WHO Director-General opens executive board session with calls for reform

Kicking off a nine-day annual WHO executive board meeting Monday, WHO Director-General Margaret Chan called for the board to consider areas where the agency can redirect resources in a more targeted manner so as to achieve greater outcomes, Reuters reports. "In a critical assessment of the United Nations body she has headed since 2006, Chan described wasteful overlap with other health financiers and said the WHO needed to concentrate on areas where it can make the most impact," the news service writes (MacInnis, 1/17).

"Chan said in opening remarks that the United Nations agency is stretched thin due to a level of demands impacting its efficiency in some areas, and that far-reaching reform is needed. She also warned against big corporations' influence on policies," Intellectual Property Watch writes in an article that examines some of the many topics to be discussed during the meeting which will run from Jan. 17 to 25 (Saez/New, 1/17).

"'We are not functioning at the level of top performance that is increasingly needed, and expected,' [Chan] told the WHO's executive board, which is reviewing a proposed $4.54 billion programme budget for 2010-2011," according to Reuters. Additionally, tough economic conditions have forced the WHO, as well as other "international health financiers such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the vaccine body GAVI" Alliance into what Chan referred to as "serious funding shortfalls."

The news service notes the WHO's 2010-2011 budget was scaled back due to the current economic situation from a proposed $5.84 billion. "Its programme budget in 2008-2009 was $4.23 billion," according to Reuters. "Chan said it was critical to avoid duplication with private-public partnerships as well as various charities, foundations and donor governments."

"WHO needs to change at the administrative, budgetary and programmatic levels. We do not need to change the Constitution, but we do need to undergo some far-reaching reforms," Chan said, noting that she would be looking to WHO's 193 member states to speak out about where areas of reform in the WHO should take place. Though Chan "did not name [program] areas to cut," Reuters writes, "she suggested the WHO should invest less in areas where others are very active" (MacInnis, 1/17).

"The level of WHO engagement should not be governed by the size of a health problem. Instead, it should be governed by the extent to which WHO can have an impact on the problem. Others may be positioned to do a better job," Chan said in her opening address, according to a transcript of her speech. "Because the determinants of health are so broad and interactive, we need to keep an eye on everything. But we do not need a programme for everything," she said (1/17).

Chan also used her opening address to the board to highlight the WHO's contributions to achievements in public health over the past year, including the launch of the meningitis vaccine in Africa, VOA News writes (Schlein, 1/17). According to the transcript from the address, Chan also highlighted the agency's commitment to a new strategy to fight polio and the launch of the WHO's first report on neglected tropical diseases (1/17).

Despite signs of progress, VOA News writes, Chan expressed concerns over what funding shortfalls would mean for future efforts to tackle diseases. "Treated bed nets need to be replaced.  Antiretroviral therapy for AIDS is a lifeline, for a lifetime. … Case finding and treatment for tuberculosis are a constant undertaking that needs to intensify.  Every new generation of babies must be protected from vaccine-preventable diseases," Chan said. "Does the international community have the stamina, and the resources, to reach the milestones?" she asked, according to VOA News (1/17).

Over the week, the rotating 34-member executive board will explore such topics "pandemic influenza preparedness, public health, innovation and intellectual property rights, the WHO HIV/AIDS strategy, substandard medicines, and the future financing of the WHO," according to Intellectual Property Watch (1/17).

The board "will make decisions to advise and facilitate the work of the World Health Organization and prepare the agenda for the next Health Assembly in May," VOA News adds (1/17).

Health Officials To Debate Whether To Destroy Last Of Known Smallpox Virus Stocks

During the meeting this week, health officials will debate "whether to set a date to destroy the last known stocks of the smallpox virus - a virus that killed hundreds of millions of people before it was eradicated in 1980," the Wall Street Journal reports in an article that examines how U.S. and Russian health officials would like to hold onto the stocks, despite the fears of other countries and health officials that "the smallpox stocks could be unleashed accidentally or fall into the wrong hands" (1/18).

"The U.S. and Russia will fight international efforts this week to set a deadline to destroy the last known stocks of smallpox, saying the deadly virus is needed for research to combat bioterrorism," the Wall Street Journal reports in a separate article. "On Wednesday, representatives of 34 countries, including the U.S. and Russia, are scheduled to discuss whether enough research has been completed on developing medical defenses to the virus to set a deadline for destroying the remaining samples. The group's executive board will then pass the debate on to the agency's larger decision-making body, the World Health Assembly, which will issue a decision at a meeting in May," the newspaper writes.

The article examines how "[w]hether to extinguish the remaining smallpox strains has been one of the fiercest debates in global public health over the past two decades," and includes comments by health experts on both sides of the debate. "Some say the argument is moot: Smallpox could eventually be synthesized in a lab, making total eradication impossible. Others argue the threat of a synthetic virus is all the more reason to get rid of the remaining strains," the newspaper writes.

Opposition to the U.S. holding onto the smallpox virus stocks could come "from developing countries, where the memory of smallpox is freshest," according to the Wall Street Journal. The article notes the amount of money the U.S. has dedicated to smallpox countermeasures - some $1.8 billion since 2001 - and details the history of the debate (McKay, 1/18).