The World Health Organisation in Global Health Governance - Essay Example

Role of the WHO in Global Health Governance Presently, the world’s health risks and opportunities are changing at an increasing rate. This has resultantly led to the inability of assuring the capacity to influence the determinants of health, status and outcome solely via national actions due to the trans-border and cross-border flows of goods, services, people and ideas. There is a dire need for considerably effective collective action by governments, businesses, as well as the civil society so as to better have control over these health opportunities and risks. At each at every political phase, governance entails a number of factors, actors and forces (WHO 2010, p.1). This has resultantly called for the reassessment of the rules and institutions governing healthy policy and practice at various levels, including subnational level, national level, regional level and global level. This has been so due to a number of factors, which despite the fact that they are outsider the health sector brackets, they are progressively affecting health. Some of these factors include such as collective violence, trade and investment flows, conflict, criminal activity, communication technologies and environmental change (WHO 2010, p.1). This thus necessitates for the broadening of the agenda of public health to include the aforementioned global forces and at the same time see to it that human health is promoted and protected. It is however broadly believed that the international health governance system is not sufficiently meeting these needs and besides, this current system is characterised by a number of gaps and shortcomings. As a result of these perceived shortcomings, the concept of global health governance has become a key interest area of debate in the field of international health. Both public health experts and official have in the recent past increasingly referred global health governance (GHG) as a sophisticated national as well as international tracking down of public health (Ramradt-Scott n.d., p.73). In the past two or so decades, both the biological and political worlds have caused profound changes in the global health governance landscape, thus bringing about overlapping and competing administration groups entailing multiple participants addressing health problems through divergent principles and processes. New health challenges, the likes of rising non-communicable chronic diseases and global warming have been looming on the horizon. This has greatly affected the role of the World Health Organisation (WHO) of availing leadership on worldwide health matter and moulding the health research agenda in a negative way. Having been founded in the aftermath of the World War II, WHO has been dedicated to making improvements in global health through its involvement in various public health initiatives, offering technical support and at times material aid geared towards helping in the fight against infectious and chronic diseases (WHO 1983, p.6). Role of the WHO Being the organisation of nation states aimed at promoting global health, WHO is an actor that focuses on the apprehension of social right in the health arena. Apart from being a core objective of the organisation, health for all is also an established principal wish of national and international health activities by all the world’s nations. Undeniably, it is common knowledge that WHO’s primary function is to direct and coordinate matters concerning international health. Nevertheless, this intergovernmental organisation is obliged to see through the fulfilment of a considerably stout normative responsibility in the creation of health-related standards that strongly enhance cooperation (Burci & Vignes 2004, p.124). Among the key roles of the WHO was the creation of health-related legal instruments including such as agreements, regulations, conventions and recommendations which would permit it exercise rational and legal authority. Since it had been obliged with ensuring the improvement of the global health grants, this intergovernmental organisation was granted a measure of moral authority which ensured that there was adequate professional staffing so as to reinforce its expert authority and uphold its prowess (Smith 2009, p.10). In ensuring that international health work is well directed as well as the merging of norm formation, the WHO adopted the International Health Regulations (IHR) in 1969 as one of its chief functions. In elaboration, tis regulations were geared towards ensuring thoroughgoing security against the worldwide spread of diseases with the smallest possible intrusion with the global traffic (WHO 1983, p.5). Under these regulations, each and every member state was under obligation to report any outbreaks of six diseases which the intergovernmental organisation had branded ‘quarantinable’. These diseases included cholera, plague, smallpox, yellow fever, louse-burn typhus and louse-borne relapsing fever. A few years later however, the scope of the reportable diseases reduced to three; plague, yellow fever and cholera and this necessitated the revision of the IHR legislative instrument. But in 2005, WHO led an amendment of the IHR 1969 treaty from the earlier three diseases so that this reporting could now be applicable to any public health event considered to be in the offing of spreading past the borders of any member country (WHO 2010, p.1). It is thus evident that over the years, it has been the role of the WHO to take hastened steps in ensuring that the spread of any diseases being reported for the very first time in contained in good time by identifying the occurrence of an outbreak. Although numerous governments have gone in measurable lengths in effort to evade making an outbreak declaration, the revised IHR 2005 has permitted the WHO to receive notifications pertaining to disease outbreaks from even nongovernmental sources (WHO 2010, p.1). This has been termed to be a profound step in the control of global infectious diseases since the receipt of such outbreak reports has heightened the probability of the WHO to receive notifications on disease outbreaks more hurriedly. In so doing, the chances of containing an outbreak in a more rapid manner, before it becomes a worldwide problem is fastened thus helping in the achievement of the principal objective of the WHO (WHO 2010, p.1). With the persistent globalization, the spread of infectious diseases has been on the increase. This has so been evidenced by the rapid outbreak of Severe Acute Respiratory Syndrome (SARS). As a result, health inequalities between as well as within countries have been reported to exacerbate. Notably, this exacerbation- borne of globalization- has been as a result of the worldwide marketing of unhealthy patterns of consumption (Kohlmorgen 2005, p.6). This means that apart from global externalities and inequalities, social and economic factors had had their contribution towards the increasing disease outbreaks and their subsequent spreading. It is also significant noting that the distribution and allocation of the various health benefits (originating from the globalization process) is a function of the already in existence social, political and economic conditions within a country. Moreover, the same depends on the equality of trade and investment treaties, political and economic factors and the strength of the global health system which is multilateral in nature. Factually, globalization presents numerous problems that are significant as well as beyond the manageability capacity of an individual state (Dogdson, Lee & Drager 2002, p.12). In globalization and health, the World Health Organisation is focused on availing assistance to member countries to not only carry out an assessment of, but also play the role of acting on cross-border risks to the security of public health. This intergovernmental organisation has come to the recognition that domestic action on its own may not be satisfactory in ensuring health at a local level. As a result, it avails necessary collective support action in efforts to ensure the addressing of the above mentioned cross-border health risks in a more satisfactory manner thus realising improvements in the global health outcomes. In the execution of this mandate, the WHO is aware of the in existence institutional mechanisms, rules as well as forms of organisations (Gostin et al 2010, p.24). Moreover, WHO has undergone a number of reforms so as to better position itself in responding to the incipient health challenges as a result of globalization. As a matter of fact, the organisation’s globalization research programme in the field of health has identified global governance for health as among the issues calling for in-depth analysis so as to better inform policymakers who have an interest in shaping the future landscape on global health. The WHO has ensured coordination of the revision process across all its members states so as to achieve global alertness and at the same time be in a better position to detect and subsequently respond to those diseases considered to be infectious within the shortest time possible thus augmenting the disease reporting and control. Another effort that WHO has made and keeps on cultivating is the alteration of the reporting norms, for the same to become not only expected, but also respected (Ruger & Yach 2008, p.5). These reforms have ensured that in the event of any outbreak, reporting has to be done irrespective of the economic consequences of the act of reporting. Initially, the IHR was engaged in an uphill battle. Later on however, following the involvement of the WHO in global health governance through the revision of some of its regulations, sufficient resources have so been obtained to help in the facilitation of the ‘syndromic’ system of reporting. The intergovernmental organisation is devotedly channelling resources so as to heighten the revision process, enhance the publication of occasional documents and hold discussions with the World Health Assembly (WHA). It was after the outbreak of the SARS that the above was intimately engaged (WHO 2010, p.1). Prior the SARS outbreak, it was broadly acknowledged that states were responsible for governing any outbreaks of infectious diseases taking place within the borders of the state. This was a state-centric approach to governing public health. An approach characterised with the Westphalian principles of sovereignty, where autonomous state governments are taken to have full authority over its own domestic affairs. During this time, WHO had weak power to influence the disease reporting and control of the state. Later on when WHO had the inclusive mandate, its approach on disease outbreaks was quite different. To begin with, this organisation made an unparalleled runs of worldwide alert and travel advisories geared towards offering assistance in the control of SARS (Smith 2009, p.10). It is even worth noting that in some incidences, the WHO never waited for approval from the states which were considerably unsympathetically affected by some of the warnings. It was its role at this point in time to bypass state governments and instead have a one-on-one talk with the general public, probably in agreement with such norms as human rights to health, which rise above the sovereignty of the state (Zacher 2009, p.19). In addition, such alerts and advisories bracketed in the self-governance authority of WHO as well as its consideration of non-state or unofficial sources of information talked of in previous paragraphs. In the SARS outbreak, it was also the responsibility of the WHO to avail assistance in the mobilization of the world’s medical and research community so as to make identification and at the same time see to it that SARS is contained. In addition, WHO is obliged with the role of collecting and thereafter reporting data from disease surveillance that is ordinarily anticipated to be vital for purposes of governing disease outbreaks at transnational level (Fidler 2004, p.62). Conclusion From the above discussion, it is quite clear that globalisation has over the years significantly amplified global health governance, and more especially through disease surveillance and reporting by the World Health Organisation. This globalisation is actually held responsible for the propagation of non-state actors as well as free information flows, both of which play the role of empowering international like WHO to act with a considerably greater authority and autonomy than was the case before. Resultantly, this globalisation is alleged to have necessitated essential change in the global order; whereby the WHO is the obliged to coerce state sovereignty over public health (Aginam 2007, p.162). As thus, there is a need for a radical change in the global health governance so as to address the failure of the states to satisfactorily get rid of the burden of infectious diseases across the globe. On their part, local and state governments have the responsibility of governing their medical treatments and infection control needs in the aftermath of a disease outbreak, which can be termed to be the most imperative actions, with respect to public health, for both the susceptible and the sick in the society. Nevertheless, the WHO has to be opted for as the principal source of necessary and vital information and at the same time be regarded as a focal point for global cooperation. Bibliography Aginam, O 2007, ‘Global Governance’, In Macrosocial Determinants of population Health (Eds.) Sandro Galea: New York. Burci, GL & Vignes, C 2004, World Health Organisation. The Hague: Kluwer law International Dodgson, R, Lee, K & Drager, N 2002, Global Health Governance: A Conceptual Review, Department of Health and Development, World Health Organization. Filder, D 2004, SARS, Governance and the Globalization of Disease, New York: Palgrace Macmillan. Gostin, LO, Ooms, G, Heywood, M, Haffeld, J, Mogedal, S, Rottingen, J, Friedman, EA & Siem, H 2010, The Joint Action and Learning Initiative on National and Global Responsibilities for Health, World Health Report, Backgroung Paper, No.53: 1-43. Kamradt-Scott, A n.d., The WHO Secretariat, Norm Entrepreneurship, and Global Disease Outbreak Control, 72-87. London. Kohlmorgen, L 2005, International Organisations and Global Health Governace. The Role of the World Health Organisation, World Bank and UNAIDS, German Overseas Institute. Ruger, JP & Yach, D 2008, ‘The Global Role of the World Health Organisation’, Global Health Governance, 2(2):1-11 Smith, FL 2009, ‘WHO Governs? Limited Global Governance by the World Health Organisation During the SARS Outbreak’, Social Alternatives, Second Quarterly, 28(2): 9-12. ProQuest Central. World Health organisation (WHO) 1983, International Health Regulations (1969), 3rd Annotated Edition, Geneva: World Health Organisation. World Health Organization (WHO) 2010, ‘Global Outbreak Alert and Response Network—GOARN: Partnership in Outbreak Response’, viewed 16 October 2012 http://www.who.int/csr/outbreaknetwork/en/. Zacher, MW 2007, ‘The Transformation in Global Health Collaboration Since the 1990s’, in Governing Global Health, (Eds.), Andrew F. Cooper, John, J. Kirton and Ted Schrecker., Burlington, VT: Ashgate. Read More