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WHO Plans To Reshape Itself To Better Handle International Outbreaks

KELLY MCEVERS, HOST:

This week, the director of the World Health Organization gave a stern warning.

(SOUNDBITE OF ARCHIVED RECORDING)

MARGARET CHAN: What we are seeing now looks more and more like a dramatic resurgence of the threat from emerging and reemerging infectious diseases.

MCEVERS: Dr. Margaret Chan was talking about diseases like Ebola, Zika and Yellow fever. And she said the world is not prepared to cope. Dr. Chan issued this warning in Geneva at the annual meeting for the WHO. She's trying to reshape that agency so it's better at handling international outbreaks. But as NPR's Michaeleen Doucleff reports, there are several obstacles.

MICHAELEEN DOUCLEFF, BYLINE: Lawrence Gostin studies global health at Georgetown Law. He says for the past decade or so, WHO has been crippled. The agency slashed its budget for emergencies, got rid of a lot of experts and greatly reduced its ability to help during an outbreak. Then Ebola hit West Africa, and WHO was widely criticized for being too slow to respond.

LAWRENCE GOSTIN: Thousands of lives were lost unnecessarily, and yet no one was fired. No one was held accountable at WHO. And this needs to stop.

DOUCLEFF: But last year, he says, the agency took a big step. It built up its capacity to get boots on the ground quickly when an outbreak hits.

GOSTIN: That's never happened in the past. They never actually got their hands dirty on the ground in a country. And what this signals is that they will.

DOUCLEFF: WHO is creating a team devoted exclusively to handling health emergencies like Zika in Latin America. Before, the agency had to rebuild this team from scratch every time an epidemic cropped up.

PETER GRAAFF: I've been at the WHO for close to 25 years, and I've never seen anything like this. It is a really - a completely new way of doing business.

DOUCLEFF: That's Peter Graaff, the director of emergency operations at WHO. He says the agency has started training medical teams around the world so they can drop whatever they're doing and rush to an outbreak. So far, they've got teams in China, Europe and Latin America.

GRAAFF: It will offer a much faster, more effective and predictable response to health emergencies.

DOUCLEFF: But others say the changes don't go far enough. Dr. Ashish Jha is the director of the Harvard Global Health Institute. I talking to him on Skype on his way to WHO's World Health Assembly meeting.

ASHISH JHA: I think it's not even close. What they've done so far I don't believe begins to fix the underlying problem because I think the underlying problem was much more about culture and openness and a sense of accountability.

DOUCLEFF: Because, he says, so much of what happens at WHO happens in secrecy. There's little transparency, which he says is exactly the opposite of what's needed when a deadly disease is spreading. Countries need to know who's making decisions and why. Gostin at Georgetown agrees with Jha. And, he says, there's another big problem, money.

WHO is asking countries for about $500 million to fund the program but hasn't gotten it yet.

GOSTIN: Even if that were fully allocated, and the assembly hasn't done that yet, it would be woefully too little.

DOUCLEFF: By comparison, U.S. health officials asked Congress for nearly $2 billion just to fight Zika in the states.

GOSTIN: So I would say the World Health Assembly has to put its money where its mouth is or else this could be a paper tiger.

DOUCLEFF: A paper tiger that will crumble when another crisis like Ebola strikes the world. Michaeleen Doucleff, NPR News. Transcript provided by NPR, Copyright NPR.

Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.
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