World Health Organization

"WHO" redirects here. For other uses, see Who (disambiguation).

World Health Organization منظمة الصحة العالمية 世界卫生组织 Organisation mondiale de la Santé Всемирная организация здравоохранения Organización Mundial de la Salud
Flag of the World Health Organization
Org type	Specialized agency of the United Nations
Acronyms	WHO
Head	Dr. Margaret Chan
Status	Active
Established	7 April 1948
Headquarters	Geneva, Switzerland
Website	www.who.int
Parent org	ECOSOC

The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that is concerned with international public health. It was established on 7 April 1948, with headquarters in Geneva, Switzerland and is a member of the United Nations Development Group. Its predecessor, the Health Organization, was an agency of the League of Nations.

Establishment

During the United Nations Conference on International Organization, references to health had been incorporated into the United Nations Charter at the request of Brazil. It similarly passed a declaration that an international health body would be set up, co-authored by Brazil and China. The Indian politician Jawaharlal Nehru also gave his opinion in favour of starting WHO. In February 1946, the Economic and Social Council of the United Nations helped draft the constitution of the new body. The draft constitution began to be signed by representative of 61 countries in June 1946, to come into force when ratified by 26 countries. Until that happened, an Interim Commission of 18 countries would prepare. The use of the word "world", rather than "international", emphasised the truly global nature of what the organization was seeking to achieve.

An international sanitary conference was held in Venice in 1892, prompted in part by the spread of Asiatic cholera earlier in that century. The first international organisation to cover this area was the Pan-American Sanitary Bureau in 1902, followed by the Office International d'Hygiène Publique in Paris in 1909. The League of Nations Health Organization was established following the First World War, although it did not subsume other health organisations. These efforts were hampered by the Second World War, during which UNRRA also played a role in international health initiatives. The Office International d'Hygiène Publique was incorporated into the Interim Commission of the World Health Organization on 1 January 1947.

The constitution of WHO was developed from four documents, submitted by the French, British, United States and Yugoslav governments. There was a common consensus that membership should not be limited to members of the United Nations and to this effect other countries were allowed to send observers to the drafting process. The International Health Conference met between 19 June and 22 July 1946, attended by representatives of all 51 members of the UN, 13 non-member countries, 3 Allied Commission and 10 international organizations. Dr. Thomas Parran served as president of the conference. The two most discussed issues were the role of the Soviet Union (which accepted a place) and the integration of other international organizations, which was agreed and would be managed. The constitution of the World Health Organization had been signed by all 61 countries by 22 July 1946, which an article in Science described as "an historic day". It thus became the first specialised agency of the United Nations to which every member subscribed. Its constitution formally came into force on the first World Health Day on 7 April 1948, when it was ratified by the 26th member state. The transfer was authorized by a Resolution of the General Assembly. The Office International d'Hygiène Publique was incorporated into the Interim Commission of the World Health Organization on 1 January 1947.

The first meeting World Health Assembly finished on 24 July 1948, having secured a budget of US$5 million (then GBP£1,250,000) for the 1949 year. Dr. Andrija Stampar was the Assembly's first president, and Dr. G. Brock Chisholm was appointed Director-General of WHO, having severed as Executive Secretary during the planning stages. Its first priorities were malaria, tuberculosis, sexually transmitted infections, maternal and child health, nutrition and environmental hygeine. Its first legislative act was concerning the compliation of accurate statistics on the spread and morbidity of disease. It pushed quickly to establish five regional offices to complement is central staff in Geneva, Switzerland.

The flag features the Rod of Asclepius as a symbol for healing.

Activities

Three former directors of the Global Smallpox Eradication Programme read the news that smallpox had been globally eradicated, 1980

The WHO's constitution states that its objective "is the attainment by all people of the highest possible level of health." Apart from coordinating international efforts to control outbreaks of infectious disease, such as SARS, malaria, tuberculosis, influenza, and HIV/AIDS, the WHO also sponsors programs to prevent and treat such diseases. The WHO supports the development and distribution of safe and effective vaccines, pharmaceutical diagnostics, and drugs, such as through the Expanded Program on Immunization.

