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Even by the standards of UN agencies, the WHO is weak. Though the world looks to it for leadership when health crises strike, it has little legal authority and so must cajole governments into action. The director-general's post is undermined by an unwieldy structure that gives too much power to six elected regional heads. The agency also has to compete with better-funded or nimbler rivals, ranging from the World Bank and bilateral donors to innovative newcomers such as the Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Why not simply scrap the agency altogether? Alas, the world still needs the WHO. Market forces alone will not tackle lethal afflictions of the poor world such as visceral leishmaniasis and Chagas disease, so there is a case for intervention. The agency provides useful advice and sets technical standards for countries too poor to have proper medical regulators like America's Food and Drug Administration. And there are global public goods that only a transnational body can provide. Pandemic diseases such as avian flu do not carry passports; only concerted global action can tackle them successfully. However, the agency must do much better if it is to fulfil its proper role as a vigilant watchman of global health.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.