Letter: It’s hard to uncouple WHO science from politics

Professor Jennifer Prah Ruger writes on the need to reform the World Health Organization (Opinion, May 6).

The call has been made before. And there are always opportunities to improve such a sprawling, often unwieldy organisation.

But it is important to also acknowledge that part of the issue around the WHO’s independence is the Catch-22 it is in. It requires co-operation, consensus (and funding) and derives its powers, such as they are, from its member states but also is expected to independently assess their actions and inactions relating to global health. How to square that circle?

And despite that flaw, what sort of organisation could be a more effective global, central co-ordinator? A public-private partnership like the Global Fund would also likely still face questions of accountability, source of authority, independence and influence, with some voices being louder than others.

Greater transparency in decision making and ensuring larger and more sustainable financing via multiyear agreements are two recommendations that Prof Ruger makes that should be eminently achievable but the patchy state of current funding suggests that some like WHO to be on a tight leash.

Similarly, how feasible is it to uncouple WHO science from its politics? Even separating them into two standalone organisations might reduce, but would not remove, the influence of politics on how the scientific evidence translates to policy and action. Current debates around management of Covid-19 in the UK and elsewhere demonstrate this.

So is it perhaps time that we accepted with serenity the things that we cannot change about WHO without losing much that is useful.

Dr Ike Anya
EpiAfric and Nigeria Health Watch,
Abuja, Nigeria