World health organization

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World Health Organization
World Health Organization

WHO logo

WHO headquarters in Geneva
Organization type Specialized agency
Abbreviation WHO, OMS, ВОЗ
management Tedros Adhanom Ghebreyesus Ethiopia
EthiopiaEthiopia 
Founded April 7, 1948
Headquarters Geneva Switzerland
SwitzerlandSwitzerland 
Upper organization United NationsU.N. United Nations
www.who.int

The World Health Organization ( English World Health Organization , briefly WHO ) is the coordinating authority United Nations (UN) for international public health . It is a specialized agency of the United Nations based in Geneva . It was founded on April 7, 1948 and today has 194 member states. It has been headed by WHO Director General Tedros Adhanom Ghebreyesus since July 2017 .

mission

The Constitution of the World Health Organization states that its goal is to achieve the highest possible level of health in all people. Its main task is the fight against diseases, with a special focus on infectious diseases , as well as promoting the general health of people worldwide.

Emergence

The idea of ​​a World Health Organization was formulated in San Francisco in 1945 as part of the founding conference of the United Nations. Following the International Health Conference from June 19 to 22, the constitution of the World Health Organization was passed in New York on July 22, 1946 and signed by 61 states. It came into force as the United Nations' “Specialized Agency” on April 7, 1948 after the ratification of the 26th signatory state.

membership

Membership is open to all member states of the United Nations . All UN states with the exception of the Principality of Liechtenstein have made use of this opportunity . The US will leave on July 6, 2021. Other countries can be accepted as members by a simple majority of the World Health Assembly. This has happened in the case of Niue and the Cook Islands . Territories whose foreign policy is carried out by other states can become associate members. You will be informed in detail and have a limited right to participate and vote. Associate members include Puerto Rico and Tokelau . Furthermore, subjects of international law can receive observer status. This is currently held by the Holy See , the Order of Malta , the International Red Cross and the Palestinian Authority .

organs

Meeting room of the WHO Executive Board in Geneva

The business of the WHO is carried out by its main organs , the World Health Assembly , English World Health Assembly (WHA), and the Executive Board (Executive Board).

  • The World Health Assembly is the highest decision-making body. All WHO members meet in Geneva every May to decide financial and organizational matters and to define future programs. For example, the 72nd WHA passed the ICD-11 in May 2019 after a 12-year development phase . Among other things, the assembly elects the general director with a two-thirds majority, with all members having one vote.
  • The Executive Board is composed of 34 health experts from the Member States. They are elected by the World Health Assembly for a term of three years. In the period between the annual meetings of the WHA, the Executive Board is responsible for governance. The main tasks of the Executive Council are to implement the resolutions and guidelines of the Assembly.

Regional offices

The six administrative regions of WHO

The six regional offices are located in the following cities:

Each regional office is headed by a regional director elected by the regional committee for a period of five years. The name of the candidate for the post of Regional Director is conveyed to the Executive Board, which appoints him.

WHO is keen to increase its presence in the Member States. Around 200 collaborating centers and research institutions as well as 149 local offices support the ongoing WHO programs through their activities. In total, the WHO has more than 7,000 employees.

financing

In the two-year budget for 2008–2009, revenues were $ 3.759 billion and expenses were $ 3.941 billion. For 2016, revenue was $ 2.364 billion and spending was $ 2.471 billion. The WHO thus had the largest budget of all the specialized agencies of the UN. The contributions are calculated according to a key, whereby the amount of the contribution depends on the solvency of the respective country. 52% of the voluntary contributions of 2.745 billion US dollars were paid by WHO member states, mainly China, Japan, Germany and the UK. The remainder of the voluntary contributions came mainly from foundations (21%), from international organizations (17%) and 5% each from NGOs and the private sector. The remaining income came from WHO services or the payment of outstanding contributions. In the two-year budget for 2018-2019, 15.18% of its funding came from the United States , 12.12% from the Bill and Melinda Gates Foundation and 8.18% from the Global Alliance for Vaccines and Immunization (GAVI) , according to the WHO The three largest donors thus already accounted for over a third of the total funding volume of the WHO. On April 15, 2020, US President Donald Trump announced that he wanted to stop payments to the WHO due to a "lack of" reforms in the future. On July 7, 2020, the USA finally announced its withdrawal from the WHO.

WHO projects are partially funded as public-private partnerships . These include:

In the meantime, according to Bernd Hontschik , 80% of the WHO budget came from voluntary contributions by member states and donations from foundations that cast doubt on the independence of the WHO, as he wrote in an article in the Frankfurter Rundschau at the beginning of 2019. Even the Germany radio reported critically about the current funding practice of WHO.

The Global Fund to Fight AIDS, Malaria and Tuberculosis (GFATM), which was founded by the G8 in 2002, is no longer part of the WHO program budget . In 2005, the WHO described its collaboration with the GFATM in a recommendation for action. Also outside the WHO, the United Nations Joint Program for HIV / AIDS (UNAIDS), the International Facility for the Purchase of Medicines (UNITAID) and, for example, the International Agency for Research on Cancer have their own accounts .

Mission and goals

According to the WHO constitution

South side of WHO headquarters in Geneva

The constitution of the WHO states that its purpose is to help all peoples to achieve the best possible state of health. The WHO strategy “Health for All in the 21st Century”, adopted by the World Health Assembly in 1998 and based on the 1978 Alma Ata Declaration , serves to achieve this goal . The aim is to achieve a state of health that enables everyone to lead a socially and economically productive life. Health is perceived as an essential part of human development.

Health is defined in the WHO Constitution as “a state of complete physical, mental and social well-being, which is not only characterized by the absence of illness or disability”. The concept of health promotion in the Ottawa Charter was further developed by the WHO in 1986. It postulates that in order to achieve this state both individuals and groups can satisfy their needs, perceive and realize their wishes and hopes, and master or change their environment. In this sense, health is defined as a state of complete physical, mental and social well-being and understood as an essential part of everyday life - and not as a primary goal in life.

Safe motherhood

Since 1987 (Nairobi) the WHO has been running the population policy Safe Motherhood Initiative together with the World Bank and UNFPA . For UNFPA and USAID (the world's largest buyer of pharmaceutical contraceptives) contraceptives that have not yet been approved are “prequalified” by the WHO. The initiative was funded by Pharmacia & Upjohn . The WHO (under the leadership of its superordinate World Bank) is a relevant organization of the Population Control Establishment (Hartmann 1995). In connection with family planning (control of population growth) the term Maternal Child Health (MCH) is used.

tasks

general tasks

  • Worldwide coordination of national and international activities in the fight against communicable diseases such as AIDS , malaria , SARS , flu and coronavirus
  • Launch of global vaccination programs, also for the prevention of pandemics , and programs against health risk factors such as smoking or obesity
  • Regular collection and analysis of global health and disease data
  • Support in setting up the most effective and cost-effective health systems in developing countries (e.g. Bamako initiative in Africa)
  • Creation of a model list of essential drugs
  • The World Health Report (English. World Health Report ) on global health care or existing disease problems, which is published annually by the WHO
  • The WHO offers medical help in radiological emergencies via the REMPAN network (Radiation Emergency Medical Preparedness and Assistance Network)

Regulatory tasks

A central task is to develop guidelines, standards and methods in health-related areas, to standardize them and to implement them worldwide. The WHO constitution provides three instruments for this: international treaties , regulations based directly on the WHO constitution and non-binding recommendations.

  • The only developed under the auspices of WHO and adopted by the WHA on 21 May 2003 international treaty, the WHO Framework Convention on Tobacco Control (Engl. WHO Framework Convention on Tobacco Control , FCTC ). The Framework Convention arose from the recognition that the global spread of tobacco consumption has serious consequences for public health. Therefore, the greatest possible international cooperation in tobacco prevention and in combating the illegal trade in tobacco products is necessary.
  • Regulations based directly on the WHO Constitution only exist in two areas. The International Statistical Classification of Diseases and Related Health Problems (ICD) was first issued in 1949 as ICD 6 and has been revised several times since then, the last time in 1999 (ICD-10). Also already in the early days of WHO were the International Health Regulations (Engl. International Health Regulations , IHR ) adopted. They were passed in 1971 and have since been revised three times, most recently in 2005. A majority of the WHA members can make both sets of regulations legally binding for all member states. The only possibility for a member state to evade the obligation is to announce within a certain period of time that it rejects the regulation or makes reservations (so-called opting out ).
  • The WHA or other organs of the WHO have adopted countless non-binding recommendations, resolutions, standards or methods. Despite the lack of legally binding force and the lack of sanctions in the event of violations, they are generally followed by the WHO member states. This applies at least to standards with a technical or scientific character. Other non-binding recommendations, such as the 1981 adopted International Code of Marketing of substitutes for breast milk (Engl. International Code of Marketing of Breast-Milk Substitutes ), are politically controversial. The implementation in the individual states and compliance with the code by the baby food industry was sometimes not carried out at all or only hesitantly.
  • In addition, the WHO is assigned regulatory tasks through international treaties, for example through the Uniform Convention on Narcotic Drugs of 1961 and the Convention on Psychotropic Substances of 1971. These are often fulfilled by the expert commission set up by the WHO.

Campaigns and Actions

With its campaigns, WHO aims to draw public attention to problem areas in health care. For example, in 2005 the aim of the WHO-5 program was to improve the hand disinfection rate ; In 2008, an operations checklist was introduced to raise global safety standards in this area.

2020 was dedicated by the WHA as the International Year of the Nursing and Midwife, as this year marks the 200th birthday of Florence Nightingale .

