Is the World Health Organization on life support its response to the coronavirus demick is to be scrutinized by a number states with calls for change growing louder all the lessons to learn for the next. This is inside story. Hello and welcome to the program on. The coronavirus pandemic is one of the Biggest Challenges the World Health Organization has ever faced its also receiving both praise and criticism for how its dealing with the crisis critics say the w. H. O. Acted too slow to declare a pandemic its Member States voted unanimously for an independent inquiry into the Global Response to covert 19 and the un bodies role its director general welcomes the review i will initiate such an evaluation earliest appropriate moment we welcome any initiative to strengthen Global Security and to strengthen doubly to your eyes on ways that related job remains fully committed to transparency accountability and Continuous Improvement of the w h os biggest donor is also its loud as critic the us president is threatening to cut all funding unless he sees what he calls substantive improvements in 30 days donald trump says the organization has failed to hold leaders in china to account even though he himself praised both the w. H. O. And the Chinese Government at the start of the outbreak the us has the worlds highest number of corona virus infections and deaths the European Commission president says now isnt the time to trade blame in times like these the greatest act of courage is to play as a team. This does not mean that once the dust will have settled and once we have delivered on our pledge to beat this virus we should not be looking to raise to modernize the w. H. O. To see what should be done for the w. H. Will to continue to live up to the new challenges because we need multilateral approaches but let us for now focus on our most immediate challenge the World Health Organization was created by the United Nations 72 years ago its mandate to Shape InternationalHealth Policies trace and advise on how to manage epidemics and pandemics based in geneva in switzerland its 194 Member States elect the director general and vote on policy they also help fund a 4 and a half 1000000000. 00 budget for the current su years the w. H. O. Also relies increasingly on private donors who can influence priorities it was criticized for failing to take command after an outbreak of ebola in 2014 its director general pledged to shake up the w. H. O. When he was elected 3 years ago. Lets bring in our guests from burnaby British Columbia in canada is kelly levy a professor of Global Health policy at Simon Fraser University shes also cofounded the w. H. O. Collaborating sensor on Global Change and health from dulles in the United States jeremy youd a specialist in Global Health politics and the dean of the college of liberal arts at the university of minnesota and in johannesburg in south africa dr regina o. C. Is a medical doctor and in sections disease specialist of the Aurum Institute welcome to all if i can start with you kelly hows the w. H. O. Struggled with managing the coronavirus pandemic or are its members just not listening were going to stand what it is designed to teach you and at the early stages very we will need to find out whether its done it in a timely manner but essentially what its designed to do is to collect intelligence about outbreaks and then share that information with Member States and it bices those Member States what it should do in response now the question is did it do it in a timely manner and it never states respond in a timely manner those are the questions i think we need to ask jeremy what do you think. Has the responded in a timely manner to the w. H. To the coronavirus outbreak. You know i think kelly is absolutely right in that the w. H. O. Cant mandate policy cant force states to do it in but it can be there to to bring in information but then also disseminate that information and provide out to members that its what those Member States then decide to do with it is up to them and so its so far it seems like theyve done point out theyve done kind of what theyre designed to do whether or not thats been the most active is something that i think will be really important to figure out as we do this independent review after the pandemic passes in south africa how has the coronavirus how is the w h os response to the coronavirus been seen there regina. Well i think that generally the debate so in countries that have less resources are seen as a provider of normative guidance guidelines too and things that people can use to be able to improve their responses and i think that from that perspective before thats mandate there are lots of different tools available on its website it is provided information on how best to manage and of course as the other panelist said its time its up to the countries to figure out what they want to do and typically south africa is quite in terms of health is quite a resource rich environment because of a lot of social a lot of Civil Society and experts in health and research who are already working a practicing here so we also have our own Key Opinion Leaders that we listen to and who are generating models that are specific to south africa however for other countries where this is not available there was a course show part or called in the wheel that allows for Public Health response kelly the has been criticism of the w. H. O. That its been too deferential perhaps to china that its not exercised leadership right at the start of all of this and it was slow to call it a pandemic because of fear of china is that a fact criticism well who find out i think with this investigation i think whats important to recognize it w. H. O. Has to work with consensus with Member States it cannot enforce a lot of it decisions it has to work and get cooperation so this what seems like deferential behavior towards china is probably diplomacy in action trying to get the chinese to cooperate as much as possible provide information and to really you know work with every show beaches very reluctant to call out Member States