Priorities, Partners, Politics

Abstract

The World Health Organization (WHO) is once more asked to reinvent itself and become more effective. This essay discusses recurrent reform proposals directed at the WHO which, in different ways, ask it to find a strategic focus and thereby its niche in the crowded global health arena. Looking back at decades of reform endeavors at the WHO, it exposes the contradictions and unresolved normative conflicts with regard to the WHO’s priorities. Ultimately, the WHO’s effectiveness hinges on Member State support for public authority in global health, and thus the political commitment to protect it against capture by special interests.

Politicising pandemics: Evidence from US media coverage of the World Health Organisation

“…Following the end of the pandemic, these attacks should then subside to a more “normal” level. Moreover, perhaps criticisms based on poor performance will lead to reforms which help improve the organisation (Hanrieder, 2020). Likewise, the WHO, facing increasing legitimacy attacks and politicisation of its role, could engage in self‐legitimation, cementing its identity and objectives internally, if not externally (Dingwerth et al, 2020; Ecker‐Ehrhardt, 2018; von Billerbeck, 2022).…”

“…Around the same time, member states adopted a resolution for a “comprehensive evaluation” of the organisation's response to the pandemic (WHO, 2022). This contestation plunged the WHO into a deep legitimacy crisis, with proponents and critics waging discursive conflict along multiple fronts (Hanrieder, 2020; Lee & Piper, 2020; Yang, 2021). This contributed to a heightened politicisation of the WHO's response, especially in the US, where newspaper coverage of the pandemic featured politicians more frequently than experts (Hart et al, 2020).…”

Planetary Precarity and ‘More-Than-Human Security’: The Securitization Challenge in the Aftermath of COVID-19

“…During the Ebola outbreak in 2014, its reputation became "irrefutably damaged", with the "general consensus in the global health community that it fell short of its leadership responsibilities", as Clare Wenham observes, due largely to its shackling "financial and organizational constraints" ([63], p. 1). In the wake of further WHO failures during COVID-19, Tine Hanrieder has considered how the organization could be "strengthened beyond the pandemic" given the lack of "political commitment" for "an organization that has been weakened over decades" by a range of issues including primarily "underfunded mission creep" ( [64], p. 534). As she notes, positive developments such as "priority setting" and "strategic budgeting" might well be consistent aspirations in the WHO but these are sought in the context of a now normative model of public-private partnerships championed by the WHO's biggest shareholders, and so "without a new global social contract for public interest policy-making" the WHO's ability to "further global public health will remain limited" ( [64], p. 541).…”

“…In the wake of further WHO failures during COVID-19, Tine Hanrieder has considered how the organization could be "strengthened beyond the pandemic" given the lack of "political commitment" for "an organization that has been weakened over decades" by a range of issues including primarily "underfunded mission creep" ( [64], p. 534). As she notes, positive developments such as "priority setting" and "strategic budgeting" might well be consistent aspirations in the WHO but these are sought in the context of a now normative model of public-private partnerships championed by the WHO's biggest shareholders, and so "without a new global social contract for public interest policy-making" the WHO's ability to "further global public health will remain limited" ( [64], p. 541). As we emerge from COVID-19, there seems no doubt that a key task lies in renewing the WHO and enabling a more effective global health governance architecture.…”