World Health Day: the WHO has much to be proud of

The upheaval caused by the Covid-19 pandemic can sometimes obscure the reality that we live in a time of unprecedented medical advances, many of them the result of countries working together. Sharing research and expertise, co-ordinating responses to natural disasters, supplying poorer countries with life-saving medical aid and the development of a Covid vaccine in record time are all examples of how co-operation has delivered real progress in fighting disease and helping people to live longer, healthier lives. It wasn’t always like this. Today is the 75th anniversary of the World Health Organisation ’s foundation, and it can be difficult to imagine what much of the globe looked like 75 years ago. Much of continental Europe was still in ruins three years after the Second World War ended. Deadly diseases such as smallpox and polio were rife and the average life expectancy in Asia and Africa was 41 and 36 years, respectively. The WHO, which inherited the assets, staff, infrastructure and experience of its League of Nations and International Office of Public Hygiene predecessors, has many achievements to be proud of. It began a mass immunisation drive against tuberculosis in 1950, helped to bring down deaths from measles by 68 per cent by 2007 and has fought for decades against malaria. From the introduction of the world’s first disease-tracking service to the eradication of smallpox in 1980, it has repeatedly proved the benefits to be gained by encouraging countries to work together on health. But it has had its critics, too. In 2020, a briefing presented to the European Parliament accused the WHO of a “delayed response to the West African Ebola epidemic of 2014, which may have cost thousands of lives”. It went on to claim that “its failures, both in the Covid-19 pandemic and in previous health crises, highlight long-standing problems: the agency is weak, underfunded and its complex organisational structure can get in the way of effective action”. The WHO’s performance in the coronavirus pandemic also attracted criticism. Accusing it of following a political agenda during the crisis, then US president Donald Trump pulled America – and its considerable funding – out of the organisation . Calls for reform have been a constant throughout the WHO’s existence, but such criticism can be misplaced. Like the UN, the WHO cannot compel its 194 member states to take particular courses of action. During the Covid pandemic, WHO members – for better or worse – made their own policy decisions on lockdowns, quarantine rules and facemasks. If criticism – justified or not – is a constant for the WHO, then so is the global pace of change when it comes to health. It is arguable that the organisation’s position as the pre-eminent body for worldwide health co-ordination has been affected as more private companies, public-private partnerships and influential individuals get involved in medicine. There is an irony to this. The push for the first international health organisation after the First World War did not come from government but from a private individual – Henry Pomeroy Davison, chairman of the War Council of the American Red Cross. His work eventually led to the foundation of the League of Red Cross Societies in May 1919. In helping to eradicate some of the world’s worst diseases, thereby saving countless lives, the WHO has proved its worth. But it will need to be nimble to maintain its position as a co-ordinator and a policy leader in a world where medical technology is developing as rapidly as its health challenges – particularly those caused by climate change. Seventy-five years promoting health and fighting illness is quite an achievement, but much more work remains to be done.