Most folks in the global health community say they they fully support the mission of the World Health Organization and then often complain — usually privately, but sometimes publicly — about how horribly bureaucratic, risk-averse and cumbersome it is.
This week in Geneva, as most people I’m sure have not noticed, is the 66th meeting of the World Health Assembly in which WHO member states and organizations discuss how best to prevent the spread of threats like pandemic flu, the challenge of polio eradication, progress made against many childhood diseases and basically try to set the global health agenda for the future.
“In these troubled times, public health looks more and more like a refuge, a safe harbor of hope that allows, and inspires, all countries to work together for the good of humanity,” WHO Director General Margaret Chan, in her opening statement.
That sounds great, except for a few disturbing signs — the declining financial support for the WHO to get us all working together and a shift away from a focus on infectious diseases to the latest fashion in global health, non-communicable diseases (like heart disease, diabetes, high blood pressure and so on).
Laurie Garrett, a journalist-now-expert at the Council on Foreign Relations and one of the world’s leading commentators on global health, sees this funding shift at WHO away from infectious disease as troubling:
“Overall, the proposed WHO 2014-15 budget offers startling changes in the mission and direction of the agency, pushing it significantly away from infectious diseases, HIV, TB, malaria, and outbreaks, and towards addressing disabilities, diabetes, heart disease, cancer, and aging…. The tuberculosis cuts are especially mysterious, as the numbers of individuals worldwide getting treatment have increased substantially over the decade, but so has incidence of multi-drug resistant TB. “
More worrisome overall, Garrett writes in the second installment of her coverage of the World Health Assembly, is the decline in funding for WHO that has forced the tough choices and cutbacks.
While there has been a substantial increase in the past decade for global health funding overall, with the growth of private donors like the Gates Foundation as well as the creation of multi-lateral funding mechanisms like the Global Fund to Fight AID, TB and Malaria, many experts are concerned that the shrinking clout and influence of WHO — as goofy as it can be — risks undermining the primary vehicle needed to globally set global health policy.
Here’s a nice overview of what’s going on by Tim France, at Inis Communications, along with this graphic depiction of the WHO budget: