandemic. This is also useful in preventing another zoonotic epidemic. It is also in alignment with the UN’s ‘One Health’ approach.
As countries and boundaries open up, WHO has a crucial role to play in international coordination for the safe reopening of economies and societies while dealing with evolving virus mutations. It must issue safety guidelines for the same, ramp up reporting of new strains and spur testing and vaccination drives.
Lastly, there needs to be a relook at the way, not the WHO but multilateral fora function in a changed global geopolitical scenario. India can start a dialogue on making these institutions more resilient, democratic and representative by ‘building back better’.
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