Education And Debate

WHO responds

BMJ 2003; 326 doi: (Published 25 January 2003) Cite this as: BMJ 2003;326:217
  1. Denis Aitken (, chef de cabinet
  1. World Health Organization, 1211 Geneva 27, Switzerland

    In November and early December we published Gavin Yamey's series examining whether the World Health Organization had dealt with its structural problems and rethought its functions—in effect, reinvented itself. Now WHO responds

    The BMJ recently published five articles written by one of its editors on the performance and future challenges of the World Health Organization. This series adds to the debate around WHO's work that is always ongoing among its 192 member states and between WHO and its partners in civil society and the private sector.

    The articles in the BMJ are critical of some aspects of the organisation's performance, which WHO is working hard to improve. But much of the criticism seems to be based on an unrealistic perception of the role, structure, and powers of WHO.

    Summary points

    Over the past four years WHO has established health as a key factor in development

    The slide in WHO's role as the global leader in public health has been halted—and in many areas drastically reversed

    WHO has worked systematically since Gro Brundtland took up her position in 1998 to restructure and improve country work

    WHO has carried out one of the most far-reaching human resources reforms in the United Nations system, in close collaboration with its staff association


    The BMJ envisages a WHO where the director general can dictate to the 192 member states, and where she is not encumbered by the limitations in budgets. It also envisages WHO as an organisation which can impose on civil society and private sector partners, while at the same time not being seen as dictatorial and dominating.

    Of course WHO fails to live up to such a standard. But if the BMJ's purpose is to deliver constructive criticism which helps the organisation to improve, it would be more useful to discuss failings and improvements …

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