In 1958, Professor Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox, resulting in Resolution WHA11.54. At this point, 2 million people were dying from smallpox every year. In 1967, the World Health Organization intensified the global smallpox eradication by contributing $2.4 million annually to the effort and adopted a new disease surveillance method. The initial problem the WHO team faced was inadequate reporting of smallpox cases. WHO established a network of consultants who assisted countries in setting up surveillance and containment activities. The WHO also helped contain the last European outbreak in Yugoslavia in 1972. After over two decades of fighting smallpox, the WHO declared in 1980 that the disease had been eradicated – the first disease in history to be eliminated by human effort. The WHO aims to eradicate polio. </ref>

The organization develops and promotes the use of evidence-based tools, norms and standards to support Member States to inform health policy options. It oversees the implementation of the International Health Regulations, and publishes a series of medical classifications including the International Statistical Classification of Diseases (ICD), the International Classification of Functioning, Disability and Health (ICF), the International Classification of Health Interventions (ICHI) and the Pandemic Influenza Preparedness Framework (PIP Framework). The WHO regularly publishes a World Health Report including an expert assessment of a specific global health topic. The organization has published tools for monitoring the capacity of national health systems and health workforces to meet primary health care goals.

In 2006, the organization endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe, which formed the basis for a global prevention, treatment and support plan to fight the AIDS pandemic.

In addition, the WHO carries out various health-related campaigns – for example, to boost the consumption of fruits and vegetables worldwide, to discourage tobacco use, and to promote road safety. Each year, the organization marks World Health Day focusing on a specific health promotion topic.

WHO conducts or supports health research in areas of communicable diseases, reproductive health, non-communicable conditions and injuries, neglected tropical diseases, health policy and systems, and other areas, as well as improving access to health research and literature in developing countries such as through the HINARI network. The organization relies on the expertise and experience of many world-renowned scientists and professionals to inform its work, such as the WHO Expert Committee on Biological Standardization, the WHO Expert Committee on Leprosy, and the WHO Study Group on Interprofessional Education & Collaborative Practice.

The WHO also promotes the development of capacities in Member States to use and produce research that addresses national needs, by bolstering national health research systems and promoting knowledge translation platforms such as the Evidence-Informed Policy Network (EVIPNet). WHO and its regional offices are working to develop regional policies on research for health – the first one being the Pan American Health Organization/Regional Office for the Americas (PAHO/AMRO) that had its Policy on Research for Health approved in September 2009 by its 49th Directing Council Document CD 49.10.^{[citation needed]}

The World Health Organization's suite of health studies is working to provide the needed health and well-being evidence through a variety of data collection platforms, including the World Health Survey covering 308,000 respondents aged 18+ years and 81,000 aged 50+ years from 70 countries, and the Study on Global Ageing and Adult Health (SAGE) covering over 50,000 persons aged 50+ across almost 23 countries. The WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), the WHO Quality of Life Instrument (WHOQOL), and the Service Availability Mapping (SAM) tool provide guidance for data collection in other health and health-related areas. Collaborative efforts between WHO and other agencies, such as through the Health Metrics Network, serve the normative functions of setting high research standards.

WHO has also worked on global initiatives in surgery such as the Global Initiative for Emergency and Essential Surgical Care and the Guidelines for Essential Trauma Care focused on access and quality. Safe Surgery Saves Lives addresses the patient safety in surgical care. The WHO Surgical Safety Checklist is in current use worldwide in the effort to improve safety in surgical patients.

