key: cord-0821339-2a02yayw
authors: nan
title: Pandemic preparedness and responses: WHO to turn to in a crisis?
date: 2020-05-29
journal: PLoS Med
DOI: 10.1371/journal.pmed.1003167
sha: 4de1b149eec1f1f357839a56490ed0c025ae5567
doc_id: 821339
cord_uid: 2a02yayw

The PLOS Medicine editors discuss the role of the World Health Organization in pandemic responses.

investigated WHO's perceived failings, it was noted that the organization had, for example, previously cut a substantial proportion of its emergency response capability, and "lacked the governance needed to coordinate multiple stakeholders" in the response to a disease outbreak [6] . Essentially, there was a sense that the organization had been trying to do too many things with too few resources, and making questionable strategic decisions in the process.

The recent suspension of US funding for WHO has elicited criticism from many in the health arena, including PLOS [7] . Additional political manoeuvring has followed [8] , and subsequently China has trumped the announcements by pledging an additional $30 million in funding, noting that WHO had been "actively fulfilling its duties and upholding an objective, scientific and impartial stance" on the disease outbreak [9] . These opportunistic political gambits could well continue in longer campaigns seeking to acquire plaudits for perceived (but at this stage perhaps ephemeral) successes in addressing the continuing outbreak, alongside creative attribution of responsibility for early, and possibly onging, errors and omissions in country-specific pandemic responses; wilful misinformation must also be considered as a factor.

We contacted a number of commentators for their views on the emerging debate around WHO's role in the current outbreak, and Margaret Kruk, of the Harvard T.H. Chan School of Public Health, argues that "WHO plays an indispensable role in our shared health and it is one of the few institutions that is seen as credible in countries at a time that health and science are increasingly politicized. But it is hamstrung by insufficient, strings-tied funding and a governance structure that precludes its ability to speak uncomfortable truths for fear of offending member countries. The goal of reforms should be to build a technically stronger, better funded, and more independent WHO". Although far too early to make definitive judgments about individual country or agency actions during the current pandemic, we can anticipate a frank debate about the capabilities and actions of WHO throughout this extraordinary time. Among thoughts that come to mind are, first, that political involvement with or by WHO is regrettable, with its parent organization, the United Nations, the forum for this purpose. Second, the experiences of the current pandemic need to be put to good use to prepare WHO and countries for future disease outbreaks-how do the agency's capabilities and infrastructure, and indeed those of country public health bodies, need to be strengthened and adapted to this end? It may be that the function of WHO needs to be refocused on convening expertise and providing normative guidance for health goals, with a distinct entity, akin to UNAIDS, adopting responsibility for outbreak surveillance and responses. Finally, a global agency for health will remain essential, and all governments should seek to work with rather than counter to WHO as an essential partner in promoting the increasingly interconnected state of the world's health.

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