Editorial, opinion piece examine future of World Health Organization

As the World Health Assembly draws to a close in Geneva this week, and Margaret Chan accepts her appointment to a second five-year term as director-general of the World Health Organization (WHO), an editorial and an opinion piece examine the future of the U.N. health agency. Summaries of these pieces appear below.

• Richard Horton, Lancet: "In WHO's annual World Health Statistics, released last week, the agency chose, correctly, to present a picture of change," Horton, editor-in-chief of the Lancet, writes, adding, "WHO must be a science-led and data-driven organization," led by scientists. He continues, "WHO's greatest challenge [is] to focus on a few priority initiatives, and to realign resources to support those priorities." Horton says the WHO should focus on "three programmatic pillars" -- health of the people of Africa, women's health, and non-communicable diseases -- that "must be part of an inspirational vision ... that has gradually been forming: universal health care in an era of sustainable development." He concludes, "The agency has 12 months to put 'reform' behind it and to embark on a phase of vigorous leadership and strategic renewal. It is at next year's World Health Assembly that another report card needs to be written -- this time not just for health, but for WHO itself" (5/26).
• Devi Sridhar, Lawrence Gostin, and Derek Yach, Foreign Affairs: "After 15 years of heralded progress on pandemic preparedness, tuberculosis control, tobacco regulation, and health metrics, the World Health Organization faces confusion over its future," Sridhar, a lecturer in global health politics at Oxford University; Gostin, a professor of law at Georgetown University; and Yach, senior vice president of global health and agricultural policy at PepsiCo and former executive director of the WHO, write. "The most serious examples [are] the WHO's inability to address non-communicable disease (NCD) prevention globally, to improve access to health systems, and to set global priorities in health," they argue. "To be effective, the WHO needs to assert the importance of health in decision-making at the national level" and "to be at the table when global trade and financial decisions are negotiated," they write, adding, "Stronger diplomatic abilities adapted from the trade and finance regimes, in addition to a well-articulated case for linkage to major global debates on sustainable development, human rights, and security, will earn the WHO its right in settings where health can truly flourish" (5/24).