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Did Global Health Governance Fail? Challenges and Opportunities

02.5.2023
WHO
Photo: WHO / Pierre Albouy - Seventy-fifth World Health Assembly, Geneva, Switzerland, 22-28 May 2022.

The COVID-19 pandemic, cancer and HIV are major global threats. How can these multiple public health challenges, diseases and viruses - which know no borders - be tackled globally?

 

[Sophie Kittmann is currently studying for the Master of Global Health at ISGlobal. She has a communication background and has worked in health communication in the past. Her goal is to bridge the gap between health and communication.]

 

There is currently no single health government. Instead, global governance consists of a complex network of actors, such as international and regional organisations and states, working together to address public health crises and challenges on a global scale. The World Health Organization (WHO) is considered the main actor in global health governance. Despite its importance, the effectiveness of global health governance is a subject of ongoing debate, with many challenges.

One strength is the existence of legally binding international agreements, such as the International Health Regulations (IHR) 2005, which provide a framework for countries to work together to prevent, detect and respond to public health emergencies. Other strengths include the existence of WHO as the lead global health agency, several global health partnerships and initiatives (such as GAVI, which provides vaccines to the world's poorest countries), and non-state actors such as philanthropic organisations that help fill gaps in funding, capacity and expertise.

Many Weaknesses in WHO's Current Structures and Mechanisms

However, there are many weaknesses in WHO's current structures and mechanisms. One of the main weaknesses is the lack of sufficient resources and funding for WHO to effectively achieve its goals. The "jurisdictional gap" can be seen as another weakness. As the need for global health governance grows, there is no authority with the power to act, raising the question: "Who has the authority to make decisions? International organisations such as the World Trade Organisation or the World Bank have a limited role in global health governance. In addition, government agencies are characterised by poor cooperation and limited capacity. Equity and universal access to health care remain an issue, as not all people have access to basic health services or medical supplies, with people in low-income countries being the most vulnerable.

In my view, WHO is not equipped to deal with public health crises and challenges. This was particularly evident during the COVID-19 pandemic.

In my view, WHO is not equipped to deal with public health crises and challenges. This was particularly evident during the COVID-19 pandemic. Pandemic prevention and preparedness lacked an adequate governance structure. As a result, vaccines were distributed unevenly and inefficiently around the world, particularly affecting LMIC. There were also shortages of face masks or food in some countries, despite WHO warnings of shortages, which were not followed by collective action. The response to this outbreak was slow and fragmented, rather than based on collaboration and coordination between stakeholders.

Reform, Rethink and Rebuild Global Health Governance

It is important to reform, rethink and rebuild global health governance structures and mechanisms. This will require increased funding and securing resources (e.g. to fill gaps). Another reform could be the creation of an open-source intelligence collaborative for global health monitoring that predicts health risks and identifies early warning signs for rapid response to crises and challenges. Strengthening regional health institutions is another important aspect of improving global health resilience, as these organisations can act more quickly and are more familiar with local political realities. In addition, improving coordination and collaboration among the various actors in the global health system is critical to an effective global health response. A whole-of-government approach to global health security can also be considered, involving political leaders and parliaments, with coordination between WHO and other global agencies, and ensuring that all relevant departments are involved and committed to addressing global health issues.


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