WHO UNDER STRESS - IMPLICATIONS FOR HEALTH-POLICY

A crisis is increasingly challenging the authority and prestige of the United Nations' specialized agencies. Although the World Health Organ ization is still held in great repute, it has not escaped criticism. M ember countries have expressed concern about WHO's bureaucratic proced ures, costs, proliferation of meetings, reports, lack of budget transp arency. Doubts have been cast on the effectiveness of some programmes. This paper argues that such criticisms must be understood within the context of the huge changes that have occurred since WHO was establish ed in the late 1940s. There has been a major shift in the financing of WHO, with extrabudgetary funding now providing more than half the tot al budget, which has implications for policy influence within the Orga nization. Policy is also being decided within an increasingly politica l milieu. These changes put significant pressure on the Organization i n a number of ways, and it is essential to generate a public debate ab out WHO's future role if the Organization is to retain the esteem with in which it is generally held. This paper makes an initial contributio n to that debate.