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Title: World Health Organization, it structure and functions


1
Lecture 9
World Health Organization, it structure and
functions
2
Birth of the WHO
  • The WHO has its origin in April 1945, during the
    conference held at San Francisco to set up the
    United Nations. The representatives of Brazil and
    China proposed that an international health
    organization should be established and that a
    conference to frame its constitution should be
    convened. The constitution was drawn up at an
    international health conference in New York in
    1946. The same conference set up an "Interim
    Commission" to prepare the ground for the new
    organization and to carry out urgent tasks until
    the WHO constitution had been accepted by the
    required number of UN Member States. The
    ratifications were secured by 7 April 1948 the
    formal existence of the WHO as a specialized
    agency began on that date. The formation of WHO
    represents the culmination of efforts to
    establish a single worldwide inter-governmental
    health agency.

3
WORLD HEALTH ORGANIZATION
  • The World Health Organization is a specialized,
    non political, health agency of the United
    Nations, with headquarters at Geneva. In 1946,
    the Constitution was drafted by the "Technical
    Preparatory Committee" under the chairmanship of
    Rene Sand, and was approved in the same year by
    an International Health Conference of 51 nations
    in New York. The constitution came into force on
    7th April, 1948 which is celebrated every year as
    "World Health Day". A World Health day theme is
    chosen each year to focus attention on a specific
    aspect of public health.

4
Objective
  • The objective of the WHO is "the attainment by
    all peoples of the highest level of health" which
    is set out in the preamble of the Constitution.
    The current objective of WHO is the attainment by
    all people of the world a level of health that
    will permit them to lead a socially and
    economically productive life - also known as
    Health for All.
  • The preamble of the Constitution states
  • "Health is a state of complete physical, mental
    and social well-being and not merely the absence
    of disease or infirmity.
  • The enjoyment of the highest attainable standard
    of health is one of the fundamental rights of
    every human being without distinction of race,
    religion, and political belief, economic and
    social condition.

5
The preamble of the Constitution states
  • The health of all peoples is fundamental to the
    attainment of peace and security and is dependent
    upon the fullest cooperation of individuals and
    States. The achievement of any State in the
    promotion and protection of health is of value to
    all.
  • Unequal development in different countries in the
    promotion of health and control of disease,
    especially communicable disease, is a common
    danger.
  • Healthy development of the child is of basic
    importance the ability to live harmoniously in a
    changing total environment is essential to such
    development.
  • The extension to all people of the benefits of
    medical, psychological and related knowledge is
    essential to the fullest attainment of health.
  • Governments have a responsibility for the health
    of their peoples which can be fulfilled only by
    the provision of adequate health and social
    measures".

6
Membership
  • Membership in WHO is open to all countries. While
    most countries are members of both the UN and of
    WHO, there are some differences. For example,
    Switzerland is a Member of WHO, but not of the
    United Nations. Territories which are not
    responsible for the conduct of their
    international relations may be admitted as
    Associate Members. Associate Members participate
    without vote in the deliberations of the WHO.
    Each Member State contributes yearly to the
    budget and each is entitled to the services and
    aid the organization can provide. In 1948, the
    WHO had 56 Members. By 1996 WHO had 190 Member
    States and two Associate Members.

7
Structure
  • The WHO consists of three principal organs the
    World Health Assembly, the Executive Board and
    the Secretariat.
  • THE WORLD HEALTH ASSEMBLY This is the "Health
    Parliament" of Nations and the supreme governing
    body of the organization. It meets annually,
    usually in May, and generally at the headquarters
    in Geneva, but from time to time in other
    countries. (The 14th World Health Assembly met in
    New Delhi in 1961). The Assembly is composed of
    delegates representing Member States, each of
    which has one vote. The main functions of the
    Health Assembly are (1) to determine
    international health policy and programmes (2) to
    review the work of the past year (3) to approve
    the budget needed for the following year and (4)
    to elect Member States to designate a person to
    serve for three years on the Executive Board and
    to replace the retiring members. The Health
    Assembly also appoints the Director General on
    the nomination of the Executive Board. It is now
    the practice to organize on the occasion of each
    Health Assembly, "technical discussions" on some
    subjects of world interest.

8
THE EXECUTIVE BOARD
  • The Board had originally 18 members, each
    designated by a Member State. Subsequently, the
    number was raised to 24 and 30. The Health
    Assembly (1976) increased the membership from 30
    to 31, providing that no fewer than three are to
    be elected from each of the WHO regions. The
    members of the Board are to be "technically
    qualified in the field of health" they are
    designated by, but do not represent their
    governments. One-third of the membership is
    renewed every year. The Executive Board meets at
    least twice a year, generally in January and
    shortly after the meeting of the World Health
    Assembly in May. The main work of the Board is to
    give effect to the decisions and policies of the
    Assembly. The Board also has power to take action
    itself in an emergency, such as epidemics,
    earthquakes and floods where immediate action is
    needed.

