Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN

User menu

  • Subscribe
  • My alerts
  • My Cart
  • Log in

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN
  • Subscribe
  • My alerts
  • My Cart
  • Log in
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

WHO signals intent to trim sails

Roger Collier
CMAJ January 10, 2012 184 (1) E29-E30; DOI: https://doi.org/10.1503/cmaj.109-4067
Roger Collier
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

The year 2012 is poised to become a time of substantial change for the World Health Organization (WHO), which plans on initiating reforms to improve its leadership, increase cooperation between member states and become more efficient and transparent. Though the proposals for reform have only been described in broad strokes thus far, one thing is certain: It all begins with money.

“This WHO debate about reform has been going on for a while, and much of the concern is about the way it is financed,” says Dr. Andrew Cassels, director of strategy in the office of the director-general of the WHO. “Our budget is made up of 25% membership fees, which everybody pays, and 75% comes from voluntary donations. That 75% is pretty heavily tied to certain areas, so some objectives get good funding and others less so. Can we do something about increasing the flexibility of our financing? That’s where we are starting.”

The financing reforms will be implemented in conjunction with a narrowing of WHO’s focus to five core areas: health development, health security, strengthening health systems and institutions, generating evidence on health trends and determinants, and convening for better health (www.who.int/mediacentre/news/notes/2011/eb_20111104/en/index.html).

WHO’s executive board also indicated during a special session in November 2011 that it supported proposals forwarded by member states and the director-general which are aimed at strengthening governance, improving financing, facilitating communication across the organization, and increasing transparency and accountability.

The integral financing issue is scheduled to be addressed at a January 2012 meeting of WHO’s executive board. Part of the strategy will likely include dealing with donor nations in the aggregate rather than individually, which will enable each country to learn what others are doing, Cassels says. It would also enable countries to cooperate to achieve international health goals and help to reduce gaps in funding in certain areas. From there, work can begin on a framework for more detailed priorities.

“The whole thing comes together at the World Health Assembly in May,” Cassels says. “We will be clear on the proposed reforms. We will know then which ones will fly and which ones will drop.”

Figure1

The World Health Organization’s executive board met in Geneva, Switzerland, in November 2011 to discuss agency reforms.

Image courtesy of Reuters/Michael Buholzer

Many experts on global health have claimed WHO is overcommitted and overextended, and that reforms to narrow its focus are long overdue (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-3933). WHO can afford to cut certain programs, the experts suggest, because countless other health agencies have been created in recent years to address particular health concerns, including charities, nonprofits, United Nations agencies, global and regional funds, global health missions and product development partnerships with a collective annual budget of US$22 billion (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-3701).

“I don’t think the organization is in crisis. This is not the first time the WHO has been through a reform process,” says Rachel Irwin, a researcher in the Global Health and Security Programme at the Stockholm International Peace Research Institute, a think tank based in Sweden. “What the WHO does well is provide a forum where health priorities can be created and standards can be made. It holds meetings that bring people together to hash out global health issues. It has the most democratic forum for these discussions to happen in. Other global health initiatives are not as inclusive.”

And though there are more health organizations now than ever before, it is still important that WHO continue to do what it does well, says David Stuckler, a lecturer in sociology at the University of Cambridge in the United Kingdom. “I strongly believe that many of the challenges we face are truly global. Chronic disease is one of those challenges,” says Stuckler. “No country on its own can stop threats that transcend borders.”

How can the WHO better address these types of international health threats?

It all comes back to money, says Stuckler. “In 1980, three-quarters of the money was in the regular budget. The problem is, now three-quarters of the budget is the voluntary budget. Within the regular budget, money is relatively aligned with health needs. But if you look in the voluntary budget, there is a major misalignment.”

Addressing that problem appears to be a major priority for Dr. Margaret Chan, the director-general of WHO. Health priorities should not be set according to the sources of financial contributions, Chan stated in a recent address (www.who.int/dg/speeches/2011/reform_priorities_01_11/en/index.html). “Priorities must be driven by burning unmet health needs, and not by resources.”

“Money follows priorities, and not the other way around,” Chan added.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 184 (1)
CMAJ
Vol. 184, Issue 1
10 Jan 2012
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
WHO signals intent to trim sails
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
Citation Tools
WHO signals intent to trim sails
Roger Collier
CMAJ Jan 2012, 184 (1) E29-E30; DOI: 10.1503/cmaj.109-4067

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
WHO signals intent to trim sails
Roger Collier
CMAJ Jan 2012, 184 (1) E29-E30; DOI: 10.1503/cmaj.109-4067
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • Scopus
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Scopus (1)
  • Google Scholar

More in this TOC Section

  • Canada’s health system is among the least green
  • Some provinces still delay access to health records via patient portals
  • Nausea-inducing illness caused by cannabis still underdiagnosed
Show more News

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Videos
  • Alerts
  • RSS

Information for

  • Advertisers
  • Authors
  • CMA Members
  • Copyright and Permissions
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact

Copyright 2019, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire