LyrArc Article Gist
As Dr Harsh Vardhan, India's representative and Health Minister, takes on responsibilities as the Chairman of the Executive Board of the World Health Organization this can be said about this critical juncture.The WHO is going through soul searching and a reevaluation of how it has implemented the vision of its founders during the closing years of a world torn apart by war in 1945, and actual founding in 1946. At the UN conference in San Francisco in 1945, Dr. Szeming Sze of China, Dr. Geraldo da Paula Souza of Brazil and Karl Ewang of Norway, were keen to set up an international organization for cooperation on health. The Indian representative was Arcot Ramaswamy Mudaliar, a member of Winston Churchill's War Cabinet, who chaired the committee on economic and social problems. He was the president of the Economic and Social Council which called for an international health conference in Feb. 1946. It was at that conference on 19 June 1946 that the World Health Conference came into being. A native of Madras he then returned to Mysore as chief minister.
The vision at the time for international cooperation on problems such as smallpox which killed 2 million people each year were quite different from the fast moving epidemics with international travel in 2020. Today 4.4 billion passengers traveled by air in 2018, according to International Travel Association, 100 times compared to less than 40 million in 1950, and about 10 times the 400 million when Nixon's visit opened up China in 1972. The world we live in is different and the World Health Organization needs to be redesigned for the 21st century.
The entire process of how the WHO operates has to be rethought. Immediate steps include-
1. The appointment by Executive Board should be reinstated as this is more representative of the world population and the major centres of advanced public health, including the major countries. Throughout its life the WHO made appointments through the Executive Board not by election. The election in 2019 by 200 countries was actually not representative of the world population as it gave India, Brazil and other early founders at the 1945-46 conferences only 1 vote each with population of 1.2 billion and 210 million, the same as tiny countries Barbados population 385,000 and Laos 7 million.
2. Reassessment of the entire process in which nations are requested to give permission of teams from major countries in Europe, North America and Asia, major population centres, so that the 6-7 week delay between the U.S. request to China for a special team to go to Wuhan on January 6, 2020 and the permission granted Feb 16, a costly delay of 7 weeks which added millions of cases and hundreds of thousands of deaths. In a super fast moving pandemic with international sports stadiums and 4 billion air passengers spreading it like wild fire around the world, there is little room for error, every day counts. Never should this happen again, as Dr. Sze Szeming China's representative said once in 1945 we must learn from mistakes, as mistakes were made in the years before World War II that were costly for China, India, North and South America, Other Asia, Africa, large population centres.
3. As was the effort then in 1946 and the early years, the effort to keep the staffing positions of leadership in the World Health Organization should be kept far from politics. Very experienced and capable people are needed from major countries with long records of public health experience and committed to the huge task, as was the vision of the founders.
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