In addition, there are campaign weeks and days, for example the campaign week for immunization.

successes

The WHO has achieved the greatest successes in the fight against infectious diseases. Thanks to global vaccination programs, the death or disability of several million people can be prevented every year. After years of fighting smallpox , the World Health Assembly of the WHO declared the disease to be eradicated in May 1980 on the recommendation of a commission of experts in December 1979.

The development of vaccines against malaria and schistosomiasis approaches a success and the eradication of poliomyelitis (polio) in the coming years will be sought.

According to Alexa , who.int is the 205th most popular website on the Internet.

criticism

Financing and Conflicts of Interest

Critics see financing as a problem. In 2014, Frontal21 reported that of the WHO's annual budget of around US $ 4 billion, around US $ 3 billion is voluntary contributions, including larger donations from companies, particularly those in the pharmaceutical industry. According to the report, Transparency International criticizes the states' far too low mandatory contributions to WHO. As a result, from 2001 the WHO was driven into the arms of industry. Similar criticism comes according to the report from Medico international , which believes that the WHO is underfunded to be able to react appropriately to a crisis like Ebola. The WHO is more and more dependent on money from the economy, which endangers the neutrality of the WHO. Medico international demands that private interests in the WHO be pushed back, the WHO decent ? finance and democratize. According to the Frontal21 report, the British Paul Flynn, who led the Council of Europe investigation into the WHO in 2010, criticized the WHO as follows: “In my opinion, it [the WHO] is still excessively influenced today by the pharmaceutical industry, which is very skilled takes action in the manipulation of health expenditure, in favor of its own financial interests. "

WHO projects are also partially financed as public-private partnerships . a. the Global Alliance for Vaccines and Immunization ( Global Alliance for Vaccines and Immunization; GAVI ) to 8.39%, which 75% from the Bill and Melinda Gates Foundation is financed (MoH), it being the latter with another almost 10% financial share lt . WHO statistics 2018/2019 is available. The foundation will u. a. of Medico International accused to deliberately propagating activities of companies and support whose shares it holds. About 18% of the budget of the World Health Organization comes from donations from both foundations, so that they have a great influence on WHO policy. In addition to the USA, these occupy the first three places among donors to the WHO. The BMGF recommends the award of WHO contracts to corporations such as MSD , GlaxoSmithKline , Novartis and Pfizer , whose shares are held by the foundation. "Big Pharma, the pharmaceutical companies, and Big Food, the food companies, unscrupulously used precisely this conflict of interests of the WHO," said Indian health expert Amit Sengupta.

Influenza

The WHO was and is criticized for its behavior in the fight against pandemics . After the occurrence of the H5N1 virus (also known as bird flu H5N1 ) in May 2005 - due to the warning from the then vaccination director Klaus Stöhr of a possible worldwide flu epidemic ("up to 7 million deaths") - governments paid huge sums of money Influenza drugs Tamiflu and Relenza purchased. Although the virus spread worldwide, there were only a few human diseases, so that only 152 people worldwide died from the H5N1 bird flu , far fewer than from seasonal flu. (In 2007, Klaus Stöhr moved from the WHO to the pharmaceutical company Novartis ).

After the appearance of the A / H1N1 virus ( swine flu ), the WHO gradually increased the epidemic warning level to the highest level 6 ( pandemic ) as the disease spread . The governments then ordered vaccines (in Germany alone for around 450 million euros) and flu drugs. Criticism arose above all because the director of the WHO vaccines department - Marie-Paule Kieny - worked for the French pharmaceutical company Transgene SA, which maintains strategic partnerships for vaccine production with the Swiss pharmaceutical company Roche , before joining the WHO . The Council of Europe investigated the suspicion that there was close interaction between WHO and the pharmaceutical industry.

Ebola

During an Ebola outbreak from 2014 to 2016 in West Africa , the WHO was criticized by various NGOs for inaction because they only managed the epidemic instead of organizing aid.

COVID-19

The COVID-19 pandemic was classified as a pandemic by the WHO on March 11, 2020 , when it had already spread from China to other countries and over 800 people died from it in Italy. Their actions have been sharply criticized , among others, by the governments of the United States , Australia and Japan as being too hesitant. The WHO had behaved "a slave to China" and "in the early phase of the world insisted that China did not have an epidemic of pneumonia". Conversely, the WHO had been chalked up eleven years earlier for the "hasty" declaration of the swine flu pandemic .

Taiwan

The Republic of China (Taiwan) , which had been excluded from the United Nations in 1971, applied to join WHO with observer status. However, the World Health Organization rejected this in 2004 under pressure from the People's Republic of China because of the one-China policy . Taiwan was allowed to attend WHO meetings and events as an observer between 2009 and 2016, but was forced to stop participating due to renewed pressure from China. In 2017-2020, the WHO refused to allow Taiwanese delegates to attend the WHO annual meeting. Taiwan journalists were denied access to reports on the gathering on several occasions.