its traditionally been very you know reticent to do that and i think thats what weve seen so other supersedes that has been too deferential thats just m. H. O. In action jeremy were told that kelly mentions how the w. H. O. Is reluctant to call out states but in a pandemic like this dont you need to be more assertive. Its one of the quandaries an organization like the w. H. O. Faces because it doesnt have all the same sort of leverage you know its it cant sanction states it cant threaten to invade say to doesnt have those sorts of tools of diplomacy so what it can do is it can think we could name and shame that state we could publicly call it out and chastise it or we could try to have a more coopted relationship and when youve got a country where a pandemic seems to be starting i think that the calculation of the w. H. O. Made was its probably going to be to our advantage were probably going to get more and better information from the Chinese Government if we are working with them if we are trying to provide a tool and so i so i completely understand the criticism i just dont know that given the structures of the w. H. O. And the powers that the Member States have given to the i dont know how much more it was going to be able to force china to do anything and to take other sorts of actions would you want to see a more assertive w. H. O. Do you do you see where the criticism of criticism has been coming from i think you know that theres always criticism and i think there are always things that can be modified i think that the investigation will be welcome and you know organizations have to grow and evolve as things change you know when the vehicle started out there very soon the diseases that it was ticking tariffs now there is down there is a t. V. There is to be peoples life expectancies have come up there is noncommunicable diseases that have increased in many countries that rely on the w. So its become a massive undertaking and i think that its always good to reexamine what the purposes and how best to achieve that however i do like the aspects that Member States are. Invited for collaboration and also that its an Inclusive Party but that its not necessarily coercive and i think that thats something that is to be appreciated when youre at the receiving end of some of the advice i think that a lot of countries are able to make their own decisions and decide how they want to address it and issues within their countries or within the boundaries of bare of their context and i think thats completely acceptable for many places kelly through the International Health regulations the w. H. O. Has got hasnt some moral authority to sort of demand of states whites doing this why its putting trial restrictions in here why its stopping people going from a to b. It hasnt really use those tools do you think has it could it use those more effectively has it been more too timid. The International Health regulations is a very important instrument its a legal treaty that Member States signing up to and they are obliged to comply with and there hasnt been a lot of compliance with it in this outbreak so yes the b. H. O. Could you know can call out Member States as weve discussed already and request that countries comply but theres no enforcement mechanism then this is what we just sort of mentioned that there isnt say equivalent of what the World Trade Organization has which are countermeasures so if the country decides that it doesnt want to comply with the decision of the t. O then what happens is that there are Counter Measures there are terrorists imposed on a country that isnt complying that the show doesnt have that kind of enforcement mechanism so the question is do we need to give. More teeth more sort of maybe carrots and sticks that will make Member States comply so that its kind of unfair to ask that we chose to sort of use methods that it actually doesnt have the capacity to do jeremy to the w. H. O. Does generally get praised for its medical expertise its scientific guidance but tries to avoid the politics but health is political isnt it i mean should it have more teeth the w. H. O. Shopped your you know europe playwright health is inherently political and thats one of the reasons that i think the current director general one of the things that he was able to campaign on when he was campaigning for this position is that not only does he have this Health Background but he also served as the foreign minister of ethiopia so he has both sort of the health side of things and the political the diplomatic so i do things and you know on a personal level yes i think that giving more teeth to the w. H. O. Would probably be a good thing but the same time we have to recognise that to do that it means that states would be giving up some degree of sovereignty. Perhaps and their willingness to do that is something that we havent yet seen and the w. H. O. Is ultimately a creature of its members states the Member States are the ones who make the decisions about what powers they want to give or not give to the organization and so if we are going to do that there needs to be some sort of movement with among the Member States and willingness to to be more deferential to w. H. O. And we havent yet seen that and we havent yet seen that sort of leadership among the members states arise regina you know as you know in south africa of course health is very much a politicize issue like in many countries would you like to see the w. H. O. Be a bit braver in touching the politics of health care. Well i think its a balance you know i think that you also want to have drive political will internally and not have it as a stick coming from an external source as i think back the biggest most successful countries that we have especially in the developing world is where the actual politicians and the people in charge have decided that Health Parity and ive been able to push that with the help of you know tools and and expertise they get from the so i think its a bit risky to become a big to politicize and also to try to in source things to radically because i think that