Main publications

• Bulletin of the World Health Organization
• Eastern Mediterranean Health Journal
• Human Resources for Health, journal published in collaboration with BioMed Central
• Pan American Journal of Public Health
• World Health Report, series of global health policy reports

Main international policy frameworks

• International Health Regulations
• International Code of Marketing of Breast-milk Substitutes, adopted in 1981
• Framework Convention on Tobacco Control, adopted in 2003
• Global Code of Practice on the International Recruitment of Health Personnel, adopted in 2010

Structure

Membership

Countries by World Health Organization membership status

As of 2012, the WHO has 194 member states, including the Cook Islands and Niue. As of 2009, it also had two associate members, Puerto Rico and Tokelau. Non-members of the WHO include Liechtenstein and other states with limited diplomatic recognition. Several other entities have been granted observer status. Palestine is an observer as a "national liberation movement" recognised by the League of Arab States under United Nations Resolution 3118. The Holy See also attends as an observer, as does the Order of Malta. In 2010, the Republic of China was invited under the name of "Chinese Taipei".

WHO Member States appoint delegations to the World Health Assembly, WHO's supreme decision-making body. All UN Member States are eligible for WHO membership, and, according to the WHO web site, "other countries may be admitted as members when their application has been approved by a simple majority vote of the World Health Assembly."

In addition, the UN observer organizations International Committee of the Red Cross and International Federation of Red Cross and Red Crescent Societies have entered into "official relations" with WHO and are invited as observers. In the World Health Assembly they are seated along the other NGOs.

Assembly and Executive Board

WHO Headquarters in Geneva

The World Health Assembly is the legislative and supreme body of WHO. Based in Geneva, it typically meets yearly in May. It appoints the Director-General every five years, and votes on matters of policy and finance of WHO, including the proposed budget. It also reviews reports of the Executive Board and decides whether there are areas of work requiring further examination. The Assembly elects 34 members, technically qualified in the field of health, to the Executive Board for three-year terms. The main functions of the Board are to carry out the decisions and policies of the Assembly, to advise it and to facilitate its work.

Regional offices

Regional offices and regions of the WHO:

  Africa; HQ: Brazzaville, Congo

  Americas; HQ: Washington DC, USA

  Europe; HQ: Copenhagen, Denmark

  Eastern Med.; HQ: Cairo, Egypt

  South East Asia; HQ: New Delhi, India

  Western Pacific; HQ: Manila, Philippines

The regional divisions of WHO were created between 1949 and 1952, and are based on article 44 of WHO's constitution, which allowed the WHA to "establish a [single] regional organization to meet the special needs of [each defined] area". Many decisions are made at regional level, including importance discussions over WHO's budget, and in deciding the members of the next assembly, which are designated by the regions.

Each region has a Regional Committee, which generally meets once a year, normally in the autumn. Representaties attend from each member or associative member in each region, including those states that are not fully recognised. For example, Palestine attends meetings of the Western Mediterranean region. Each region also has a regional office. Each Regional Office is headed by a Regional Director, who is elected by the Regional Committee. The Board must approve such appointments, although as of 2004, it had never overruled the preference of a regional committee. The exact role of the board in the process has been a subject of debate, but the practical effect has always been small. Since 1999, Regional Directors serve for a once-renewable five-year term.

Each Regional Committee of the WHO consists of all the Health Department heads, in all the governments of the countries that constitute the Region. Aside from electing the Regional Director, the Regional Committee is also in charge of setting the guidelines for the implementation, within the region, of the health and other policies adopted by the World Health Assembly. The Regional Committee also serves as a progress review board for the actions of WHO within the Region.

The Regional Director is effectively the head of WHO for his or her Region. The RD manages and/or supervises a staff of health and other experts at the regional offices and in specialized centres. The RD is also the direct supervising authority—concomitantly with the WHO Director-General—of all the heads of WHO country offices, known as WHO Representatives, within the Region.

