One of the things I have learned from working in the non-profit sector is that reliance on funding often shifts an organization away from the mission, as well as leading to inefficiencies. Most of the time funding comes with strings attached, requiring extensive reporting on the number of people served or the number of cases of X prevented within a specified timeframe, often predetermined by numbers stipulated in grants. While funding is extremely important, it can also hinder the collective good that organizations could provide. Many of the international NGOs also become engrossed in providing deliverables to funders at the sake of improving programs and sharing their best practices with organizations who share a similar mission. I ask, is this the best way to fund international health programs that help communities fight and prevent disease?
My fear is that as globalization and the scale of funding for international NGOs continues to increase, more money in funding will not yield the health benefits expected. With thousands of programs through out the world aimed at combating different types of diseases, there seems to be little coordination from funders as to which programs should get funding, which diseases should be tackled or prioritized, which interventions are working better than others, and most importantly, which programs are working alongside national governments to improve health care delivery to their citizens.
Here the WHO can increase their capacity and scope. WHO is known for being the global leader on health issues, on being the technical expert and learning best practices to handle any global health issue. WHO creates informative reports that help us understand what is going on globally in health.
Before the WHO can take on a true governance role, however, they must make some hard but needed changes to the organization. I refer specifically to organizational structure, to the way decisions are made, who hires who for what length of time, the timeframe within which decisions are made. I believe that once true reform has been achieved, the WHO will be able to be the global governing body for health issues. Would the WHO have complete access to all the global health funding available and appropriately distribute it among disease causes and to aid national governments in improving their health delivery systems, we can expect to see an important difference in global health within the next generation. Through proper funding distribution the WHO would ensure that programs that are in true service of communities, perhaps led by community leaders themselves, with known and tracked effectiveness would be funded. We could also expect a growing capacity to track programs and make them sustainable on a global scale. I understand national governments are often weak and under resourced to be able to improve their health systems. This again, is where the WHO can come in, with political clout and an improved reputation, to aid governments in creating long term programs to improve health care access.
I know I have not been a global health policy student for long, so I might seem a bit naïve. I would still hold on to hope, however, that governments such as ours will see the benefits of a stronger WHO and that supporters of global health, such as Bill and Melinda Gates, will push for the improvement of WHO to ensure that we can tackle current global health issues and create a safe world for those who will come after us.