Handling epidemics isn’t the World Health Organization’s forte—unless fighting against sugary drinks counts.
The Ebola outbreak has again revealed an international health system that lacks the plans and capabilities to fight an epidemic or pandemic. Atop the pyramid of this health system sits the United Nations’ World Health Organization, whose 1948 charter gives it “directing authority” for “international health work.”
In lieu of another round of incremental reforms at the WHO and another appeal for budget increases, it is time to try something else. We need a new organization within the international health system to prevent, detect and verify outbreaks—and respond rapidly to them.
The WHO’s record of handling epidemics over 30 years reveals a health system that is getting worse, not better. On at least four occasions the U.N. organization has failed to deal with major outbreaks of communicable disease.
In the 1980s, the WHO underestimated the scale of the AIDS epidemic and was plagued by infighting and poor coordination. The U.N. Economic and Social Council concluded in 1994 that the AIDS crisis was beyond the WHO’s capabilities to coordinate, so the U.N. created a new entity, the Joint U.N. Program on HIV/AIDS, or Unaids. Although the WHO opposed the new program, history has shown that Unaids, with its clear, narrowly defined mission, has been more effective in addressing the AIDS epidemic.
In 2009 the World Health Organization was slow to address the H1N1 flu pandemic. It later commissioned an expert panel to investigate its mishandling of the crisis. The report released in 2011 slammed the WHO for making crucial errors, including a lack of transparency, poor external communication, management conflicts, and a “needlessly complex” definition of pandemic and its phases. H1N1 ended in 2010 and we were fortunate the strain had a lower mortality than initially feared. Notably, the panel concluded that the world isn’t ready to handle a major health disaster.