9
THE SECRETARIAT
  • The secretariat is headed by the Director General
    who is the chief technical and administrative
    officer of the Organization. The primary function
    of the WHO secretariat is to provide Member
    States with technical and managerial support for
    their national health development programmes.
    While in 1948, WHO staff counted 250 persons, the
    Organization in 1985 counted 4475 international
    public servants. At WHO headquarters in Geneva,
    there are 5 Assistant Director Generals each of
    whom is responsible for the work of such
    divisions as may from time to time be assigned to
    him by the Director General.

10
On 31 December, 1985, the WHO Secretariat
comprised of the following divisions
  1. Division of epidemiological surveillance and
    health situation and trend assessment
  2. Division of communicable diseases
  3. Division of vector biology and control
  4. Division of environmental health
  5. Division of public information and education for
    health
  6. Division of mental health
  7. Division of diagnostic, therapeutic and
    rehabilitative technology
  8. Division of strengthening of health services
  9. Division of family health
  10. Division of non-communicable diseases
  11. Division of health manpower development
  12. Division of information systems support
  13. Division of personnel and general services
  14. Division of budget and finance

11
In order to meet the special health needs of
different areas WHO has established six regional
organizations.TABLE 1. WHO Regional
Organizations
Region Headquarters
1. South East Asia New Delhi (India)
2. Africa Harare (Zimbabwe)
3. The Americas Washington D.C. (U.S.A.)
4. Europe Copenhagen (Denmark)
5. Eastern Mediterranean Alexandria (Egypt)
6. Western Pacific Manila (Philippines)
12
Regions
  • The regional organizations are integral part of
    the WHO and have under the constitution an
    important part in implementing the policies and
    programmes of the WHO. The regional office is
    headed by the Regional Director, who is assisted
    by technical and administrative officers and
    members of the secretariat. There is a regional
    committee composed of representatives of the
    Member States in the region. Regional Committees
    meet once a year to review health work in the
    region and plan its continuation and development.
    Regional plans are amalgamated into overall plans
    for the Organization by the Director General at
    WHO's headquarters in Geneva.

13
The South East Asia RegionThe headquarters of
the South East Asia Regional Office (SEARO) is in
New Delhi, the official address being World
Health House, Indraprastha Estate, Delhi. The
Region has now 11 members. Table 2. WHO SEARO
Member countries
Year of joining Member country SEARO Population 2002 (million)
1972 Bangladesh 143.8
1982 Bhutan 2.2
1948 India 1049.5
1950 Indonesia 217.4
1973 Korea (Dem. People's Rep.) 22.5
1965 Maldives Islands 0.3
1948 Myanmar 48.9
1953 Nepal 24.6
1948 Sri Lanka 18.8
1947 Thailand 62.2
14
  • The WHO activities in South East Asia Region
    cover a wide range of subjects such as malaria
    eradication, tuberculosis control, control of
    other communicable diseases, health laboratory
    services and production of vaccines, health
    statistics, public health administration and
    rural health services, maternal and child health,
    nursing, environmental health and water supply,
    health education, nutrition, mental health,
    dental health, medical rehabilitation, quality
    control of drugs and medical education.

15
Work of WHO
  • WHO'S first Constitutional function is to act as
    the directing and coordinating authority on all
    international health work. This function permits
    WHO's Member States to identify collectively
    priority health problems throughout the world, to
    define collectively health policies and targets
    to cope with them, to devise collectively
    strategies, principles and programmes to give
    effect to these policies and to attain the
    targets. The WHO also has specific
    responsibilities for establishing and promoting
    international standards in the field of health,
    which comprise the following broad areas

16
PREVENTION AND CONTROL OF SPECIFIC DISEASES
  • Almost all communicable diseases are or have been
    at sometime the subject of WHO activities. The
    global eradication of smallpox is an outstanding
    example of international health cooperation. With
    the same energy and commitment with which WHO
    eradicated smallpox, it is now directing the
    global battle against AIDS.
  • An important activity of WHO is epidemiological
    surveillance of communicable diseases. The WHO
    collects and disseminates epidemiological
    information on diseases subject to International
    Health Regulations and occasionally other
    communicable diseases of international importance
    through an Automatic Telex Reply Service (ATRS)
    and the "Weekly Epidemiological Record" (WER).
    The latter contains more complete details and
    brief reviews of communicable diseases of
    international importance. Member States can also
    make use of the "WHO Emergency Scheme for
    Epidemics" whenever necessary. The aim of
    International Health Regulations is to ensure
    maximum security against international spread of
    diseases with the minimum interference with world
    traffic.

