Definition

The World Health Organization (WHO) is a unit of the United Nations that is devoted to global health issues. WHO coordinates and provides leadership and directions on health matters through health research programs, guidelines, and standards. The organization also provides technical support to governments to help them address global health problems and to improve the well-being of their respective populations.

The organization is governed by a constitution that has eighty-one articles or principles. The objective of WHO (described in chapter I, article 1) is “the attainment by all peoples of the highest possible level of health.”

The WHO constitution came into force on April 7, 1948. Soon thereafter, the first World Health Assembly(WHA), the highest WHO decision-making body, called for the creation of a World Health Day to mark the founding of the organization. Since 1950, World Health Day has been celebrated on April 7 annually around the world. A theme, which highlights a priority area of concern, is chosen each year to focus on key public health issues that affect the international community.

Membership

Any country that is a member of the United Nations may become a member of WHO by accepting the WHO constitution. Other countries may be admitted as members following the approval of their application by a simple majority vote of the WHA. Associate membership may be granted to territories not responsible for the conduct of their international relations when applications are made on their behalf by a member or other authority that is responsible for their international relations. There are 193 member states within WHO, and they are grouped according to regional location and offices.

Structure

WHA’s main function is to determine WHO policies. The assembly meets yearly in May at its headquarters in Geneva, Switzerland, with delegates from member states. The WHA appoints a director-general, who supervises the financial policies of WHO and reviews and approves the proposed program budget for a given year.

The executive board, whose members are elected to three-year terms, comprises members who havetechnical qualifications in health fields. The main function of the executive board is to facilitate the work of the WHA by approving their decisions and policies.

The secretariat of WHO is staffed by about eight thousand health and other experts and support staff on fixed-term appointments. The staff works at the headquarters in Geneva, in the six regional offices, and in member countries. WHO is headed by a director-general, who is appointed by WHA on the nomination of the executive board. Since the inception of WHO in 1948, eight directors-general have served. Brock Chisholm, from Canada, was the first director-general and served from 1948 through 1953. Director-general Margaret Chan, from the People’s Republic of China, was appointed in November of 2006. The organization is financed by dues contributed by member states, by voluntary donations from private nongovernment organizations and foundations, andby partnership with research and pharmaceutical companies.

Regional Offices

There are six WHO regional offices, each of which is headed by a regional director. The regional director manages a staff of health and other experts at the regional headquarters and in specialized centers within a given region.

The director is elected to a five-year term by a regional committee that consists of all heads of health departments in the governments of the member states within the given region. The tenure of the regional director is renewable once. The committee also implements the health policy guidelines that are outlined by WHA. The committee also monitors all WHO activities and operations within its respective region.

WHO regional offices represent Africa, the Americas, Southeast Asia, Europe, the eastern Mediterranean, and the western Pacific. The Regional Office for Africa (AFRO) is headquartered in Brazzaville, the Republic of Congo, and has forty-six members, which includes most of the nations of Africa.

The Regional Office for the Americas (AMRO) is headquartered in Washington, D.C. The region has thirty-five member nations and was established before the founding of WHO as the Pan American Health Organization, the oldest international public health organization in the Western Hemisphere. The Regional Office for South East Asia (SEARO) is headquartered in New Delhi. This region consists of eleven member nations in Southeast Asia and includes North Korea. The Regional Office for Europe (EURO) is headquartered in Copenhagen. The region consists of fifty-three member nations in the European Union. The Regional Office for the Eastern Mediterranean (EMRO) is headquartered in Cairo. The region consists of twenty-one member nations, including the African nations of Egypt, Sudan, Tunisia, Libya, and Morocco, and the countries of the Middle East (except Israel).

The Regional Office for the Western Pacific (WPRO)is headquartered in Manila. The region consists oftwenty-seven member nations, including the countries in Oceania and South Korea and Asian countries that are not served by SEARO or EMRO.

Liaison and Country Offices

In addition to the six WHO regional offices, the organization has country offices and liaison and specialist offices at critical international institutions. The country offices are usually located in a country’s capital and may also involve the establishment of satellite offices. Country offices are headed by WHO representatives, who most often are trained physicians but are not citizens of the host country. These physicians typically hold diplomatic rank and are accorded diplomatic privileges and immunities similar to those of a nation’s ambassador or high commissioner.

WHO country offices serve as the primary advisers on health and pharmaceutical policies to the host government. The international liaison offices have functions similar to country offices, but on a smaller scale; they are usually located in countries with an adequate health system but who nonetheless request the presence and cooperation of WHO.

There are nine liaison and specialists’ offices in Africa, Japan, Europe, and North America, headed by liaison officers, who are citizens of the host country and who do not hold diplomatic rank. These offices are the International Agency for Research on Cancer and the Office for National Epidemic Preparedness and Response, both in Lyon, France; the Centre for Health Development in Kobe, Japan; the Liaison Office and the Office at the World Bank and the International Monetary Fund, both in Washington, D.C.; the Mediterranean Centre for Vulnerability Reduction in Les Berges du Lac, Tunisia; the Office at the African Union and the Economic Commission for Africa in Addis Ababa, Ethiopia; the Office at the European Union in Brussels; the Office at the United Nations, New York; and WHO collaborating centers.

