Intended for healthcare professionals

Education And Debate

Commentary: Change will not happen overnight

BMJ 2005; 330 doi: (Published 27 January 2005) Cite this as: BMJ 2005;330:250
  1. A Griekspoor (, technical officer, policies, capacities and intelligence1,
  2. D Nabarro, representative of director general for health1,
  3. A Loretti, coordinator of policies, capacities and intelligence1,
  4. I Smith, adviser to director general2
  1. 1Department of Health Action in Crises, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland
  2. 2Director General's Office, World Health Organisation
  1. Correspondence to: A Griekspoor

We endorse the view expressed by Walker et al, that short term thinking and related funding mechanisms can undermine efforts for a more sustained approach to reducing the risk of disaster.1 Inequity in the scale of response poses other problems. Over the past decade, about half of the $2bn (£1bn; €1.5bn) committed to the Inter Agency Standing Committee Consolidated Appeals went to high profile crises such as those occurring in Bosnia, Afghanistan, and Kosovo. Other countries affected by chronic conflict, such as Liberia and Somalia, received much less per person affected, although their needs are at least as great. Rapid onset disasters can also trigger a series of responses that are influenced more by emotions or political motives than by evidence based assessments of needs.2 Some of these responses are harmful and can add to the suffering or chaos, such as rapid burials in mass graves because of unwarranted fear of epidemics.3

It is harder to raise funds for disaster prevention, preparedness, …

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