World Health Organization and emergency health: if not now, when?
BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i469 (Published 28 January 2016) Cite this as: BMJ 2016;352:i469All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
WHO has many arms and responsibilities. Emergency Health includes physical catastrophes like earthquake, drought, wild forest fires, cyclones, storms,volcanoes, pathological ( viral,bacterial or any other vector related) , war and radiation hazards. The department has to be permanently operational with experts of panel in each segment of disasters so that relief could reach in time ( stitch in time saves many lives). Regional centers must have departments of disaster related to the region so that they could be activated by the WHO central committee.
All these disasters devastate humanity and many die because of delayed response to the calamity. The funding for the department needs to be independent and has to be allocated faster on the recommendations of Governing council ( advisory committee).
Paper work, bureaucratic delays and approval from the stronger nations must be facilitators but not deterrent.
A timely intervention is so important to save many innocent lives who are victims for no reason.
WHO stands for global health and it needs to be when it really matters.
Competing interests: No competing interests
Re: World Health Organization and emergency health: if not now, when?
The paper underlines some of the fundamental issues that are so visibly manifest and, indeed, typify the dynamics at the Government-W.H.O.-NGO interface in any cluster coordination fora in emergencies. Lack of both, transparency and meritocracy and political influence are key constraints that the organization would do well to do away with. The need for organizational reform, strategic programming and operational synergy, too, is well-articulated by the authors.
To be fair, the article takes an over-simplistic view of the complexities that are inherent in the types of crises, examples of which are positioned as being central to the article's theme.
The statement - "WHO, however, sees itself as accountable to and providing technical assistance to governments, even those with dubious legitimacy", belies a lack of appreciation of the fundamental mandate and capacity of the UN specialized agency.
The "Examples of past WHO under-performance" stands out for its rhetoric. Many of these are based on blogs or narratives of personnel, who may not in the best position to appreciate the ground complexity. The activist tenor of the arguments and reference to media reports is a major shortcoming of the paper.
Due to insecurity, the average stay of an expatriate health expert in such settings may not exceed a couple of days or even hours. Expertise is quintessential but not enough to deliver health care in, say, amid a raging civil war in Juba, a certain Zimbabwean mega shanty or amid the post-coup looting of health facilities in a certain far-away Central African Republic.
Overall, the article raises compelling issues but perhaps falls short in its treatment of the issues.
Competing interests: No competing interests