World Health Organization

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. Established on 7 April 1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the League of Nations.

Mission

The WHO's constitution states that its objective "is the attainment by all peoples of the highest possible level of health." Its major task is to combat disease, especially key infectious diseases, and to promote the general health of the people of the world.

Establishment

The World Health Organization is one of the original agencies of the United Nations, its constitution formally coming into force on the first World Health Day, (7 April, 1948), when it was ratified by the 26th member state. Prior to this its operations, as well as the remaining activities of the League of Nations Health Organization, were under the control of an Interim Commission following an International Health Conference in the summer of 1946. The transfer was authorized by a Resolution of the General Assembly.

Summary of activities

As well as coordinating international efforts to monitor outbreaks of infectious diseases, such as SARS, malaria, and AIDS, the WHO also sponsors programs to prevent and treat such diseases. The WHO supports the development and distribution of safe and effective vaccines, pharmaceutical diagnostics, and drugs. After over 2 decades of fighting smallpox, the WHO declared in 1980 that the disease had been eradicated - the first disease in history to be eliminated by human effort.

The WHO is nearing success in developing vaccines against malaria and schistosomiasis and aims to eradicate polio within the next few years. The organization has already endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe (from October 3 2006), making it an international standard.

In addition to its work in eradicating disease, the WHO also carries out various health-related campaigns — for example, to boost the consumption of fruits and vegetables worldwide and to discourage tobacco use.

Experts met at the WHO headquarters in Geneva in February, 2007, and reported that their work on pandemic influenza vaccine development had achieved encouraging progress. More than 40 clinical trials have been completed or are ongoing. Most have focused on healthy adults. Some companies, after completing safety analyses in adults, have initiated clinical trials in the elderly and in children. All vaccines so far appear to be safe and well-tolerated in all age groups tested.

The WHO also conducts research, on, for instance, whether the electromagnetic field surrounding cell phones has a negative influence on health. Some of this work can be controversial, as illustrated by the April, 2003, joint WHO/FAO report, which recommended that sugar should form no more than 10% of a healthy diet. This report led to lobbying by the sugar industry against the recommendation, to which the WHO/FAO responded by including in the report the statement "The Consultation recognized that a population goal for free sugars of less than 10% of total energy is controversial", but also stood by its recommendation based upon its own analysis of scientific studies..

Additional Responsibilities

In addition to the WHO's stated mission, international treaties assign the Organization a variety of responsibilities. For instance, the Single Convention on Narcotic Drugs and the Convention on Psychotropic Substances call on the WHO to issue binding scientific and medical assessments of psychoactive drugs and to recommend how they should be regulated. In this way, the WHO acts as a check on the national drug policymaking Commission on Narcotic Drugs.

The WHO also compiles the widely-followed International Classification of Diseases (ICD). The tenth revision of the ICD was released in 1992 and a searchable version is available online on the WHO website. Later revisions are indexed and available in hard-copy versions. The WHO does not permit simultaneous classification in two separate areas.

The WHO also maintains a model list of essential medicines that all countries' health-care systems should make available and affordable to the general population.

Structure

WHO Headquarters in Geneva

WHO Member States appoint delegations to the World Health Assembly, WHO's supreme decision-making body. All UN member states are eligible for WHO membership, and, according to the WHO web site, “Other countries may be admitted as members when their application has been approved by a simple majority vote of the World Health Assembly.” The WHO has 193 member states.

The Republic of China (Taiwan) was one of the founding members of the WHO, but was compelled to leave after the People’s Republic of China was admitted to the UN in 1972 and Taiwan left the UN. Taiwan has applied for participation in the WHO as a 'health entity' each year since 1997 but is denied each year because of pressure from China. China claims sovereignty over Taiwan, and its position is that Taiwan is represented in the WHO system by China. In practice, Taiwanese doctors and hospitals are denied access to WHO information, and Taiwanese journalists are denied accreditation for participation in WHO activities.

The WHO Assembly generally meets in May each year. In addition to appointing the Director-General every five years, the Assembly considers the financial policies of the Organization and reviews and approves the proposed programme budget. The Assembly elects 34 members, technically qualified in the field of health, to the Executive Board for three-year terms. The main functions of the Board are to carry out the decisions and policies of the Assembly, to advise it and to facilitate its work in general.

Membership

The WHO has 193 Member States, including all UN Member States except Liechtenstein , and 2 non-UN members, Niue and the Cook Islands. Territories that are not UN Member States may join as Associate Members (with full information but limited participation and voting rights) if approved by an Assembly vote: Puerto Rico and Tokelau are Associate Members. Entities may also be granted observer status: examples include the Palestine Liberation Organization and the Holy See (Vatican City).