This is cause for criticism, as Taiwan is cut off from the international health system and it is difficult to share its own knowledge with others. At the end of 2019, the country was the first country ever to warn the global community and the WHO about the new virus, but was not heard.

When asked about ignoring Taiwan, Bruce Aylward, as WHO advisor for China , broke off an interview with a Hong Kong journalist in March 2020. After two invitations to be heard were declined, Aylward was summoned in a unanimous decision by the Health Committee of the Canadian Parliament . The WHO appointed Aylward as a member of its Global Leadership Committee in Geneva.

United States

On April 15, 2020, US President Donald Trump announced the temporary suspension of US payments to WHO and stated that the organization had failed to perform its basic tasks during the coronavirus outbreak in China, for which it must be held responsible. He accused the WHO of mismanagement and of concealing the extent of the epidemic in its early days in China. Under its director-general Tedros Adhanom Ghebreyesus, the WHO had shown too close a closeness and too uncritical attitude towards the People's Republic of China. UN Secretary General António Guterres and German Foreign Minister Heiko Maas criticized Trump's decision. The Swiss press commented on the decision as an “ own goal ”, saying that China's influence in the UN would increase and that he apparently wanted to divert attention from his own failures. The Alliance for Multilateralism published a statement in which over 20 countries pledged their support to the WHO.

On May 18, 2020, Trump reiterated his massive criticism of the WHO, in which he complained, among other things, that the WHO had not responded to the early warnings from Taiwan at the end of December 2019. According to Trump, these warnings were not forwarded to the world public for political reasons. He announced that he would finally cease payments to WHO and reconsider WHO membership of the USA if desired reforms (“substantive improvements”) did not take place.

On May 29, 2020, Donald Trump announced the end of his country's cooperation with the WHO in a press conference. In July 2020, the US officially submitted its withdrawal from the WHO. It will take effect on July 6, 2021.

Cooperation with the IAEA

On May 28, 1959, the 8th World Health Assembly between the International Atomic Energy Agency and the WHO passed resolution WHA12-40. The contract states u. a states that the responsibility for investigations, developments and applications in the field of nuclear energy lies primarily with the IAEA and that the WHO has to consult the IAEA on relevant activities and to regulate these by mutual agreement. This dependence of the WHO on the IAEA, which, according to the statutes, is supposed to promote the peaceful use of nuclear energy worldwide, has been criticized many times. For example, WHO and the IAEA jointly estimate the number of worldwide victims of the Chernobyl disaster to be far too low. From different sides, u. a. of the MEPs Rebecca Harms , so the resolution of the resolution WHA12-40 is required.

General Directors

No Surname country Length of service
1 Brock Chisholm CanadaCanada Canada 1948-1953
2 Marcolino Gomes Candau BrazilBrazil Brazil 1953-1973
3 Halfdan T. Mahler DenmarkDenmark Denmark 1973-1988
4th Hiroshi Nakajima JapanJapan Japan 1988-1998
5 Gro Harlem Brundtland NorwayNorway Norway 1998-2003
6th Jong-wook Lee Korea SouthSouth Korea South Korea 2003–2006 († May 22)
7th Nordström is different SwedenSweden Sweden 2006-2007
8th Margaret Chan China People's RepublicPeople's Republic of China People's Republic of China 2007-2017
9 Tedros Adhanom Ghebreyesus EthiopiaEthiopia Ethiopia since 2017

Action days

The WHO and the WHA have passed resolutions on numerous world days or have supported world days already initiated by other international organizations. Other days of action related to health topics can be found in the list of days of remembrance and days of action .

Honors

In 2009, WHO received the Princess of Asturias Prize in the international cooperation category for its success .

Broadcast reports

literature

  • Yves Beigbeder : The World Health Organization is changing. In: German Society for the United Nations eV (Ed.): United Nations. Journal for the United Nations and its specialized agencies. Issue 5/2012. BWV, Berlin 2012, ISSN  0042-384X , pp. 195-201 ( PDF ).
  • Günther Unser, Ingo Winkelmann : ABC of the United Nations. 9th edition. Foreign Office, Berlin 2017, pp. 252–253 ( PDF ).
  • Günther Unser: The UN - Tasks, Structures, Politics. 7th edition. dtv, Munich 2004, ISBN 3-423-05254-6 , pp. 217-222.
  • Helmut Volger (Ed.): Lexicon of the United Nations. Oldenbourg Wissenschaftsverlag, Munich / Vienna 2000, ISBN 3-486-24795-6 , pp. 654-660.

Web links

Wiktionary: World Health Organization  - explanations of meanings, word origins, synonyms, translations
Commons : World Health Organization  - collection of pictures, videos and audio files

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