key: cord-0024178-lpe758zz
authors: nan
title: Department of Error
date: 2020-10-22
journal: Lancet
DOI: 10.1016/s0140-6736(20)32130-9
sha: 21aae0e3edf107163ec50580ffb5e7ffdbdad472
doc_id: 24178
cord_uid: lpe758zz

nan

www.thelancet.com Vol 396 October 24, 2020 accurate sepsis epidemiology rather than estimates that might greatly misrepresent the truth (in either direction), and to adopt a balanced approach to antibiotic prescribing, media reporting, and public education. Most children with infections will not benefit from antibiotics and might be harmed by the effects on microbiota and other unwanted complications, notwithstanding the impact on antimicrobial resistance. 

In a call to action, Arlene King and colleagues 1 emphasise the potential for insolvency at the Pan American Health Organization (PAHO) and urge member states to pay their outstanding contributions. King and colleagues called on the spirit of solidarity in member states. However, PAHO, which was established well before WHO, has always had problems of solidarity. As such, it is apparent that solidarity might not be attainable in the near future to overcome the crisis at PAHO. King and colleagues also argued that health security will not be possible without a functioning PAHO; however, it is imperative to note that a functioning PAHO entails more than securing funding from member states. News reports alleging that PAHO exploited Cuban doctors by retaining a portion of their income (US$75 million), which arguably constitutes negligent and criminal behaviour, 2 provide a reminder that additional funds alone are insufficient.

Ultimately, solidarity and funding, although important, are unlikely to be sufficient or attained in the immediate short term. There needs to be reform and awareness. This reform should require member states to provide sustainable funding that cannot be withdrawn with a change in government, as seen in the USA. 3 Awareness should not only emphasise the public health achievements of PAHO across its more than 100 years of existence but also its effects on the countries that most greatly benefit from PAHO's work-countries with gross inequities. Member states should agree to continued and sustained funding agreements with a focus on the vulnerable communities that PAHO most greatly affects. 

Financial crisis at PAHO in the time of COVID-19: a call for action

Cuban doctors accuse international agency of profiting from their work

Coronavirus: Trump moves to pull US out of World Health Organization