Happy 75th birthday World Health Organization
BMJ 2023 ; 381 doi: https://doi.org/10.1136/bmj.p812 (Published 07 April 2023) Cite this as: BMJ 2023;381:p812
World Health Day this year marks the 75th birthday of the World Health Organization (WHO). 1 Founded alongside the United Nations, it was accompanied by a family of global organisations, including UNICEF, UNESCO, the World Bank, and the Food and Agriculture Organisation of the United Nations. Global policy governance was borne out of post war political optimism and a universal desire to address William Beveridge’s five giant evils—want, idleness, ignorance, squalor, and disease. There was a vision to rebuild a fairer, cleaner, healthier, wiser, and productive global community. It was a time for the old colonial powers to retreat and for new independence to come to the Global South.
Previous attempts to bring together international efforts on health had had limited success, hindered by the two world wars and other conflicts around the world. The Pan American Health Organisation (PAHO) —the first international health grouping—became one of the regions of WHO. The League of Nations health organisation existed before WHO and much of its work was assimilated into WHO. The World Health Organization met for the first time on 7 April 1948 and the first World Health Assembly (WHA) followed in June that year. 2
WHO has been strong on vision over many years. The vision to eradicate smallpox began early on, 3 but an actual plan didn’t begin in earnest until 1967. 4 The last confirmed case of smallpox was in Somalia, in 1977, and in Birmingham 4 in 1978. The world was declared free of smallpox in 1980. 5 WHO rightly describes the achievement as among the most notable and profound public health successes in history. 6
Emboldened— perhaps by the successful eradication of smallpox— WHO launched the ambitious Alma Ata declaration for primary health care in 1978. 7 The declaration stimulated the global strategy for Health for All by the Year 2000. 8 In Europe, this led to the publication of 38 European Targets for Health for All by the Year 2000 in 1985. 9 A practical outworking of European health for all came through the Healthy Cities project, and later, the Healthy Regions initiative. Such movements have provided substantial impetus for local health improvement efforts, developing multi-agency and multidisciplinary interventions, and recognising the need for “H ealth in all Policies .” 10
Global vision for health is now enshrined in the Sustainable Development Goals (SDGs). 11 A focus on health is clear throughout the SDGs, and WHO is the lead global actor for the health SDG3. 12 The cross referencing with the other goals is strong and demonstrates that “public health is everybody’s business.” The SDGs are the driver and reference point we should all be using to frame our policy making.
The Framework Convention on Tobacco Control was another landmark in international health policy, but there is still a long way to go on delivering its promise. Globally, aggressive marketing of tobacco continues, particularly in lower income countries with limited regulation and taxation of tobacco products. Vulnerable adults on lower incomes, women and children are also victims of aggressive marketing. Transnational advertising and sponsorship, trade liberalisation, and direct foreign investment by Big Tobacco all contribute to the explosive increase in tobacco use. 13
The pandemic has shown us we need more, and better global public health resources. 14 No single country can protect itself from new health threats, however wealthy, however sophisticated in its science, and however strongly its government is committed to public service. We need to see an effective and well resourced WHO, able to support countries in their emergency responses, across the world. 15 WHO needs to be able to support the development of national health systems, not just implementing responses to individual disease problems, favoured by its donors. 15 16
WHO recognises the crisis in healthcare workforce recruitment and capacity, for all health systems in rich and poor worlds alike. In lower income countries, a lack of a trained healthcare workforce is a barrier to implementing universal healthcare coverage. In wealthier countries that already have universal healthcare coverage, it undermines our ability to maintain and develop it. 17
We also need to see investment in public health training and education across the globe. 18 To this end, the WHO has set up a roadmap looking at national workforce capacity to implement the essential public health functions including a focus on emergency preparedness and response. 19 20 This is vital work in support of the pandemic preparedness treaty due to come to the World Health Assembly in 2024. 21 There are opportunities for eligible countries to bid for Pandemic Fund. 22
WHO has its detractors. It must operate in the most complex and politically fraught situations. It has had to battle political intransigence, chronic underfunding, and failures to deliver on promises of support from national governments. If we did not have a World Health Organization, we would have to invent one. In all our interests we must back the organisation, be robust and critical friends, but be wholesome in our support and our commitment to WHO initiatives and policy advice. 23 The 21st century is an era of disinformation, climate breakdown, mass marketing of unhealthy products and services by multinational companies, the commercial plunder of the environment, political corruption and geopolitical instability. We need unity in the global health community. 24 So Happy 75th Birthday, World Health Organization. Here’s to the next 75!
Footnotes
-
Competing interests: JM is an elected unpaid official of a member organisation, the Association of Schools of Public Health in the European Region, (ASPHER) he has undertaken two short consultancies for WHO in 2015 and 2021. SS is retired professor from the medical school, Andrija Stampar School of Public Health, University of Zagreb, Croatia; an unpaid co-chair of ASPHER Honours Platform and an unpaid member of Advisory Committee Healthy Cities, Health Promotion and Wellbeing, WHO Regional Office for Europe.
-
Provenance and peer review: not commissioned, not peer reviewed.