Regional Offices of WHO

Region	Headquarters	Notes	Website
Africa	Brazzaville, Republic of Congo	AFRO includes most of Africa, with the exception of Egypt, Sudan, South Sudan, Tunisia, Libya, Somalia and Morocco (all fall under EMRO).	AFRO
Europe	Copenhagen, Denmark.	EURO includes most of Europe and Israel.	EURO
South-East Asia	New Delhi, India	North Korea is served by SEARO.	SEARO
Eastern Mediterranean	Cairo, Egypt	EMRO includes the countries of Africa that are not included in AFRO, as well as the countries of the Middle East, except for Israel. Pakistan is served by EMRO.	EMRO
Western Pacific	Manila, Philippines.	WPRO covers all the Asian countries not served by SEARO and EMRO, and all the countries in Oceania. South Korea is served by WPRO.	WPRO
The Americas	Washington D.C., USA.	Also known as the Pan American Health Organization (PAHO), and covers the Americas.	AMRO

Financing and partnerships

The WHO is financed by contributions from Member States and donors. In recent years, the WHO's work has involved increasing collaboration with external bodies; there are currently around 80 partnerships ("official relations" and "working relations") withNGOs and the pharmaceutical industry, as well as with foundations such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation. By 2007, voluntary contributions to the WHO from national and local governments, foundations and NGOs, other UN organizations, and the private sector, were more than double the level of assessed contributions (dues) from the 194 Member States.

WHO liaison and other offices

WHO has a number of specialist offices/agencies, as well as liaison offices at the most important international institutions.

• IARC, International Agency for Research on Cancer (Lyon, France)
• WHO Centre for Health Development – WHO Kobe Center (Kobe, Japan)
• WHO Lyon Office for National Epidemic Preparedness and Response (LYO) (Lyon, France)
• WHO Mediterranean Centre for Vulnerability Reduction (Tunisia)
• WHO Office at the African Union and the Economic Commission for Africa (Addis Ababa, Ethiopia)
• WHO Liaison Office in Washington (USA)
• WHO Office at the European Union (Brussels, Belgium)
• WHO Office at the United Nations (New York, USA)
• WHO Office at the World Bank and the International Monetary Fund (Washington, USA)

Country offices

The World Health Organization operates 148 country and liaison offices in all its regions. The presence of a country office is generally motivated by a need, stated by the Member State. There will generally be one WHO country office in the capital, occasionally accompanied by satellite-offices in the provinces or sub-regions of the country in question.

The country office is headed by a WHO Representative (WR), who is an internationally experienced physician or other health professional, not a national of that country, who holds diplomatic rank and is due privileges and immunities similar to those of an Ambassador Extraordinary and Plenipotentiary. In most countries, the WR (like Representatives of other UN agencies) is de facto and/or de jure treated like an Ambassador – the distinction here being that instead of being an Ambassador of one sovereign country to another, the WR is a senior UN civil servant, who serves as the "Ambassador" of the WHO to the country to which he or she is accredited. Hence, the title of Resident Representative, or simply Representative. The WR is member of the UN system country Team which is coordinated by the UN System Resident Coordinator.

The country office consists of the WR, and several health and other experts, both foreign and local, as well as the necessary support staff. The main functions of WHO country offices include being the primary adviser of that country's government in matters of health and pharmaceutical policies.

International liaison offices serve largely the same purpose as country offices, but generally on a smaller scale. These are often found in countries that want WHO presence and cooperation, but do not have the major health system flaws that require the presence of a full-blown country office. Liaison offices are headed by a liaison officer, who is a national from that particular country, and place without diplomatic immunity.

People

Former Directors-General of WHO

Name	Years of tenure
Brock Chisholm	1948–1953
Marcolino Gomes Candau	1953–1973
Halfdan T. Mahler	1973–1988
Hiroshi Nakajima	1988–1998
Gro Harlem Brundtland	1998–2003
Lee Jong-wook	2003–2006
Anders Nordström*	2006
*Acting Director-General following the death of Lee Jong-wook while in office

The head of the organization is the Director-General, appointed by the World Health Assembly. The current Director-General is Margaret Chan, who was appointed on 9 November 2006. On 18 January 2012, Chan was nominated by the WHO's Executive Board for a second term. If confirmed by the World Health Assembly in May 2012, Dr Chan will remain Director-General until the end of June 2017.

WHO employs 8,500 people in 147 countries. In support of the principle of a tobacco-free work environment the WHO does not recruit cigarette smokers. The organization has previously instigated the Framework Convention on Tobacco Control in 2003.

