Diseases know no frontiers: How effective are intergovernmental organisations in controlling their spread?
Author(s)/Editor(s): Committee on Intergovernmental Organisations
Publisher/Organizer: UK Parliament
Publication date: 7 July 2008
Number of pages: 79
“The twentieth century witnessed remarkable advances in many parts of the world in standards of public health and in the conquest of killer diseases, such as smallpox and poliomyelitis. However, during the second half of the century the advent of globalisation (in particular, increased international trade and travel) and changes in human lifestyles (for example, greater human-animal contact) have enabled new infections to emerge and to spread much more rapidly around the world. The onset of HIV in the 1980s and the outbreaks of SARS and avian influenza in the 1990s are striking, but by no means the only, examples. On average, a previously unknown infectious pathogen emerges somewhere every year. At the same time a number of infectious diseases, including some—such as tuberculosis and malaria—which were previously close to eradication, have developed resistance to antibiotics and in their resistant form they are much more difficult to treat. These problems cannot be tackled solely by States within their own borders: effective intergovernmental action is needed.
In recent years there has been a substantial and welcome upsurge in funding for infectious disease control from governmental, intergovernmental, charitable and private sources. At the same time, however, there has been a significant increase in the number of organisations involved, with the result that the landscape of international health has become, in the Government's words, "crowded and poorly coordinated". We have taken evidence from many of these organisations, and it is clear to us that, while there is an urgent need for rationalisation of effort, it is unrealistic to think in terms of imposing coordinating structures from above. The process has to be evolutionary rather than revolutionary, but it needs leadership. There is no doubt in our mind, and in the minds of most of those from whom we have taken evidence, that that leadership function must rest with the World Health Organisation (WHO) and that, given appropriate strengthening of its management arrangements, WHO's remit and resources should be developed in order to encourage and support collaboration and rationalisation among the many actors on the international health stage.”
Chapter 3: International health: The institutional labyrinth
“In this chapter we review the interaction of the various actors on the international health stage, particularly those concerned with infectious disease control. We look in some detail at the role of the World Health Organisation (WHO) and then turn to address a number of the key issues which have arisen during our inquiry, including the synergy with which the various bodies are working under the existing system and the case and scope for some rationalisation of global health governance."