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Expectations from new Director General of WHO
- Dinesh Kumar Sharma (23 May 2003)
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politics before health for all?
- Peter WS Chang (25 May 2003)
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Dinesh Kumar Sharma, Senior Medical Officer ESI Hospital Amritsar-143001, India
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Mr. Jong-Wook Lee is taking over as Director General of World Health Organization (WHO) at a very crucial juncture. Stop TB partnership, which he headed till recently, is engaged in a grim battle against ‘white plague’. In spite of all previous activities, the majority of world’s TB patients continue to live in districts that have yet to provide Directly Observed Treatment, Short-course (DOTS). Tuberculosis continues to kill 2 million people every year. Poliomyelitis eradication has met a stumbling block in India and recent reports suggest that that target date has been quietly extended to 2005. As if the pandemic of AIDS was not enough we are faced with threat of another ‘serial killer’ Severe Acute Respiratory Syndrome (SARS). A steep rise in life style related diseases like diabetes is also causing concern to public health workers. Another issue confronting us head-on is how to ensure access to essential medicines in third world countries after World Trade Organization (WTO) regime is fully implemented. Third world countries are facing a severe resource crunch and it is affecting their struggle against diseases like TB. AIDS and Malaria. The primary, secondary and tertiary health infrastructures are in dilapidated state. Private health care is very expensive and out of reach of the poor and middle classes. WHO will have to catalyze the growth of health care infrastructure in developing and transitional countries. It must persist with its efforts to advocate an increase in per capita health spending by national governments. WHO needs to have a fresh look at its relations with NGOs both at international and national levels. Dr. Lee carries with himself the experience of building Stop TB partnership. A significant percentage of its 250 members are NGOs. The role NGOs can play in supporting and facilitating the task of WHO is undeniable. But many a time WHO and NGOs find themselves in unenviable situations. WHO and its frontal organizations must be open to criticism and demands from NGOs. The mutual mistrust must give way to enduring partnership. A policy shift where NGOs are allowed more space in supporting and critically examining WHO policies is need of the hour and no one else can do it better than Dr. Lee. Competing interests: None declared |
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Peter WS Chang, professor in public health institution National Yangming University, Taiwan (current: 56 rue de Moillebeua, 1209, Geneva, Swiss)
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Politics before health for all? WHO has the 7th time since May 1997 rejected the proposal by her many Member States to admit to discuss possible allowing Taiwan's health authority to act as an observer into the largest global health network. WHO has more than 190 members and led the world health community since 1948, when health professionals from Taiwan initiated with Brazil for its establishment. But Taiwan's health professionals and delegates were refused to participate on it since 1972, and there remained no participation or communication between Taiwan's health professionals and those of the WHO. Several incidents illustrated the disadvantages for Taiwan's health professionals not in the WHO. For example, polio was eradiated effectively in Taiwan at early 1980s, but not even until all countries in the Western Pacific regions of the WHO were free of polio epidemic then Taiwan was "suggested" indirectly to be polio free in 2000. Enterovirus infection was prevalent in Japan in mid 1970s, and remained active in several south Asian countries, but hit Taiwan's 7 million children severely, resulting in 80 died, more than 400 hospitalized for weeks, and 1.4 million infected from April to October, 1998. Even today, dozens of children still remained handicapped in the hospitals. In that 6 plus months of epidemic, not a piece of assistance or information from WHO in Geneva or Manila was available to medical professionals in Taiwan. A Danish laboratory with collaboration with WHO even refused to provide specific antibodies to help doctors taking care of the patients to identify specific strains of virus in Taiwan's hospitals. In late November last year, as a clinician in one Taipei City Hospital, patients returned from China mentioned repeatedly unknown pneumonia seen in southern China hospitals where thousands of Taiwans traveled or worked. However, WHO was not able to identify the cause of this strange disease, later coined as SARS, at that early golden period. It was not until the diseases spread to Hanoi and Hong Kong that WHO started to wake to work and dismiss the messages which was already too late to curb and contain it in China's border. Physicians in Taiwan as well infectious disease team in WHO failed to prevent it into unprecedented catastrophe which we experienced in Taiwan and many other places. Moreover, WHO failed to show effective collaboration with health professionals in China to act responsibly and swiftly. Taiwan now contains the 3rd largest numbers of SARS cases since its importing from China, 538 as of May 23rd, and more than 60 people died, including several health care workers. In May 19th, WHO again rejected the proposal to consider Taiwan's observership. In May 20th, in the SARS technical meeting, WHO Director-General Dr. Brundtland openly refused to provide the opportunity for her Members to hear the presentation by Dr. CJ Chen, the Health Minister of Taiwan, on Taiwan's SARS epidemic. Dr. Lee J.W., who will take office of the WHO at late July, will simply be asked fundamental questions, how can he work to protect people of the planet with best available health care resources and not to enforce health apartheid on any region or health entity or territory on it, like the one imposed on Taiwan. Competing interests: None declared |
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