Collaborating Centers

WHO collaborating centers are institutions such as those conducting research that are designated by the WHO director-general to carry out activities in support of WHO programs at the country, regional, and global levels. The centers also participate in the strengthening of country resources according to WHO policy and its strategy of technical cooperation.

There are more than eight hundred WHO collaborating centers in more than eighty member states that are actively working in areas such as food safety and nutrition, nursing and midwifery, traditional medicine, injury and violence prevention, occupational health, health promotion, communicable diseases, nutrition, mental health, chronic diseases, and health technologies.

The second WHA, in 1949, adopted a policy that prevents WHO from establishing its own international research institutions but allows it to coordinate and make use of the activities of existing institutions to advance health research. A department or laboratory within an institution or a group of facilities for reference, research, or training that belongs to a different institution may be designated as a WHO collaborating center.

Designation as a collaborating center is made with the agreement of the head of the establishment to which the institution is attached or with the agreement of the director of the institution, if it is independent, and after consultation with the national government. An institution is designated initially for a term of four years; the designation may be renewed for the same or a shorter period. A WHO collaborating center may be jointly designated by WHO and by other competent and specialized international bodies. Networks, working groups, partnerships, and programs, or nongovernmental organizations and similar bodies with a membership structure, including professional associations or foundations are not eligible for designation as WHO collaborating centers.

Other center activities include collecting and disseminating information; standardizing terminology and nomenclature of technology, substances, methods, and procedures; participating in collaborative training and research training; and the coordination of activities carried out by affiliates’ institutions.

The collaborating centers help to facilitate the fulfillment of WHO-mandated activities through using resources in the respective countries and regions. The exchange of information and research findings, for example, is enhanced by regular meetings and by a database that is accessible through the Internet. This database serves as the official source of information on the centers.

Annual Events

World Health Day is an annual WHO event. A theme is selected each year that focuses on a particular health issue or program. The theme for the 2010 World Health Day was urbanization and health, and its slogan was 1000 Cities-1000 Lives. Events were organized globally with a call on cities to open streets for health-related activities. In 2009, the theme was Save Lives—Make Hospitals Safe in Emergencies, which focused on the safety of health care facilities and on the readiness of health workers who handle emergencies.

WHO also observes a series of annual events that focus on specific health issues or themes. Events for 2010 included World Cancer Day on February 4, World Water Day on March 22, World TB Day on March 24, World Health Day on April 7, World No Tobacco Day on May 31, and World Blood Donor Day on June 14.

Reports and Publications

Beginning in 1995, WHO began publishing its World Health Report, considered by many to be the organization’s leading publication. Each report focuses on a specific subject and combines expert assessment of global health and informative statistics about member countries. The report provides countries, donor agencies, international organizations, and others with the information and data to help make adequate policy and funding decisions. It is also a good source for researchers and journalists and for general readers with an interest in international health issues.

The World Health Report 2010: Health Systems Financing: The Path to Universal Coverage promotes the importance of good health to human welfare and to sustained economic and social development. The report maps out what countries can do to modify their financing systems to be able to move quickly toward the goal of universal health coverage while sustaining the progress that has been achieved.

The report also builds on new research and on lessons learned. It provides an agenda for countries at all stages of development and proposes ways that the international community can better support efforts in low income countries to achieve universal coverage and improve the health of their respective populations.

The first World Health Report, in 1995, with the theme of “Bridging the Gaps,” focused on how poverty wields a destructive and often deadly influence at every stage of human life. The report describes WHO’s efforts in helping to bridge the widening gaps between the rich and poor and between those with and without access to adequate health care.

International Health Regulations

WHO’s International Health Regulations (IHR) 2005 is an international legal instrument that is bindingon 194 countries across the globe, including WHO member states. The IHR came into force in June of 2007.

The aim of the IHR is to help the internationalcommunity prevent and respond to acute public healthrisks that have the potential to cross borders and threaten people worldwide. The IHR was developed in response to the exponential increase in international travel and trade and to the emergence and reemergence of disease threats and other health risks on a global scale.

The IHR calls for member countries to build up their capacity to prevent, protect against, and control disease outbreaks, and it defines the rights and obligations of countries to report to WHO certain disease outbreaks and public health events. The IHR also establishes a number of procedures that WHO must follow in helping to maintain global public health.

Further Reading

Web Sites of Interest

Centers for Disease Control and Prevention

http://www.cdc.gov

Global Health Council

http://www.globalhealth.org

Health Protection Agency

http://www.hpa.org.uk

World Health Organization

http://www.who.int

See also: Biosurveillance; Centers for Disease Control and Prevention (CDC); Developing countries and infectious disease; Disease eradication campaigns; Emerging and reemerging infectious diseases; Emerging Infections Network; Epidemic Intelligence Service; Epidemics and pandemics: Causes and management; Epidemics and pandemics: History; Epidemiology; Globalization and infectious disease; National Institute of Allergy and Infectious Diseases; National Institutes of Health; Outbreaks; Public health; Tropical medicine; U.S. Army Medical Research Institute of Infectious Diseases.