The World is One
Our world is more interconnected and interdependent today than ever before. All living beings and the complex environment they live in are interconnected and interdependent. In this complex web of interconnected world, no one is safe until everyone is safe and no one is strong until everyone is strong. Being a highly complex, dynamic evolving system, our world needs a governance structure that looks at the world as one.
Global governance architecture has been evolving
Family is the smallest governance structure. Families coalesced into tribes. Tribes merged into states or provinces, which in turn joined together as nations. The United Nations (UN) was born and evolved along a natural evolutionary path of self-governance structure. Various arms of the UN came into existence to sub serve good governance responsibility. The World Health Organization (WHO) came into being to secure health, the World Trade Organization (WTO) to bring order in world trade, the World Bank (WB) to oversee the global financial structure, the International Labor Organization (ILO) to regulate labor, and the United Nations Security Council (UNSC) to protect sovereignty of member nations and promote peace and harmony amongst them. Global non-governmental philanthropic and civil society organizations have been emerging in recent times to play an increasingly important role in global governance.
Strengthening the WHO is essential for securing global health
The COVID-19 pandemic brought out the need for a strong WHO. Since microbes do not respect national boundaries and can spread rapidly through ariel connectivity across the world, global disease surveillance becomes a necessity to prevent the emergence and spread of future pandemics. Microbes also do not respect species barriers, necessitating surveillance of all living beings. Climate change may bring species together for emergence of new pathogens. Digital and molecular technologies have made it possible to think of a robust global disease surveillance system on the basis of the One Health concept. The International Health Regulation (IHR) framework can be further broadened to enable this. Financial resources will be needed to support nations in putting their systems in place. Global health data standards should be notified by the WHO for integration of health information systems across the world, while ensuring individual privacy and data security.
Many countries faced acute shortages of personal protective equipment (PPE), diagnostic tests, and essential drugs due to unforeseen surges in demand coupled with disruptions to supplies due to containment barriers across and within countries. The WHO is in a position to develop a coordinated response plan at global, regional, and national levels to meet the demands of member nations, especially those that do not have manufacturing capacities, during crises.
The world has witnessed a never seen before feat of bringing out an effective vaccine within 12 months of the pandemic declaration. The world also has witnessed the gross inequity in accessing these vaccines. The WHO alone may not be able to address the challenge. It needs a coordinated effort by various other arms of the UN and a mutually agreed framework to prevent similar situations in the future.
Many countries lack capacities in preparing themselves for next pandemics and in mounting rapid and effective responses to absorb health shocks in terms of technical knowhow, generating scientific evidence and financial resources. The WHO needs to be well funded to provide this support function.
An infodemic of misinformation ran in parallel to the COVID-19 pandemic. Scientific evidence that is not peer reviewed was flooding through preprints. While the instantaneous right information sharing was tremendously beneficial, there was an equal harm resulting from the spread of wrong information. The world needed a voice of authenticity and trust. The WHO did falter in this context given the enormity of the pandemic. However, the WHO is best positioned to be the voice of right information that can be trusted.
A mandated funding by members may be needed to make the WHO independent, unbiased, and accountable
The current way in which the WHO is funded is not conducive to its effective functioning. There is a risk of coming under the influence of big funders including non-governmental foundations. The concept of risk pooling can be adopted to contribute funds to support nations in an equitable way. The rich nations should subsidize poor nations. The contributions should be mandated and be commensurate to the economy of a member nation.
Whole of Governance concept be brought to UN
Just as various social determinants account for the health status of a country’s people, various arms of the UN are collectively responsible for the security of people’s health across the globe. Bodies dealing with education, nutrition, labor, trade, environment, economy, information, geopolitical tensions etc., are as essential as the WHO in securing health. Existing agreements, laws, and regulations may have to be amended in order to respond in an appropriate way during various global crisis resulting from climate change, pandemics, wars, mass migrations, economic collapse etc. Patent laws that are relevant during normal times may have to be relaxed during crisis times with a time window.
It is time for the world to learn, adapt, and transform its health systems to be stronger and more resilient
As the world is seemingly recovering from the deadly pandemic that consumed many lives and livelihoods, there is a window of opportunity for all of us to learn and transform at individual, family, community, village, district, state, country, and the global levels. The learning can come from within, from personal experience or without, through others’ experience or evidence. Nations can learn from each other. States can learn from each other within a country. Researchers can learn from practitioners and vice versa. Governments can learn from non-governments and vice versa. These learnings, when applied properly can build our broken systems back to stronger and more resilient systems.
Dr Krishna Reddy Nallamalla
Regional Director, South Asia, ACCESS Health International
Photo Credits: –JNSLP