Understanding global security - Peter Hough

HEALTH THREATS TO SECURITY
World Health Organization
A WHO Interim Commission came into operation in 1946 prior to the establishment
of the WHO proper in 1948 and had notable success in controlling a cholera epidemic
in Egypt in 1947. The organization was from the start marked by an independent
streak and it was agreed that the term ‘United Nations’ should not feature in its official
title, and that it would have a far more decentralized structure than any other UN
specialized agency. The decision to devolve a great deal of the work of the WHO to
six regions (Africa, the Americas, Europe, Eastern Mediterranean, South East Asia
and Western Pacific 2 ) was partly a practical decision as it facilitated the continuation
of the world’s oldest health IGO as the American arm of the new global body.
Centrally, the work of the WHO is directed by an annual World Health
Assembly (WHA), held in Geneva, in which delegates of its 191 member governments
vote on budgetary matters and overall policy. The WHA elect a geographically
balanced 32-member Executive Board to oversee the implementation of WHO policy.
The Executive Board members are intended to be public health specialists rather
than government delegates, although the six Regional Committees are made up
of health ministers. The WHO Director-General is elected by the WHA, on the
recommendation of the Executive Board and serves a five-year term at the Geneva
headquarters supported by 30 per cent of the WHO’s 3800 strong Secretariat.
A further 30 per cent of the Secretariat serve the regions, while the remaining 40
per cent are represented throughout the world in field programmes or as resident
advisers to government (WHO 2003). The WHO is financed by two distinct budgets:
the regular budget, made up of assessed government contributions, which finances
the central institutions; and the extra-budgetary funds, made up of voluntary aditional
contributions from governments and donations from other UN agencies (particularly
the World Bank) and private sources. The extra-budgetary funds can be targeted at
specific programmes at the donor’s request. The American information technology
tycoon Bill Gates, for example, has made contributions to campaigns on guinea worm
disease eradication and HIV research.
The undoubted high point of the WHO’s history was the global eradication of
smallpox, declared in 1978 after a vast immunization campaign. This momentous
effort, which had to overcome obstacles such as a cultural reluctance to accept injections
in some parts of India, saw many millions of people vaccinated and around
two million lives a year saved. Other successes include greatly reducing the impact
of Onchoceriasis (river blindness) through pesticide sprayings of the larvae of the
Simulium black fly and the development of the drug Ivermectin, and bringing yaws
and Poliomyelitis close to eradication through antibiotic and vaccination campaigns.
Fuelled by the breakthrough inventions of penicillin and DDT in the 1940s,
global health security appeared to be a realizable dream for the WHO, but many
of the battles in this major war have not been won. In 1955 a global eradication
programme for malaria was launched, the largest of its kind in public health history.
The use of DDT around human dwellings in the late 1950s and 1960s rapidly killed
all mosquitoes that came into contact with it, and virtually eliminated the disease
in all areas in which it was used. An illustration of DDT’s success in eliminating
malaria comes from comparing the numbers of infections before and after its extensive
use in Sardinia, Italy. There were 78,000 cases of malaria on the island in 1942
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