World Health Organization (WHO)

views updated

World Health Organization (WHO)

Introduction

The World Health Organization, as part of the United Nations (UN), has expertise to coordinate international public health matters. Within its constitution, its mission “is the attainment by all peoples of the highest possible level of health.” With health as its prime concern, the WHO defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Its prime concern is to, generally, promote the health of all peoples of the world and to, specifically, combat diseases—especially critical infectious diseases.

The public widely recognizes some work performed by WHO. The WHO responds to natural and human made disasters by providing emergency aid, funds medical research, conducts immunization campaigns against fatal diseases, and improves housing, nutrition, sanitation, and working conditions in developing countries.

The WHO is probably best known for its immunization programs and smallpox eradication. Currently, it is working with other health organizations to treat tuberculosis, malaria, SARS (severe acute respiratory syndrome), and HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency deficiency syndrome).

However, the WHO also performs work that is less familiar to the public. It charts statistical health trends and issues warnings about possible health problems. The WHO is also responsible for assigning a common international name to drugs. WHO standards are used for measuring air and water pollution. WHO personnel work with agencies, foundations, governments, non-governmental organizations, and private sector groups to address the world's health needs.

Headquartered in Geneva, Switzerland, the WHO consists of one hundred ninety three Member States (along with two associate Member States). It is governed through representatives within its World Health Assembly. A thirty-four-member Executive Board, elected by the World Health Assembly, supports the WHO. In addition, six regional committees focus on health concerns within Southeast Asia, the Eastern Mediterranean, the Americas, Africa, the Western Pacific, and Europe.

History and Scientific Foundations

Chinese physician Szeming Sze, Norse physician Karl Evang, and Brazilian physician Geraldo de Paula Souze proposed the formation of an international health organization in 1945 at the United Nations (UN) Conference on International Organization (San Francisco, California). The constitution for the international health organization was approved in 1946. The UN approved its charter and the World Health Organization was established on April 7, 1948. It became the successor organization of the Health Organization, which was an agency of the League of Nations.

The priorities for the fledgling organization were to deal with cholera, malaria, maternal and child health, mental health, nutrition and environmental sanitation, parasitic diseases, plague, smallpox, venereal diseases, yellow fever, and viral diseases. It also expanded immunization programs for diphtheria, measles, polio, whooping cough, tetanus, and tuberculosis.

The WHO provided health programs for food, food safety, and nutrition; health education; immunizations; prevention and control of endemic diseases; essential drugs; safe water and sanitation; and treatment of diseases and injuries.

Applications and Research

Three of the WHO's largest programs called for the global eradication of smallpox, polio, and leprosy (Hansen's disease). The worldwide campaign to eliminate smallpox began in 1967 as the WHO held vaccination programs in developing countries. By 1972, only a few countries in Africa and southern Asia reported any incidence of smallpox. In 1979, the WHO reported that smallpox was eradicated throughout the world.

WORDS TO KNOW

ENDEMIC: Present in a particular area or among a particular group of people.

ERADICATION: The process of destroying or eliminating a microorgan or disease.

MULTIBACILLARY: The more severe form of leprosy (Hansen's disease) is called multibacillary leprosy. It is defined as the presence of more than 5 skin lesions on the patient with a positive skin-smear test. The less severe form of leprosy is called paucibacillary leprosy.

PAUCIBACILLARY: Paucibacillary refers to an infectious condition, such as a certain form of leprosy, characterized by few, rather than many, bacilli, which are a rod-shaped type of bacterium.

In the 1980s, the WHO led programs to eliminate polio and leprosy. Today, the Global Polio Eradication Initiative (GPEI) is a partnership among the World Health Organization, Rotary International, the Centers for Disease Control and Prevention (CDC), and the United Nations Children's Fund (UNICEF) to eliminate polio. The WHO provides strategic planning; technical direction; and monitoring, evaluation, and certification for the coordinating and planning of the Initiative.

As of May 1, 2007, according to the GPEI, the number of polio cases worldwide is 130 (107 in endemic countries and 23 in non-endemic countries). In 2006, 1,997 cases (1,869 in endemic countries and 128 in nonendemic countries) of polio were reported.

The WHO has been instrumental in reducing the number of leprosy cases around the world. The key to this success is a campaign to deliver information, diagnoses, and treatment to endemic countries. The WHO has recommended two types of multi-drug therapy (MDT) since 1993: a two-year treatment for multibacillary cases using clofazimine, dapsone, and rifampicin; and a six-month treatment for paucibacillary cases using dapsone and rifampicin. Free packs of MDT have been supplied by the WHO to all endemic countries since 1995, and this process has been extended into 2010.

According to WHO statistics, as of early 2006, approximately 219,826 cases of leprosy are known to exist in 115 countries/territories. In the previous four years, the number of new cases has steadily declined by about 20% annually. Areas where leprosy are still prevalent include Angola, Brazil, Central African Republic, the Congo, India, Madagascar, Mozambique, Nepal, and Tanzania.

Impacts and Issues

The WHO estimates that over one billion people worldwide do not have access to clean drinking water. Contaminated water is a source of infectious disease and parasites. The United Nations announced the “Water for Life” Decade, a cooperative initiative between several UN agencies and local governments to increase access to clean water and promote sanitation. By 2015, their goal is to reduce by half the number of people living without clean water and to aggressively treat or eradicate water-borne diseases and parasites in areas where they have been endemic.

At the United Nations Millennium Summit in 2000, 189 governments adopted a set of goals, most aimed at improving the quality of life for people worldwide. The Millennium Development Goals (or Millennium Goals) seek to reduce poverty, protect the environment, fight infectious disease, and promote health. The WHO is a key organization in the Millennium Goals project.

Several of the Millennium Goals directly address infectious disease. Goals to reduce infant mortality and promote maternal wellness both involve projects to combat infectious disease. Goal Six specifically seeks to combat HIV/AIDS, malaria, and other diseases. In response to the Millennium Goals challenge, the WHO, along with UNAIDS and other organizations, launched the “3 by 5 Initiative” with the aim of treating 3 million HIV/AIDS infected persons with antiretroviral therapy. To combat malaria, the WHO has partnered with private organizations to provide mosquito netting and preventative medications.

The WHO's disease-based approach has been criticized by some as being too simple and narrow for society's changing needs in the 2000s. Critics tell of the poorest of countries desperately in need of health assistance, but not receiving any from the WHO. Some public health officials find that its Member States withhold funds to receive support for their own agendas. The WHO has been criticized for not doing more to reduce the escalating cost for drugs used in developing countries. In addition, more organizations are competing with the WHO, such as the World Bank, which makes it more difficult for the WHO to garner financial support. In contrast, the entire 2005 budget of the WHO was about the same amount as public health expenditures in the state of California in 2005.

BIBLIOGRAPHY

Books

Burci, Gian Luca. World Health Organization. Hague, Netherlands: Kluwer Law International, 2004. Sze, Seming. The Origins of the World Health Organization: A Personal Memoir 1945–1948. Boca Raton, FL: LISZ, 1982.

Web Sites

BBC News. “World Health Organization: a profile.” April 25, 2003 <http://news.bbc.co.uk/1/hi/health/2975139.stm> (accessed May 8, 2007).

Global Polio Eradication Initiative (GPEI). “Home website of GPEI.” <http://www.polioeradication.org/> (accessed May 7, 2007).

World Health Organization (WHO). <http://www.who.int/en/> (accessed May 8, 2007).

World Health Organization. “The World Health Report 2006—Working Together for Health.” <http://www.who.int/whr/2006/en/> (accessed May 7, 2007).

William Arthur Atkins

Infectious Diseases: In Context