This article intends to inquire into whether aforementioned statements are consistent with the reiterated claims by WHO officials who have been interviewed by the media that WTO cannot tell countries what to do.
by Dr. Ruwantissa Abeyratne
Writing from Montreal
We don’t know what sort of damage this virus could do if it were to spread in a country with a weaker health system. We must act now to help countries prepare for that possibility.
- Tedros Adhanom Ghebreyesus, Director General, World Health Organization, 20 January 2020
The World Health Organization (WHO) says in its website that it “works worldwide to promote health, keep the world safe, and serve the vulnerable. Our goal is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and well-being”.
This article intends to inquire into whether aforementioned statements are consistent with the reiterated claims by WHO officials who have been interviewed by the media that WTO cannot tell countries what to do. If WTO cannot tell countries (or advise them) what to do, how does it propose to “help countries” as claimed by the WHO Director General, or “promote health and keep the world safe and help the vulnerable”?. Rather, it would be correct to say that WHO cannot “force” countries to do what they should be doing. This is all the more evident in the further claim by WHO in its website that it focuses inter alia on primary health care and assists countries with their health issues.
To place this issue in perspective, one has to go into the meaning and purpose of the United Nations of which WHO is a specialized agency. The United Nations Charter states in Article 1 inter alia that its objective is to achieve international cooperation by solving international problems of a social, economic, cultural and humanitarian nature. Embodied in this objective is the 3rd Sustainable Development Goal of the United Nations of global health which primarily involves WHO.
Article 57 of the Charter of the United Nations establishes specialized agencies of the UN by stating that the various specialized agencies, established by intergovernmental agreement and having wide international responsibilities, as defined in their basic instruments, in economic, social, cultural, educational, health, and related fields, must be brought into relationship with the United Nations in accordance with the provisions of Article 63. Article 63 provides that he Economic and Social Council may enter into agreements with any of the agencies referred to in Article 57, defining the terms on which the agency concerned must be brought into relationship with the United Nations. Such agreements must be subject to approval by the General Assembly. It may co-ordinate the activities of the specialized agencies through consultation with and recommendations to such agencies and through recommendations to the General Assembly and to the Members of the United Nations.
The operative words of Article 57 of the Charter are “and having wide international responsibilities, as defined in their basic instruments…” This brings to bear the need to inquire as to what the “international responsibilities” of WHO are. The Constitution of WHO defines the Organization inter alia as "the directing and coordinating authority on international health work." Some other responsibilities of WHO as identified in Article 2 of the WHO Constitution that are relevant to Covid-19 are: to establish and maintain effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups and such other organizations as may be deemed appropriate; to assist Governments, upon request, in strengthening health services; to furnish appropriate technical assistance and, in emergencies, necessary aid upon the request or acceptance of Governments; to provide or assist in providing, upon the request of the United Nations, health services and facilities to special groups, such as the peoples of trust territories; to establish and maintain such administrative and technical services as may be required, including epidemiological and statistical services; to stimulate and advance work to eradicate epidemic, endemic and other diseases;) to promote, in co-operation with other specialized agencies where necessary, the prevention of accidental injuries; to promote, in co-operation with other specialized agencies where necessary, the improvement of nutrition, housing, sanitation, recreation, economic or working conditions and other aspects of environmental hygiene; to promote co-operation among scientific and professional groups which contribute to the advancement of health; to propose conventions, agreements and regulations, and make recommendations with respect to international health matters and to provide information, counsel and assistance in the field of health;
The last two responsibilities would intrinsically and inextricably involve telling States what they should be doing, although admittedly they do not carry a mandate to “order” .or “force” States to take any measures.
It must be noted that WHO has played an invaluable and much appreciated role in public health. Encyclopedia.com says: “ WHO has played a very pivotal role in setting health policies, as well as providing technical cooperation to its member states. Life expectancy rose from 48 years in 1955 to 69 years in1985. During the same period, the infant mortality rate fell from 148 per 1000 live births to below 59 per 1000. Population growth has been slowed dramatically in many of the most populous countries. Smallpox, the ancient scourge, has disappeared. Other successes include the control of lice-borne typhus and yaws. Polio and guinea worms are on the verge of total elimination. A number of other communicable and tropical diseases, including onchocerciasis and schistosomiasis, are in retreat”.
The question therefore is: did WHO meet its responsibilities as per The UN Charter and its Constitution in the context of the Covid-19 spread? Did it tell States what they should be doing? For one, WHO declared the outbreak a Public Health Emergency of International Concern on 30 January 2020. It then updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery and mitigating the risk of system collapse. Then, WHO's online learning platform, OpenWHO, offered free COVID-19 training from WHO experts in 17 languages. WHO also issued guidelines to on countries that they should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts to ensure that increasingly limited resources provide maximum benefit for the population. They also need to comply with the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment This requires robust planning and coordinated actions between governments and health facilities and their managers.
These are only some of the many things WHO did in guiding countries through the pandemic. WHO even collaborated with other Organizations such as the International Civil Aviation Organization and the International Telecommunications Union in helping countries address the thread of the pernicious Covid-19 pandemic.
So WHO should not say it cannot tell countries what they should be doing. That seems to be the only slip up.
The author is a former senior official of the International Civil Aviation Organization
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