The WHO operates "Goodwill Ambassadors", members of the arts, sport or other fields of public life aimed at drawing attention to WHO's initaitves and projects. There are currently five Goodwill Ambassadors (Jet Li, Nancy Brinker, Peng Liyuan, Yohei Sasakawa and the Vienna Philharmonic Orchestra) and a further ambassador associated with a partnership project (Craig David).

Controversies

IAEA – Agreement WHA 12–40

Demonstration on Chernobyl disaster day near WHO in Geneva

In 1959, the WHO signed Agreement WHA 12–40 with the International Atomic Energy Agency (IAEA), which some have claimed prevents the WHO from independently researching the effects on human health of radiations caused by the use of nuclear power, for examples after nuclear disasters. The agreement states – specifically in Article 1, Paragraph 2 – that the WHO recognises the IAEA as having responsibility for peaceful nuclear energy without prejudice to the roles of the WHO of promoting health. However, the following paragraph adds: "Whenever either organization proposes to initiate a programme or activity on a subject in which the other organization has or may have a substantial interest, the first party shall consult the other with a view to adjusting the matter by mutual agreement." This last statement, which stresses the requirement for mutual agreement, has led some observers to question whether this effectively jeopardizes the WHO's independence when assessing matters relating to nuclear power.

Condom promotion, religion and AIDS

Main article: Roman Catholic Church and AIDS

In 2003, the WHO denounced the Roman Curia's health department's opposition to the use of condoms, saying: "These incorrect statements about condoms and HIV are dangerous when we are facing a global pandemic which has already killed more than 20 million people, and currently affects at least 42 million."

In 2009, the World Health Assembly President, Guyana's Health Minister Leslie Ramsammy, condemned Pope Benedict's call for ending condom use in the fight against AIDS, saying he was trying to "create confusion" and "impede" proven strategies in the battle against the disease.

Intermittent preventive therapy

The aggressive support of the Bill & Melinda Gates Foundation for intermittent preventive therapy of malaria which included the commissioning of a report from the Institute of Medicine triggered a memo from the former WHO malaria chief Dr. Akira Kochi. Dr. Kochi wrote, “although it was less and less straightforward that the health agency should recommend IPTi, the agency’s objections were met with intense and aggressive opposition from Gates-backed scientists and the foundation”.

Diet and sugar intake

Some of the research undertaken or supported by WHO to determine how people's lifestyles and environments are influencing whether they live in better or worse health can be controversial, as illustrated by a 2003 joint WHO/FAO report on nutrition and the prevention of chronic non-communicable disease, which recommended that sugar should form no more than 10% of a healthy diet. This report led to lobbying by the sugar industry against the recommendation, to which the WHO/FAO responded by including in the report the statement "The Consultation recognized that a population goal for free sugars of less than 10% of total energy is controversial", but also stood by its recommendation based upon its own analysis of scientific studies.

2009 influenza pandemic

Main article: 2009 flu pandemic

In 2007, the WHO organized work on pandemic influenza vaccine development through clinical trials in collaboration with many experts. A pandemic involving the H1N1 influenza virus was declared by Director-General Margaret Chan in April 2009.

By the post-pandemic period critics claimed the WHO had exaggerated the danger, spreading "fear and confusion" rather than "immediate information". Industry experts countered that the 2009 pandemic had led to "unprecedented collaboration between global health authorities, scientists and manufacturers, resulting in the most comprehensive pandemic response ever undertaken, with a number of vaccines approved for use three months after the pandemic declaration. This response was only possible because of the extensive preparations undertaken in during the last decade."

See also

• Global health
• Global Mental Health
• Health for all
• Health promotion
• International Health Regulations
• International standards for drinking water
• Millennium Development Goals
• Pan American Health Organization
• Public health
• World Health Day
• High 5 Project, a patient safety collaboration
• Healthy city / Alliance for Healthy Cities, an international alliance
• Health Sciences Online, virtual learning resources
• Open Learning for Development, virtual learning resources

External links

• World Health Organization
• Weekly Epidemiological Record (WER)
• Multi-country Study on global AGEing and adult health (SAGE)