17
PREVENTION AND CONTROL OF SPECIFIC DISEASES
  • The WHO has also paid attention in its programme
    of work to non-communicable disease problems such
    as cancer, cardiovascular diseases, genetic
    disorders, mental disorders, drug addiction and
    dental diseases.
  • The activities of WHO have also branched out into
    the fields of vector biology and control,
    immunology, quality control of drugs and
    biological products, drug evaluation and
    monitoring and health laboratory technology as
    these activities are relevant to the control of
    both communicable and non-communicable diseases.
  • Immunization against common diseases of childhood
    (Expanded Programme on Immunization) is now a
    priority programme of the WHO. The 30th World
    Health Assembly adopted a resolution aimed at
    ensuring immunization of all children.

18
DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES
  • WHO's most important single function is to
    promote and support national health policy
    development and the development of comprehensive
    national health programmes. This broad field of
    endeavour encompasses a wide variety of
    activities such as organizing health systems
    based on primary health care, the development of
    health manpower and utilization, building of
    long-term national capability, particularly in
    the areas of health infrastructure development,
    and managerial capabilities (including monitoring
    and evaluation) and health services research.
    Appropriate Technology for Health (ATH) is
    another new programme launched by the WHO to
    encourage self-sufficiency in solving health
    problems. The new programme is part of WHO's
    efforts to build up primary health care. WHO's
    main activities in 1980 were towards promoting
    national, regional and global strategies for the
    attainment of Health for All.

19
FAMILY HEALTH
  • Family health is one of the major programme
    activities of WHO since 1970, and is broadly
    subdivided into maternal and child health care,
    human reproduction, nutrition and health
    education. The chief concern is improvement of
    the quality of life of the family as a unit.

20
ENVIRONMENTAL HEALTH
  • Promotion of environmental health has always been
    an important activity of WHO. WHO advises
    governments on national programmes for the
    provision of basic sanitary services. Recent
    activities are directed to protection of the
    quality of air, water and food health conditions
    of work, radiation protection and early
    identification of new hazards originating from
    new technological developments. A number of
    programmes have been developed such as the 'WHO
    Environmental Health Criteria Programme' and 'WHO
    Environmental Health Monitoring Programme'
    towards improving environmental health. The WHO
    is committed to attain the target adopted by
    Habitat, the UN Conference on Human Settlements
    that was to have Water for All by 1990.

21
HEALTH STATISTICS
  • From its earliest days in 1947, WHO has been
    concerned with the dissemination of a wide
    variety of morbidity and mortality statistics
    relating to health problems. The data is
    published in the
  • (a) Weekly Epidemiological Record
  • (b) World Health Statistics Quarterly and
  • (c) World Health Statistics Annual.
  • Readers interested in current data may obtain it
    from the Chief Statistician, Dissemination of
    Statistical information. WHO, Geneva. In order
    that statistics from different countries may be
    comparable, WHO publishes 'International
    Classification of Diseases' which is updated
    every 10th year. The Tenth Revision of ICD came
    into effect from 1 January 1993. Assistance is
    also given to countries in the improvement of
    their medical records, and in the planning and
    operating national health information systems.

22
BIO-MEDICAL RESEARCH
  • The WHO does not itself do research, but
    stimulates and coordinates research work. It has
    established a world-wide network of WHO
    collaborating centers, besides awarding grants to
    research workers and research institutions for
    promoting research. There are Regional Advisory
    Committees on health research which define
    regional health research priorities and a Global
    Advisory Committee, which in close collaboration
    with the regional committee deals with policy
    issues of global import. Six tropical diseases
    (malaria, schistosomiasis, trypanosomiasis,
    fllariasis, leishmaniasis and leprosy) are the
    target of the WHO Special Programme for Research
    and Training in Tropical Diseases to develop new
    tools, strengthen research institutions and
    training workers in the countries affected.

23
HEALTH LITERATURE AND INFORMATION
  • WHO acts as a clearing house for information on
    health problems. Its publications comprise
    hundreds of titles on a wide variety of health
    subjects. The WHO library is one of the satellite
    centers of the Medical Literature Analysis and
    Retrieval System (MEDLARS) of the U.S. National
    Library of Medicine. MEDLARS is the only fully
    computerized indexing system covering the whole
    of medicine on an international basis. The WHO
    has also a public information service both at
    headquarters and each of the six regional offices.

24
COOPERATION WITH OTHER ORGANIZATIONS
  • WHO collaborates with the UN and with the other
    specialized agencies, and maintains various
    degrees of working relationships. Besides, WHO
    has also established relations with a number of
    international governmental organizations.
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