Contemporary Challenges to Global Health Governance. The WHO, Unjust Victim of the Selfishness of Powerful States

Contemporary Challenges to Global Health Governance. The WHO, Unjust Victim of the Selfishness of Powerful States

01.3.2021
COVID-19_HopitalSaintJosephDRC_09
Foto: DNDi - Democratic Republic of Congo.

[Post written as part of the Governance subject in the ISGlobal Master of Global Health.]

 

Humanity continues to face urgent and complex health challenges with no lessons learnt from the past. As I write, the number of COVID-19 cases around the world has exceeded 100 million, and more than 2 million lives have perished. Since the Spanish Flu, also known as 1918 flu pandemic, the world cultivated a continuous economic and political interdependence.

States are interconnected in a planetary network and relations are growing highly varied, taking difficult, if not impossible, the coordination between states during a public health emergency of international concern (PHEIC). Global Health Governance (GHG) has undergone multiple transformations as well throughout generations, reinforcing laws and norms for responding to health distresses (the main binding instrument for GHG being the International Health Regulations).

The World Health Organization (WHO) has been harshly criticized –unfairly in my opinion– for inadequate and delayed response and management of the ongoing planetary epidemic. I’ll proceed to explore two situations where states decided to not uphold to WHO’s COVID-19 guidelines and recommendations.

The management of the novel-coronavirus (COVID-19) represents a defeat in the Global Health Governance. States have failed in engaging in collective responsibility, solidarity, and purpose

First – The management of the novel-coronavirus (COVID-19) represents a defeat in the Global Health Governance. States have failed in engaging in collective responsibility, solidarity, and purpose. WHO’s Director-General declared COVID-19 outbreak of international concern on January 30, 2020 – 1 month after the first case was reported in China. Hit by a wave of psychosis and panic, states began to implement irrational lockdowns and travel restrictions, affecting medical supply chains and harming economies and livelihoods – meanwhile the WHO advised against travel and trade restrictions. For example, shortage in personal protective equipment (PPE) was, on one hand, because of this illogical decision (making healthcare professionals unprotected in front of the virus) and, on the other hand, due to an increase in market prices (resulting in reduced purchasing power by vulnerable countries). States continuously ignored and underestimated WHO’s preceding alarms on world’s unpreparedness for future pandemics; no stock of PPE was available; no training of the healthcare staff; no contingency plans for public response to an epidemic. Years of diminished health expenditures brought the planet into a vertigo of suffering.

It is outrageous that the most vulnerable Africans are forced to wait for vaccines while people at lower risk get protected

Second – Today, a year later since the pandemic’s onset, many vaccines are available –an amazing achievement for the global health platform in terms of governance, collaboration and engagement. But the same represents a great failure. 13% of the world population – the European Community, together with five other rich countries – pre-ordered almost half of the total world vaccine production capacity. Sadly, there still exists a vast disparity between countries; although 50 developed countries have already started mass vaccination campaigns – by prioritizing the healthcare personnel and the most vulnerable populations – Guinea is the only low-income country to receive any vaccines and has as of yet only received a miserable 25 doses. It is outrageous that the most vulnerable Africans are forced to wait for vaccines while people at lower risk get protected.

The world is facing an important strategic crossroad; make no change in global health governance – aware of the tragic future consequences – or reform, reorganize and redistribute decision-making, funds and governance towards a fairer world

The world is facing an important strategic crossroad; make no change in global health governance – aware of the tragic future consequences – or reform, reorganize and redistribute decision-making, funds and governance towards a fairer world. In my vision, WHO remains at the core of the global health governance, with independent power for managing its funds in order to prioritize scarce resources based on needs alone. Health equity and social fairness should be rooted in the pillars of the new era of global health governance. It is time for global states to return trust and political independence to WHO. Health is a human right; health should be universal, in order for all humans to be considered equals. The road is tortuous and unpredictable. Flexibility and sensibility to sudden changes in global panoramic are core characteristics for an efficacious Global Health Governance.

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