King’s Think Tank Working Group Visits the WHO

In March 2019, the Global Health working group of the King’s Think Tank, visited the World Health Organisation (WHO) in Geneva. Time was of the essence on this trip so the group had a packed schedule. The seven colleagues managed to get a flavour of the working life at WHO HQ. They met several health policy experts whose work focused on the working group’s research fields, including mental health and global health security. The WHO employs around 4,000 people; there are a myriad of roles within the organisation highlighting the complexities of protecting the health of the globe. 

The day began with an introduction from Dorine van der Wal in the WHO briefing centre (pictured below). Ms Van Der Wal explained the WHO’s mission and the role it has in mediating between its 194 member state delegates to devise policies targeting complex global health issues. The group had a chance to learn more about the funding process of the WHO. The organisation strives to be neutral, however, only 20% of the funding is equally gained from the member states (calculations are based on GDP). 80% of the remaining funding is received through voluntary donations from some of the member states. Unfortunately this type of funding isn’t flexible. Based on their donations member states might want to set the health agenda, leading to inequity, something the director general, Tedros Adhanom Ghebreyesus, plans to change during his term. The WHO liaises with the Ministry of Health in the member states by offering guidelines that aren’t legally binding due to the sovereignty of the member state.

Next up, Alison Schaefer, Technical Officer Mental Health, discussed how the WHO has now incorporated mental health in their Universal Health Coverage goal. Dr Schaefer, explained that treating mental health problems sometimes isn’t perceived as saving lives as much as other disease treatment plans like for malaria, hence funding has been granted to other global health programmes.

The final morning presentation was delivered by Jun Xing, WHO Medical Officer, who chose to focus on the International Health Regulations and health security. His team have a daily morning meeting with where they analyse global surveillance data of diseases to predict new or manage current outbreaks. Dr Xing explained how the SARs outbreak in 2009 emphasised the need for global coordination.

Following on from a lunch in the WHO canteen, the afternoon session was initiated by the innovation and access team. Nicole Homb presented the global action plan for health lives and wellbeing for all, which sits in yet again a separate section of the organisation. Whilst this plan was presented as a set framework for collective action, Nicole described it as a dynamic, interchangeable plan that was consistently being updated. The plan aimed to coordinate and set right incentives in new ways of joint working for 12 agencies affiliated to the WHO, that included the likes of UNAIDS and UNICEF.

The second to last discussion was introduced by Dr Antonio Montresor, scientist in the neglected tropical diseases department (NTDs). What stood out from his presentation is that the treatment per person for an NTD such as schistosomiasis is as cheap as $0.05. He argued that before these diseases had been pooled together as NTDs, they had not been addressed in the WHO’s agenda – only collectively did the burden of NTDs transpire. The final presentation of the day was by Hans Willmann. He discussed career opportunities within the WHO worldwide (including the four regional offices), encouraging King’s Think Tank members to apply for the internship programme. He stressed that working on the ground in low- and middle-income countries (LMICs), where change is happening in real time, can be inspiring opportunities for future generations. Dr Tedros has affirmed that the interns will start getting paid as of January 2020.

Being able to hear directly from people within WHO about their daily work was a fantastic opportunity for the group. Vaccine hesitancy was a recurrent theme throughout the day, as this has lead to an uprise in measles cases across the globe and is of grave concern for the WHO. Nevertheless, the success of WHO’s eradication of smallpox is very close to being repeated with polio. Other take-home messages from the day emphasised that a lot of effort and time goes into global health decision-making, as there are numerous delegates  involved in a justifiably democratic process. 

Francesca Monticelli is a postgraduate student in Public Health at King’s College London. Her research interests include child mental health, homelessness, and tailored healthcare policies.

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