Opinions: Questioning WHO's relevance; Reforming foreign aid; Efforts to prevent child marriage

Dec 10 2010

Reviving WHO As World's Foremost Health Authority

"The WHO - for 62 years the world's go-to agency on all public health matters - is today outmoded, underfunded, and overly politicized," Jack Chow, former assistant director-general on HIV/AIDS, tuberculosis and malaria at WHO, writes in a Foreign Policy Argument where he outlines some of the major issues facing the WHO, including personnel challenges, the agency's "archaic" governance system and a "new atmosphere, where [other] organizations are taking health into their own hands."

As a potential solution to some of the challenges facing the agency, Chow writes, "Perhaps what's needed is a move away from the region-centric approach toward a strategy that would allow the WHO to devote more resources to country-level work. … The WHO could empower its country-based staff to deliver timely, accurate, and actionable advice where it is needed most - not just at the national policymaking level, but to local health workers in communities. … Another advantage of this local focus would be the opportunity to forge stronger relationships with the private organizations, such as Doctors without Borders and Partners in Health, that actually implement health programs. Rather than being pushed out by new players in public health, the WHO could bring them under its technical wing now."

"In many of the world's most difficult places, the WHO does still retain its prominence as the chief reference body on health matters. But it is no time for complacency. The recent barrage of health crises has revealed the WHO's value, yet its weaknesses as well," Chow writes. "The agency cannot remain underfunded and understaffed, struggling with a system whose origin dates back to the dawn of the antibiotic era. For the WHO to be revived as the world's foremost health authority, it now needs intensive therapy itself," the author concludes (12/9).

Reforming Foreign Aid

Although "[t]he Quadrennial Review of Diplomacy and Development, or QDDR, has been 1 1/2 years in the making and represents a serious and thoughtful attempt to identify and repair the gaps in our civilian capacity to operate effectively abroad," Rep. Howard Berman (D-Calif.) writes in Washington Times opinion piece that "[t]he real challenge … will be to use the results of this review to implement meaningful reforms with lasting impact."

Berman offers what he calls "a list of common-sense reforms that both parties, both houses and both the legislative and executive branches of government ought to be able to agree on" to reform foreign aid, including holding governments to greater accountability, eliminating duplication and waste and increasing transparency. "While the State Department can enact some of the reforms unilaterally through policy changes and regulations, doing so will not guarantee that the reforms survive. Only by mandating the new structures and processes in law can we establish the level of bipartisan support and executive-legislative consensus that will guard against backsliding and retrogression," Berman writes.

"Foreign assistance programs not only reflect American values and principles but serve as essential means for protecting U.S. economic, foreign-policy and security interests. Regardless of the size of our international affairs budget, we have an obligation to make it more effective, more efficient and more accountable," Berman adds. "While the details undoubtedly will be complicated and sometimes controversial, we can start by identifying areas … where we all agree and where we can make real progress" (12/8).

Investing In Efforts To Prevent Child Marriage Is Critical To Attainment Of MDGs

The passage of The International Protecting Girls by Preventing Child Marriage Act by the U.S. Senate last week "illustrates how support for securing a just and healthy life for every woman and girl transcends politics," Mary Robinson, former president of Ireland, and Desmond Tutu, archbishop emeritus of Cape Town, South Africa, write in a Washington Post opinion piece that reflects on the impact child marriages have on the health, education and employment of women in developing countries.

To decrease the numbers of child marriages worldwide "we first need to provide greater options for girls by investing in them and supporting their families," Robinson and Tutu write before highlighting how aid and women's rights groups have already begun "fostering community conversations about the health risks for very young mothers and the benefits of education."

"[W]e believe that investing in efforts to prevent child marriage is critical to global development and the achievement of the U.N. Millennium Development Goals. We applaud the Senate for passing this forward-looking legislation and urge the House of Representatives to follow suit. … We know that these efforts can have real impact," they write (12/5).