Funding

The WHO is financed by contributions from member states and from donors. In recent years, the WHO's work has involved more collaboration; there are currently around 80 such partnerships with NGOs and the pharmaceutical industry, as well as with foundations such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation. Voluntary contributions to the WHO from national and local governments, foundations and NGOs, other UN organizations, and the private sector, now exceed that of assessed contributions (dues) from the 193 member nations. Template:PDFlink

Regional Offices

Regional offices and regions of the WHO:

  Africa; HQ: Brazzaville, Congo

   Americas; HQ: Washington, D.C., USA

  Eastern Med.; HQ: Cairo, Egypt

  Europe; HQ: Copenhagen, Denmark

  South East Asia; HQ: New Delhi] India

  Western Pacific; HQ: Manila, Philippines

Uncharacteristically for a UN Agency, the six Regional Offices of the WHO enjoy remarkable autonomy. Each Regional Office is headed by a Regional Director (RD), who is elected by the Regional Committee for a once-renewable five-year term. The name of the RD-elect is transmitted to the WHO Executive Board in Geneva, which proceeds to confirm the appointment. It is rare that an elected Regional Director is not confirmed.

Each Regional Committee of the WHO consists of all the Health Department heads, in all the governments of the countries that constitute the Region. Aside from electing the Regional Director, the Regional Committee is also in charge of setting the guidelines for the implementation, within the region, of the Health and other policies adopted by the World Health Assembly. The Regional Committee also serves as a progress review board for the actions of the WHO within the Region.

The Regional Director is effectively the head of the WHO for his or her Region. The RD manages and/or supervises a staff of health and other experts at the regional headquarters and in specialised centres. The RD is also the direct supervising authority — concomitantly with the WHO Director General — of all the heads of WHO country offices, known as WHO Representatives, within the Region.

The Regional Offices are:

• Regional Office for Africa (AFRO)^I, with headquarters in Brazzaville, Republic of Congo. AFRO includes most of Africa, with the exception of Egypt, Sudan, Tunisia, the Libyan Arab Jamahiriya, and Morocco which belong to EMRO. Somalia is also not counted as it does not have an official government, though it is in the process of getting one.
• Regional Office for Europe (EURO), with headquarters in Copenhagen, Denmark.
• Regional Office for South East Asia (SEARO), with headquarters in New Delhi, India. North Korea is served by SEARO.
• Regional Office for the Eastern Mediterranean (EMRO), with headquarters in Cairo, Egypt. EMRO includes the countries of Africa, and particularly in the Maghreb, that are not included in AFRO, as well as the countries of the Middle East.
• Regional Office for Western Pacific (WPRO), with headquarters in Manila, Philippines. WPRO covers all the Asian countries not served by SEARO and EMRO, and all the countries in Oceania. North Korea is served by WPRO.
• Regional Office for the Americas (AMRO), with headquarters in Washington, D.C., USA. It is better known as the Pan American Health Organization (PAHO). Since it predates the establishment of WHO, PAHO is by far the most autonomous of the 6 regional offices.

Country Offices

The World Health Organization operates 147 country and liaison offices in all its regions. The presence of a country office is generally motivated by a need, stated by the member country. There will generally be one WHO country office in the capital, occasionally accompanied by satellite-offices in the provinces or sub-regions of the country in question.

The country office is headed by a WHO Representative (WR), who is a trained physician, not a national of that country, who holds diplomatic rank and is due privileges and immunities similar to those of a Head of Diplomatic Mission or a diplomatic Ambassador. In most countries, the WR (like Representatives of other UN agencies) is de facto and/or de jure treated like an Ambassador - the distinction here being that instead of being an Ambassador of one sovereign country to another, the WR is a senior UN civil servant, who serves as the "Ambassador" of the WHO to the country to which he or she is accredited. Hence, the slightly less glamorous title of Representative, or Resident Representative.

The country office consists of the WR, and several health and other experts, both foreign and local, as well as the necessary support staff. The main functions of WHO country offices include being the primary adviser of that country's government in matters of health and pharmaceutical policies.

International liaison offices serve largely the same purpose as country offices, but generally on a smaller scale. These are often found in countries that want WHO presence and cooperation, but do not have the major health system flaws that require the presence of a full-blown country office. Liaison offices are headed by a liaison officer, who is a national from that particular country, without diplomatic immunity.

