Collision Course on World Health

Dr. Margaret Chan, director-general of the World Health OrganizationThe World Health Organization's director-general, Margaret Chan, delivered a direct and sobering speech Monday to the WHO executive board.

She told its members that WHO faces a "serious funding shortfall" and must pick its targets carefully -- even as public health on many fronts is poised to make big gains.

These include:

  • A new meningitis vaccine was launched in Burkina Faso after being developed through a unique partnership, manufactured in India with regulatory approval assistance from Canada, and tested in African clinical trials. Additional campaigns are being launched in Mail and Niger, but funding may not be available to make the vaccine available in other "meningitis belt" countries where it is needed, she said. "Will progress stall? Will powerful innovations, like the meningitis vaccine, like the vaccines for preventing diarrheal disease and pneumonia, like the new diagnostic test for tuberculosis, fall short of reaching their potential? Public health has been on a winning streak, but will we still have the resources to maintain, if not accelerate, these gains?" Chan asked.
  • WHO's declared goal of eradicating polio might not be reached because of the funding problem, she suggested.
  • Declaring the 2009 influenze pandemic had ended did not mean H1N1 had gone away; some countries in the Northern Hemisphere are seeing severe cases this year among a comparatively young age group, Chan said. But public mistrust of about influenza vaccines, and vaccines generally, may be a larger progblem, she said. "We may need to accept the fact that public perceptions about vaccine safety can be permanently changed by unfounded fears, to an extent that no amount of evidence can change the public's mind. This is a worrisome new trend that needs to be addressed," she said.
  • The UN secretary-general has asked WHO to propose a set of core indicators for measuring the health of women and children, in support of a global strategy for women's and children's health to which countries and partners have pledged $40 billion in the next five years. Chan discussed this project and the upcoming UN General Assembly meeting on preventing and controlling noncommunicable diseases, then turned to the state of WHO. "You have a packed agenda. WHO has a packed agenda," she said. "This organization is over-extended. We are constantly asked to do more and more. This has a limit. We are there. . . . The challenges have become far more complex, often entangled with thorny trade issues and the interests of large and powerful industries. The landscape of public health is crowded with an ever growing number of partnerships, initiatives, and implementing agencies. The demands on WHO, and on countries, have become overwhelming."

Chan asked for guidance from member states and said she would listen attentively to the board members' views and consult with WHO staff.

Posted by Jerry Laws on Jan 19, 2011