that could also put some people off and you could lose the ground of the footing that you had in countries where you know maybe there be some tenuous political environments and youve been trying to navigate those while obviously keep focusing on the house of the population and all of a sudden youre no longer invited in and people suffer so i think those are the considerations that the also has to and the International Community at large usually has to take into consideration in order to make decisions like that kellies is the w. H. O. Trying to do too much of the moment is original remit was womens and womens and Childrens Health and nutrition sanitation malaria tb and now it now is involved in g. M. Foods a Climate Change road safety should it narrow again its focus now that supreme you know question i i think it should but the question is what do we drop so it does everything from aids to seek as i often describe it and you know the question is what is less important and thats when it gets really difficult because all of these issues are very important and its a World Health Organization its not a World Disease Organization so what it means is that it has to you know to fill a mandate that is very broad and if you look at the constitution it really set out a very broad definition of health not just the absence of disease so were thinking about you know health in a very broad associative terminus of how clay but also the. 194 countries which are very very diverse so we have a huge menu of things to do this is the challenge for it of each oh and you know theres been lots of discussions about how do we narrow this how do we set priorities its very very difficult and the budget ends up being stretched extremely thin the jeremy aids to seeker is a good way of describing it does the w. H. O. Is he trying to do too much. It has a ton on its plate and theres you know theres increasing expectations of the w. H. O. Takes on more and more but it also doesnt have the resources to do all of that and as you point out in the introduction a lot of the resources that are coming to w. H. O. These days are coming from donors who are specifying specific purposes we will give you x. Number of dollars to work on this particular issue and so not only do you have an organisation that is expected to do more with a relatively small budget but has it has a decreasing amount of control over that budget because the donors are exercising their theyre there to sit there their discretion over what they want that money to be spent on and so you know at some point there has that there have to be some decisions either we need to give this or in more resources or to take on this broader mandate or we need to cut back the mandate and then the question becomes how do we decide what is considered less important or can be taken off the w. H. O. His mandate and wales with those sorts of issues go and this comes into the question about the 194 Member States that you have who is going to make those decisions what sorts of issues are going to to rise to the surface because the priorities for say the United States or for canada or for the United Kingdom are not entirely going to be the same as the priorities for say brazil or zimbabwe or thailand and so then youve got some conflicts that come up when you try to shrink the mandate of the debate show regina tights a monday through the w. H. O. Would that be what you would want to see a more full focus on specific things. Well i think that there is a bit of overlap in terms of Different International organizations that are providing support for Different Things and different diseases but has always had a key role in care of health areas that are completely neglected by others and that up where little attention is being. Put on for example the also our or a couple of other you know neglected topical diseases and i think that as the others have said its going to be really difficult to understand which ones they should prioritize and which ones they shouldnt i think that you know the health needs of the countries are going to be very different and there are lots of countries that really very highly rely on the vehicle for everything that they do get to terms of Technical Support and therefore those countries perhaps will need to the prioritized in terms of how we address which things that they can keep and which things they should drop but i do think that you know we should review the overlap and see whether there are other were going to is a subset of providing similar. Help but i think the future what we shouldnt forget is that as a mandate to convene and coordinates which is something that is difficult to do if youre not a mandated and even a part of this u. N. System so you can be a private organization or another donor are funded organization but this power to coordinate and convene should not be underestimated and also its really good about giving us data collecting data from countries which really informs a lot of programming in many different areas and i think that also those functions should be retained in some way. Kelly of course there are only states that contribute to the w. H. O. Its increasing reliance on private financing is thats a worry as well bill and bill and Melinda Gates foundation huge donors of the w. H. O. Gives private groups opportunistic direct where the money goes doesnt it thats right so the paper pace that you know the paper how does that saying you know whoever pays the piper places too much and so what we have is an organization that really isnt in control of a lot of its budget and so i think its 75 to 80 percent of its funding comes from these extra budgetary contributions so theres a big question about the beaches budget how its funded it needs to have core resources to cover you know things like keeping the lights on but also providing those technical guidelines those protocols that all Member States for lie on and this is where its less maybe attractive to funders to donors they like to give to making high profile diseases and this sense to use that every budget towards a certain causes and the Gates Foundation is much welcome in terms of its resources but what would be much preferred and this is a course depending on whether these organizations trust the b. H. O. Is that they put their money into a hat and that the World Health Assembly the 194. 