Some WHO-private sector partnerships

• PATH: Program for Appropriate Technology in Health (http://www.path.org)
• IAVI: International AIDS Vaccine Initiative (http://www.iavi.org)
• MMV: Medicines for Malaria Venture (http://www.mmv.org)
• MVI: Malaria Vaccine Initiative (http://www.malariavaccine.org)
• TB Alliance: Global Alliance for TB Drug Development (http://www.tballiance.org)
• Aeras: Aeras Global TB Vaccine Foundation (http://aeras.org)
• IPM: International Partnership for Microbicides (http://www.ipm-microbicides.org)
• PDVI: Pediatric Dengue Vaccine Initiative (http://www.pdvi.org)
• FIND: Foundation for Innovative New Diagnostics (http://www.finddiagnostics.org)
• IOWH: Institute for One World Health (http://www.oneworldhealth.org)
• DNDi: Drugs for Neglected Diseases Initiative (http://www.dndi.org)

Directors-General of WHO

Margaret Chan, incumbent Director-General of the World Health Organization

Name	Country/Region	Term of Office
Brock Chisholm	Canada	1948–1953
Marcolino Gomes Candau	Brazil	1953–1973
Halfdan T. Mahler	Denmark	1973–1988
Hiroshi Nakajima	Japan	1988–1998
Gro Harlem Brundtland	Norway	1998–2003
Lee Jong-wook	South Korea	2003–2006 (died on May 22)
Anders Nordström	Sweden	2006
Margaret Chan	Hong Kong,China	January 4, 2007–

• Former Directors General

Other notable persons associated with WHO

• Manuel Carballo (Epidemiologist)
• Kevin De Cock
• Velma Kay Lopez
• Arata Kochi
• Jonathan Mann
• David Nabarro
• Peter Piot
• Andrija Štampar
• Carlo Urbani
• David L. Heymann

Personnel policy

The World Health Organization is an agency of the United Nations and as such shares a core of common personnel policy with other agencies.

Smokers

The World Health Organization has recently banned the recruitment of cigarette smokers, to promote the principle of a tobacco-free work environment.

World Health Report

The annual World Health Report, first published in 1995, is the WHO's leading publication. Each year the report combines an expert assessment of global health, including statistics relating to all countries, with a focus on a specific subject. The World Health Report 2007 - A safer future: global public health security in the 21st century was published on August 23, 2006.

Statistics

The WHO website A guide to statistical information at WHO has an online version of the most recent WHO health statistics.
According to The WHO Programme on Health Statistics:

The production and dissemination of health statistics for health action at country, regional and global levels is a core WHO activity mandated to WHO by its Member States in its Constitution. WHO produced figures carry great weight in national and international resource allocation, policy making and programming, based on its reputation as "unbiased" (impartial and fair), global (not belonging to any camp), and technically competent (consulting leading research and policy institutions and individuals).

Controversies

Ionizing radiation

Dr. Michel Fernex, Wladimir Tchertkoff, and Dr. Christopher Busby, on June 27, 2007, in front of the WHO building in Geneva

There is pending controversy on the relation between the WHO and the International Atomic Energy Agency. Since May 28, 1959, there has been an agreement between these organizations, confirmed by World Health Assembly resolution WHA12.40 Numerous people, including Michel Fernex (a retired medical doctor from the WHO), have criticized this agreement as preventing the WHO from properly conducting its activities relating to health effects of ionizing radiation. Notably it is argued that the consequences of the Chernobyl catastrophe are significantly played down by the WHO because of this agreement. The WHO has concluded on 50 near-immediate deaths and potentially 4,000 cancers in the longer term, but other accounts quote between 50,000 and 150,000 people already died, and several hundreds of thousands people are ill, handicapped, etc. Former Secretary-General Kofi Annan said that seven million people are affected by the catastrophe.

Particularly, the proceedings of the 1995 Geneva conference and the report of the Kiev 2001 conference on the effects of the Chernobyl disaster were never published, which is very unusual. Dr. Hiroshi Nakajima, former WHO Director-General, admitted in a Swiss television interview that these documents had been censored based on the agreement with the International Atomic Energy Agency. Since April 27, 2007, a permanent presence opposite the main driveway to WHO premises is maintained in protest against the agreement between WHO and IAEA.

See also

• World Health Day
• International Agency for Research on Cancer in Lyon, France
• WHO Centre for Health Development in Kobe, Japan
• Hideyo Noguchi Africa Prize

References

Henrik Karl Nielsen: The World Health Organisation - Implementing the right to health, 2. edition, Copenhagen 2001

External links

• World Health Organization
• Weekly Epidemiological Record (WER)
• AIDS.gov - The U.S. Federal Domestic AIDS Resource
• Open Training with UNITAR, FAO, ITU, WHO, ILO and UNEP partners