The World Health Organization interview

7 minutes of reading2 hours

The World Health Organization (WHO) was founded in 1948 to promote good health for everyone, everywhere. Since then, he has helped eradicate smallpox, reduce polio by 99 percent and develop a vaccine against Ebola.

But today, critics say the WHO has become mired in bureaucracy: a Geneva-led quango enjoying power without accountability. More recently, his handling of the Covid-19 pandemic – downplaying the virus's power while praising China's commitment to transparency – has provoked widespread anger.

In 2020, Donald Trump announced that he would suspend US funding to the WHO on the grounds that it had covered up the spread of Covid-19. There are now whispers that British taxpayers' money would be better spent on the NHS than on the WHO.

It is not viable to rely solely on attracting foreign labor.

But today Dr Hans Kluge, WHO regional director for Europe, says it would “hurt both of us” if the UK turned off the taps.

“Would that hurt?” Yes, it would hurt, because WHO is the only legitimate institution led by Member States to coordinate international health, health policy and strongly advocate for vulnerable people,” Kluge proudly says, speaking to The House on Zoom – a major WHO organization. flag in the background.

“Let’s be honest, this puts the UK in a global leadership role in health,” he says. “The WHO gives the UK a very, very important platform to demonstrate leadership and credibility, so I think it will harm us both.”

In 2022, the UK sent the WHO around £320 million. In contrast, NHS England's budget for the next financial year will be £164.9 billion. Stopping UK funding for the WHO would not solve the structural problems of the NHS, Kluge says, pointing to the relatively small proportion of money the NHS would stand to gain.

“To put things in perspective, the entire WHO budget – not in Europe but globally – is the same as that of a specialist hospital in Geneva. It's crazy. And we are supposed to solve all the health problems in every corner of the world,” he says. “The issue is not about decreasing funding; the question is to increase funding.

The WHO is cautiously watching Trump's return to the White House, but Kluge remains optimistic. “The United States of America is of course the largest donor to the WHO. This would obviously have huge implications,” he says, “but our WHO director-general [Tedros Adhanom Ghebreyesus] managed to overcome this last time.

Yet the WHO envisions a future where Trump returns to power. “Of course it worries us, and we should worry about it. But we already carry out risk analysis, trying to predict and anticipate.

What does this risk analysis look like?

“We are exploring potential new partnerships, while being ready to engage with any government,” he says. “The second point is financial: we have to make calculations for new recruitments and for next year, we have to be a little more careful, especially with regard to long-term commitments. So it’s a bit of a period of caution, while preparing ourselves to be ready to engage with anyone.”

In Europe, the WHO is strengthening its relations with a number of countries, including Norway, which “waits to strengthen its contributions”.

But these discussions about defunding couldn't come at a worse time. “We are in a permacrisis: it’s like a permanent period of crisis and tension,” explains Kluge.

Although ongoing wars, infectious diseases, and mental health all contribute to this permacrisis, he says the decline of the healthcare workforce is the biggest problem facing our healthcare system. “If you ask me what the main crisis in the health system is in my region, I think it is very clear: it is the health workforce. There is no health without health personnel.

The problem is particularly acute in the UK, he says, where the pandemic has amplified chronic underinvestment in the NHS.

We already carry out risk analysis, trying to predict and anticipate

“The NHS was the crown jewel of the UK, but it has not been on an upward trajectory. There is now a new role for physician associates, but this does not solve the problem; they can do certain things but they cannot take on the role of doctors. It is not viable to rely solely on attracting foreign labor.”

As for whether the world will experience another pandemic, Kluge is sure: “It won't take another 100 years. » But can we trust the WHO next time?

“I disagree that WHO has underperformed during the pandemic,” he says. “Are there lessons to be learned? Absolutely. But we have never seen such rapid production of very high-quality, evidence-based guidelines as during the pandemic.

In March 2021, a group of world leaders, including Boris Johnson, committed to creating a pandemic treaty. During the Covid crisis, rich countries have stockpiled vaccines, diagnostic devices and personal protective equipment. This treaty would ensure that all countries would be treated fairly during a future pandemic.

“If the global community fails to agree on the pandemic, it means we have learned nothing and are not in a better situation for the next pandemic,” warns Kluge.

However, the treaty must be ready for the World Health Assembly in May, and the WHO director for Europe is unsure whether that deadline will be met. “It will be hard. It's possible, but it will be difficult.

Does the treaty still need refinement?

“Yes, everyone needs to take a step forward,” he says, accepting that some areas – the United States and the European Union, for example – see the sharing of intellectual property rights as a “red line” . Today, he says the biggest sticking point is the proportion of vaccines that will be shared with the WHO for equitable distribution: “Twenty percent, 30 percent: that's the kind of negotiations. »

Negotiations are being slowed by what Ghebreyesus calls “a torrent of fake news, lies and conspiracy theories” circulating online. Such theories have even infiltrated Parliament, albeit with little impact – with independent MP for north-west Leicestershire Andrew Bridgen questioning why the House is “so happy to cede its powers and sovereignty to an Organization unelected, undemocratic and diplomatically immune global health system.” short film by Commons Leader Penny Mordaunt.

Kluge says the WHO works with tech companies — Facebook and Google, for example — to crack down on conspiracy theories. But the organization also works with local community figures to build trust. It could be a certain priest from an Orthodox community, he says, or a local football player.

Kluge calls these “tense geopolitical times” where the WHO is an “easy target.” Today, it is inspired by organizations like Unicef, which are more proactive in terms of communication.

“It’s a big lesson learned,” he said. “Basically, I tell my people: if you work 12 hours a day, we have to work 10 hours, and for two hours we have to explain to the world what we did in those 10 hours.”

Kluge believes the world would be worse off without the World Health Organization. But even if the image of the WHO were to disappear, he asserts that the structure of a global health organization must remain.

“I firmly believe that even our – I won't say 'enemies', but those who are skeptical of the WHO – can at least agree on one thing: if the WHO was not there, we should create another one,” he says. “Because if we lose our values, who will defend the poor and the most vulnerable?

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