KATHMANDU, Nepal, February 10 (IPS) – The global consensus on an international treaty on pandemic control is certainly a milestone towards the creation of a global health security framework. .
A new treaty has the potential to bind member states to higher standards of compliance, especially if a global accountability mechanism is also in place.
Consider the disregard for International Health Regulations (2005), IHRs, the only tool available to control what in jargon is called a Public Health Emergency of National Concern. economy (PHEIC).
Although there are numerous review exercises, some of which took place more than a decade after the first SARS outbreak in Asia and again after EBOLA hit West Africa, the majority These regulations were not enforced in the following years.
As a result, we are still paying the price and it is very expensive.
Although negotiations over the details of the treaty, especially the complex aspects of its binding legality, will not be an easy walk, such a tool could provide a bulwark against deadly cross-border infections in the future.
However, a global pact will not be enough to guarantee a pandemic-free future.
What is missing is the will to truly link preparation and primary health care, which is complicated and at the same time very expensive.
A real breakthrough in the global health system will be seen in finding a new level of readiness for basic health financing that is unprecedented around the world, especially in countries around the world. developing.
We need massive investments in building national health systems that can provide what is commonly known as Universal Health Coverage, defined by WHO, as access to a wide range of services, includes services that contribute to future pandemic preparedness
If new resources are needed, the capacity to manage them properly is equally important so that the weakest member states of the United Nations can strengthen their health systems.
Unfortunately, for most of them, there is still a long way to go.
WHO has a great responsibility and obligation to support this process but so far it has failed and with it the international community.
Instead, another organization, starting with its own governance, can radically change the status quo and create the confidence needed if we want more money to build a national public health system based on it. on fairness.
In the case of the IHR, the main responsibility for implementing them rests with the Member States, with WHO being the guardian and also the main issuer in their implementation.
A stronger WHO could have done more not only to force governments towards IHR implantation, but also more effectively to work with developing countries in restarting centers and hospitals. their national primary health care.
Instead, the agency’s notorious failures since the first SARS outbreak in the early 2000s show the inability of an organization so complex and so political that it doesn’t have the means.
That is why we need to ensure that WHO can play a much larger role: not in replacing health ministries in developing countries but in assisting them in building health systems. equitable health system.
For this to happen, we do not need the WHO to be retooled and repurposed, but re-established.
The focus of the new treaty must not prevent drastic changes to the way public health services are delivered in developing countries and the lifting of any “red lines” in the rethinking of WHO.
Since 2017, Dr Tedros Ghebreyesus, its current General Manager, has embarked the organization on a process of significant change but these improvements, as important as they are now, have not gone far enough.
What we need is a complete change.
After the Covid-19 pandemic, once again new proposals were put forward to strengthen the organization.
Much emphasis has been placed on increasing the predictability and availability of undervalued resources, known as the “Assessed Contribution”, instead of having, as it is now, WHO relies entirely on into voluntary contributions from donors, which to date still make up the majority of the resources it manages.
Those contributions are driven by the interests and priorities of the donors rather than the agency.
Balancing an organization’s budgetary contributions can certainly be helpful, but it can also be worth reflecting on that some of the most results-oriented agencies in the UN System are entirely dependent on voluntary contributions. that wish.
Take for example the case of UNDP and UNICEF, the strongest and richest institutions in the UN System. Perhaps the real problem is not the lack of resources but the politicization of an organization essentially owned by the member states, the governments.
The same can be said for UNESCO.
It is no coincidence that both agencies share low budgets and are among the weakest of their peers.
At UNICEF, for example, there is nothing like the role of the World Health Assembly in effectively controlling WHO.
The governance there is quite different, and it is led by an Executive Board representing the member states, which, though, has significant influence over the management of the agency (which is why the Director General). executive is always American), it is less politicized and less controlling than a council of member states.
Perhaps what we should have is a global public health fund that is more similar in how it is administered and delivered to UNICEF.
Such a radical transformation, which is unlikely at this time, could be instrumental in really rebuilding WHO from the ground up and turning it into a much more efficient agency with power centers. less competitive force as is happening now with what is practically a semi-independent sector. offices.
As a result, a new organization called the Global Fund for Public Health could attract the huge investments that developing countries need to build strong and resilient health systems that ensure Universal Health Insurance for all of its citizens.
So far, donors are still too narrow and selective when it comes to public health.
For example, the focus is on antenatal and postnatal care, reproductive health, all very important areas of public health.
However, such a narrow focus on these areas through a silo approach has prevented investment in creating, in cooperation with developing countries, reliable health systems. and based on fairness for public use.
Don’t forget what the Secretary-General said in the 2016 20th Agenda entitled “Strengthening the Global Health Architecture” dedicated to strengthening the implementation of the recommendations of the High Council on Journalism. Global Health Crisis Response Report, one of a number of reports released to date to retrofit health systems to deal with global pandemics.
“I believe WHO needs to reposition itself as an operations organization, clarifying reporting routes and aligning its business processes to be able to fulfill its most effective operational role in the region. period of health crisis”.
Furthermore, in 2016, the Committee on the Global Health Risk Framework for the Future argued that “public health is the foundation of the health system and the first line of defense of the health system”.
For this to happen, we need a new WHO, and such a new organization that can inspire unprecedented public health funding, a resource that the World Bank and other organizations have been able to rely on. Regional banks and funding agencies need to disburse.
Both Indonesia and Germany, guiding the G 20 and G 7 respectively this year, have expressed strong commitment to reforming the global health system.
A narrow focus on a pandemic preparedness pact would be a missed opportunity to truly revolutionize global health management and with it, reset and transform WHO.
Simone Galimberti is Co-Founder of ENGAGE, an NGO that works with youth with disabilities. Opinions expressed are personal.
By @IPSNewsUNBureau
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