WHO Calls For $100 Million Emergency Fund, Doctor 'SWAT Team'

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The Ebola outbreak "overwhelmed" the World Health Organization and made it clear the agency must change, WHO's director-general, Dr. Margaret Chan, said Monday in Geneva. (AFP/Getty Images)
The Ebola outbreak "overwhelmed" the World Health Organization and made it clear the agency must change, WHO's director-general, Dr. Margaret Chan, said Monday in Geneva. (AFP/Getty Images)

Nearly 3,000 delegates from around the world are gathering this week in one of the most expensive cities in Europe to debate the fate of the World Health Organization.

There's one main question on the table: Will the WHO be given the power and money it needs to be the world's leading health agency, or will it plod forward in its current state — as a weak, bureaucratic agency of the U.N. known more for providing advice than taking action.

The Ebola outbreak in West Africa "overwhelmed" the agency and made it clear that the WHO must change, said WHO's director-general, Dr. Margaret Chan at the 68th World Health Assembly.

The U.N. health agency was slow to recognize the magnitude of the Ebola outbreak. It didn't have the money or the personnel to attack the epidemic on the ground. And probably most damning, the WHO failed to take the lead on what was clearly a major international health crisis.

Doctors Without Borders was frantically treating patients — and warning the world that the outbreak was out of control. The U.S. sent in military troops to build treatment centers. The U.N. Security Council side-stepped its own health agency and created a rival Ebola response mission that answered to New York instead of Geneva.

Chan says she has heard the critics and is pushing through change. "I am creating a single new program for health emergencies, uniting all our outbreak and emergency resources across the three levels of the organization," she said this week.

Chan is promising to streamline command of the WHO's global operations. She also wants to create a $100 million emergency fund and a rapid response team — think a SWAT team of doctors and nurses — to deploy to health crises around the world.

But this isn't the first time WHO has tried to better prepare for international pandemics. Previous efforts to reform the WHO have fallen flat, says Dr. Joanne Liu, the president of Doctors Without Borders, who is in Geneva for this meeting.

"It was like this after the swine flu in 2011, and the reality is it never materialized in some concrete changes," Liu says.

Even right now, her aid group is battling a meningitis outbreak in Niger that's killed more than 400 people, and they're struggling to get enough vaccines. There's an overall lack of leadership at the global level to get her workers the help they need out in the field, Liu says.

But reform has a better chance now because Ebola was so bad, says Lawrence Gostin, a professor of global health law at Georgetown University.

"A rapidly transmitted disease in the world's poorest countries, that's what WHO was created for, and it just utterly failed," he says. "It was unconscionable."

Structural changes at the WHO, however, still need to be approved by representatives from the nearly 200 nations currently meeting in Geneva.

Some countries don't trust the WHO, Gostin says. Others don't want to pay more money to fund it.

Some reforms will make it through this time, he says. But will those changes be enough to make the World Health Organization live up to its name — and be the world's leading health agency?

Gostin isn't optimistic. "In terms of long-term, sustainable, fundamental change — I don't see it."

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Copyright NPR. View this article on npr.org.

Transcript

STEVE INSKEEP, HOST:

And then there's the health of humans, which is much on the mind of the leader of the World Health Organization. Margaret Chan says her agency is not prepared for the next Ebola outbreak or any other major international health crisis. At an annual meeting, she called for major changes. All she has to do now is get representatives from 194 different countries to agree. Here's NPR's Jason Beaubien.

JASON BEAUBIEN, BYLINE: Nearly 3,000 delegates from around the world have gathered in one of the most expensive cities in Europe to debate the fate of the World Health Organization.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED MAN: We shall now take item three of the agenda.

BEAUBIEN: The main question at this meeting is this; will the WHO be given the power and money it needs to be the world's leading health agency, or will it plod forward in its current state as a weak, bureaucratic U.N. agency known more for providing advice rather than action? The WHO's Margaret Chan said the West African Ebola outbreak overwhelmed her agency and made it clear that the WHO must change.

(SOUNDBITE OF ARCHIVED RECORDING)

MARGARET CHAN: As director-general of WHO, I'm committed to building an organization with the culture, systems and resources to lead the response to outbreaks and other health emergencies.

BEAUBIEN: The U.N. health agency was slow to recognize the magnitude of the Ebola outbreak. Once it did, it didn't have the money or the personnel to attack the epidemic on the ground. And probably most damning, the World Health Organization failed to take the lead on what was clearly a major international health crisis. Doctors Without Borders was frantically treating patients. The U.S. sent in military troops to build treatment centers. The U.N. Security Council sidestepped its own health agency and created a rival Ebola response mission that answered to New York rather than to Geneva. Chan says she's heard the critics and is pushing through change.

(SOUNDBITE OF ARCHIVED RECORDING)

CHAN: I am creating a single new program for health emergencies, uniting all our outbreak and emergency resources across the three levels of the organization.

BEAUBIEN: Chan is promising to streamline command of the WHO's global operations. She also wants to create a $100 million emergency fund and a medical rapid response team - think a SWAT team of doctors and nurses - to deploy to health crises around the world. Joanne Liu, the international president of Doctors Without Borders, is in Geneva for this meeting. She says previous efforts at reform fell flat.

JOANNE LIU: It was like this after the swine flu in 2011, and the reality, it never materialized in some concrete changes.

BEAUBIEN: Even right now, her aid group is battling a meningitis outbreak in Niger that's killed more than 400 people, and they're struggling to get enough vaccine. Liu says there's an overall lack of leadership at the global level to get her workers the help they need out in the field. Lawrence Gostin, a professor of global health law at Georgetown University, says reform has a better chance now because Ebola was so bad.

LAWRENCE GOSTIN: A rapidly transmitting infectious disease in the world's poorest countries, that's what WHO was created for, and it just utterly failed. And it was just unconscionable.

BEAUBIEN: Structural changes at the WHO, however, still need to be approved by representatives from the nearly 200 nations currently meeting in Geneva. Some countries don't trust the WHO, Gostin says. Others don't want to pay more money to fund it. He thinks some reforms will make it through this time. But will those changes be enough to make the World Health Organization live up to its name and be the world's leading health agency?

GOSTIN: In terms of long-term, sustainable, fundamental change, I don't see it.

BEAUBIEN: Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.