This year marks the end of an era for the World Health Organisation: its director-general for a decade, Margaret Chan, is stepping down. But, just as the shortlist of figures to replace her was reduced to a final three, the organisation was dealt a blow — with a report from the British government suggesting that half of Britain’s voluntary funding could be withheld if a reform programme is not drawn up in the next three months.
In a document published this week, the government maintained its ‘commitment to improved global health’, praising the WHO as a ‘powerful agent for change’ and pointing out that Britain is its third highest annual donor, contributing over £100 million a year to the WHO’s budget. Its future contributions, however, will henceforth be subject to the organisation attaining a series of objectives.
These mainly revolve around ‘value for money’ for the British taxpayer: that is, making its operations more cost-effective, streamlining bureaucracy, becoming more financially transparent and focusing far more on developing rapid, flexible responses to outbreaks of disease. Failure to do so would lead to Britain withdrawing half of its contribution, to the tune of £58 million, over the next four years.
As the WHO exists entirely through monetary donations, and is undergoing a squeeze on its finances as it seeks to fight a multitude of health crises across the world, this may seem an especially harsh measure to take. Yet the World Health Organisation is in dire need of reform, and much of this is down to damaging inefficiency and a bizarre set of priorities.
For a body supposedly at the forefront of tackling outbreaks of viruses and infections, the WHO spends an inordinate amount of time and precious resources inserting itself into issues of lifestyle. Take, for example, Chan’s praise of North Korea for its low levels of obesity, chiding Western counterparts, a WHO endorsement of the Philippines’ strongman president Rodrigo Duterte’s ban on smoking, or Chan’s addressing of the Ebola outbreak while at a conference in Moscow, supporting Vladimir Putin’s campaign against e-cigarettes. In recent years, the WHO has frittered money away on reports into plain-packaging, sugar taxes and the effects of smoking in films.
All this at a time when Ebola, Avian flu and Zika remain high in the public consciousness and bacteria resistant to antibiotics are becoming more prevalent. Responses to outbreaks, when they have occurred, have been sharply criticised. Indeed, Britain wants the WHO to respond to any such outbreak within 72 hours and to work better with other international groups such as UNAIDS and Vaccine Alliance.
If the WHO is to be effective, this is an essential development. But it is also important for limited financial resources not to be frittered on areas where, frankly, the WHO’s intervention is neither needed nor wanted. Stopping contagions from spreading across a populace requires a strong international health body; lecturing people on alcohol, cigarettes and sugar consumption does not.
The approach of the government is therefore a welcome change of tack, from a policy of giving without scrutiny to one of arm-twisting to achieve essential, potentially life-saving reform. Britain is an unsparing contributor to overseas aid in all forms, and a more than generous supporter of the WHO. It must, however, guarantee that the taxpayer is not taken for a ride, and that what money it gives is not wasted. These reforms should have been on the agenda regardless of Britain’s new stance; it is high time the new director-general, whoever that may be, sees to it that this change is forthcoming.