00 Member States decide what the priorities are and not individual donors and that way you know we can have a much fairer and open transparent process of setting priorities jeremy do you think the da joe would have the power or the influence to say to its private donors this money is going into a pot well let the experts share it sounds. I think thats could be a really interesting strategy for the w. H. O. To take and you know these put extra budgetary funds these these voluntary contributions that is receiving are not just coming from private donors but theyre also coming from Member States as well and there has been a question about that sort of political will do we try to put some sort of conditions on this saying ok if youre going to give this this specify contribution certain percentage has to go into into the into this pot into that this indicating that we can decide how were going to prioritize this and i think the other thing that comes up a lot when we look at the voluntary contributions of the role of private donors with a w. H. O. Is this question about whether that thats allowing for the abdication of states to do what theyre supposed to do if the word if theres just an expectation by by governments that oh the bill and Melinda Gates foundation will be able to step in and will be able to make up the shortfall and so theres a responsibility on the part of the Member States that they you know again because this is ultimately an organization is a creature of the Member States its up to the Member States inside how what sorts of regulations they want to put in place and how they want to make the regulations around the funding that division receive and how that gets spent so so there is theres definitely a role for for w. H. O. To play with the private organizations and trying to encourage them to give it to give those funds into ended to the core budget but i think theres also a responsibility on the part of the Member States that think about what sort of obligations did they have to the organization what sorts of responsibilities did they have with their own contributions to w. H. O. Regina what can you say weve learned from any lessons weve learned so far from the dani light shows handling of the pandemic and how that might affect how a reform w. H. O. Looks in the future well i think that that what salient is that it seems that not everybody is satisfied with the way that stuff each has handled it so maybe theres not our understanding of what should be doing with an endemic set the Member States and what its wallace and maybe that needs to be tiresome. And when i fulfill that role or not i think its a set and i think there are lots of diverse diverts opinions about whether the w. H. O. Did or didnt do what it was supposed to do and course the the main thing is if we all agree on whats the actual role is and how was the expect that to show up in pandemics and that will points people get involved and what the responsibility is of the w. H. O. And of the Member States i think that that would be one step sort of not having this disconcerts is disconcerting discourse at this point when were trying to fight a pandemic yet at the same time were fighting the organization thats supposed to do it so i think that thats where i i think there are lessons learnt kelly if you can get over if you can get 194 members to agree on whats a reform w. H. O. Should look like thats the 1st challenge how do you how would you like to see it look in the future. Well we touched on some of these issues one of them is to give debate show more teeth and to give it more authority and ability to challenge and to enforce some of its Member States in terms of the legal obligations the 2nd is the budget i think that needs to be sorted out has been starved for decades in terms of its funding its been very very underfunded under invested in and we need to look at that very carefully and how that money is used how its actually paid into the organization and so on and then i think the 3rd thing is to pull the camera back a bit and not just look at death really chill there are many Many Organizations out there is already mentioned that working group will help and we have a real patchwork of organizations that work in this in this domain there is a proliferation of initiatives doing many Different Things its quite a tangle theres some overlap theres some gaps i think we have to look at the bigger you know system that we need to create in what we call Global Health governance and see what we can do to create a more rational more you know effective system that would really protect us all from future tend them ix well unfortunately were out of time folks but thank you very much for joining us banks to Carrie Lee Jeremy youd and dr regina o. 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The footballer whose personal story swayed of votes that alter the history of his country Carlos Caselli and the demise of a young day on aljazeera examining the impact of todays headlines extraordinary times require extraordinary measures but these should not be at the expense of our privacy setting the agenda for tomorrows discussed moods i know the life that was in these walls and now there is no live in the wall global experts in discussion in this democracy why are people not voting International Filmmakers and world class journalists. On how to sarah. More than 10 years after the Global Financial crisis youve taken home more than 480000000. 00 your company is now bankrupt our economy is of a state of crisis i have a very basic question is this where millions lost their homes in the u. S. Whos held responsible i will be fabulously wealthy and i will be in christ for thank the lord the man who still looms on aljazeera. I dont really. Getting anywhere near. The. 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