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In a speech last week, Tedros Adhanom Ghebreyesus recalled the posters about smallpox that he saw as a child in his hometown Asmara, in what is now Eritrea. “I remember hearing about an organization called the World Health Organization [WHO] that was ridding the world of this terrifying disease, one vaccination at a time,” he said. Much has changed since then. Smallpox was vanquished; Tedros, who’s Ethiopian, is the first African head of WHO; and in a series of reforms laid out in the same speech, he is trying to restore the storied organization to health.
The changes aim to bring more talent to WHO and improve coordination between its headquarters in Geneva, Switzerland, and six regional offices. But some observers say Tedros’s agenda doesn’t address long-standing problems, including a chronic shortage of money, little power over how to spend it, and the regional offices’ prickly independence. “The main problems of WHO are unsolved by this reform,” says Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University in Washington, D.C.
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Founded in 1948 as a United Nations agency to promote public health, WHO is partly financed by 194 member states, but most of its $4 billion annual budget comes from donors, many of whom earmark their contributions for specific projects. Tedros became director-general in 2017, succeeding Margaret Chan, who was heavily criticized for her handling of the West African Ebola epidemic. In last week’s speech, Tedros recalled the lofty new goals WHO set last year: ensuring that by 2023 1 billion more people benefit from universal health coverage, 1 billion people are better protected from health emergencies, and 1 billion people enjoy better health. To achieve them, Tedros said, will require “changing the DNA of the organization.”
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