Several books and films recently released have portrayed the World Health Organization (WHO) as a heroic agency that saves the world from disease and disaster. Reality offers a different view—bureaucracy, politicization, and inefficiency are the words Barry Bloom uses to describe the agency in his essay “WHO Needs Change.”
Inefficiency and politicization aside, the WHO has made significant progress in places that are difficult for other global health agencies to work, such as the Russian Federation, which have a nuanced view of international non-governmental organizations. The WHO has built a strong partnership with the Russian Ministry of Health and Social Development that has enabled the agency to help shape the research currently being conducted in the region and to organize opportunities for Russian and international health specialists to exchange experiences and ideas on combating the challenges to global health in the 21st century.
International health diplomacy is not the only component of the agency’s work—the WHO has also shown that it has the stomach for difficult conversations. In July, the WHO released a policy recommendation that urged countries to ban serological tests to diagnose active tuberculosis. It was the first time in history that the WHO has issued a ban on a diagnostic tool that is widely used in tuberculosis care. The WHO said its action was a direct response to the predatory practices of some companies that manufacture the tests, all of which have their headquarters in Europe and North America. The WHO has provided evidence to show that these companies target countries with heavy tuberculosis burdens and weak regulatory systems to sell inaccurate tests that result in patients receiving either the wrong treatment or treatment at a later stage when the odds of recovering are much lower.
Bloom is right, in my view, as the WHO badly needs reform. But in spite of its faults, the WHO has the most potential to unite a global health landscape as divided as ours.