World Health Organization
Health for all
World Health Organization, WHO(layout.types.url.description) is a specialised UN agency with the task of guaranteeing the best attainable health to all humans, as defined by the WHO Constitution. The Constitution defines health as a complete state of physical, mental and social well-being, and not merely as the lack of disease or infirmity. The Constitution also states that enjoyment of the best attainable health is a fundamental right, without any distinction of race, religion, political belief or social and economic conditions. To achieve this, WHO should lead and coordinate global health work and, among other tasks, monitor the development of health status, promote health research, develop and maintain health related norms, prevent communicable disease epidemics and, on request, support Member States in the development of health policy and in responding to health emergencies. Moreover, WHO can act as a convener for international agreements or conventions in the health domain.
From a medical and communicable disease organisation to an actor for sustainable development
WHO was established in 1948, with national health ministries as the focal points in Member States. Under the guidance of Member States, WHO developed - within the framework of health systems – primarily into a medically oriented and communicable disease organization. At the same time, WHO has always had an especially important role in the promotion of maternal and child health. In the domain of communicable diseases the single most important achievement of WHO is the eradication of Variola in 1980. In recent years, WHO has actively worked to eradicate Polio from the world. Although WHO has, in different ways, taken into account that the global burden from non-communicable diseases today exceeds that caused by communicable diseases, communicable diseases still feature as a significant proportion of the organization’s actions.
The Agenda 2030 and the inclusion of health in the sustainable development goals opened a window of opportunity for WHO to strengthen its weight in the UN. The General Programme of Work (GPW) 2019–2022, adopted by the World Health Assembly in 2018, was designed with a view to support the achievement of the health targets of the Agenda 2030. The GPW is the first of its kind that reflects the modern concept of public health, considering health as a resource for societies and as a source of both wellbeing and economic growth. The health system has its specific role in promoting health and providing health services. Still, health is produced, and it can be endangered, in all environments of our societies, which calls for wide pro-health actions across government sectors.
The GPW includes the triple billion targets: 1) one billion more people are to benefit from universal health coverage, 2) one billion more people are to be better protected from health emergencies, and 3) one billion more people are to enjoy better health and well-being. The least advanced of these targets is the attainment of health coverage. The Secretariat has suggested the GPW be extended with two years in orders to allow for the achievement of the triple billion targets, where strengthening of health systems and investing in primary health services are considered to be the key measures.
The perhaps most widely known example of WHO’s normative work is the International Classification of Diseases, ICD-11. Many science-based health related recommendations of WHO provide important guidance to Member States in the development of their national health policies.
The Coronavirus pandemic and WHO
Despite the warnings of WHO and international communicable disease experts about a disease X, the coronavirus pandemic surprised both WHO and its Member States in early 2020. Due to the rapid measures taken by China at the beginning of 2020, countries had a few weeks to prepare for the spread of this disease, which was caused by a novel, unknown virus. The pandemic response was initiated under the guidance of the WHO simultaneously with the intensive collection of information on the pathogen and its origin and the development of medical countermeasures, including vaccines in particular. Completely new operational arrangements were established together with other major global health actors for the development and distribution of vaccines, medicines and tests. As the pandemic continued, several lines of action were started to strengthen the global response to health emergencies, based on lessons learned during the crisis. In addition to strengthening the WHO’s capacity in health emergency preparedness and response, updating of the WHO International Health Regulations (2005) and developing a new international agreement on pandemic preparedness and response are under consideration.
The World Health Assembly is the highest governing body of WHO. It meets annually in May and defines the direction of global health policy and the Organization. The Executive Board with its 34 members prepares the World Health Assembly and implements its decisions. The Executive Board meets twice annually.
Dr Tedros Adhanom Ghebreyesus has been the Director General of WHO since 2017. He is a former health and foreign minister of Ethiopia and Chair of the Board of the Global Fund. Dr Ghebreyesus’ credibility in the health domain comes in particular as a result of the reorganization of health service delivery in Ethiopia to extend coverage to the entire population.
Perhaps the most notable innovations brought to WHO by Dr Ghebreyesus are, among others, moving from output to impact-based assessment of the results of the organization (GPW 2018 – 2022); attempts towards improved collaboration among global health actors; and strengthening the work of WHO at the country level. Tedros is the sole Director General nominee for the five-year term 2023-2028.
Finland and WHO
Finland has a long and confidential relationship with WHO. Finland was a pilot country for primary health care and “Health for All 2000” and later the “Health for all 2015” Programme. WHO has evaluated Finland’s health policy three times.
Finland contends that the world needs a strong, efficient, independent and credible WHO and participates actively in the administration and technical work of the organization, particularly in processes that are seen strategically as most important for public health, often together with the EU. Finland was a member of the Board from 2019 to 2021.
Mental health promotion, health promotion across government sectors, also called “Health in All Policies, health in humanitarian emergencies and essential public health functions as a prerequisite to the achievement of the sustainable development goals are examples of issues that Finland focusses on in WHO.
In recent years, Finland has worked actively in different fora to promote global health security. Finland promotes also the rights of women and girls and sexual and reproductive health rights and services, the main targets of Finland’s development policy. In the most strategically important matters, Finland joins the EU’s positions, expressed in the governing bodies mostly by the EU Council Presidency.
The Ministry of Social Affairs and Health is responsible for the assessed contribution, the membership fee, of Finland to WHO. In 2021 the assessed contribution was 1.8 million euros. In addition, 0,5 million euros were allocated to specific programmes. Other similar contributions of around 1 million euros were made by the Ministry of Social Affairs and Health to the International Agency for Cancer Research (IARC), the Secretariat of the Framework Convention of Tobacco Control (FCTC), and the European Observatory on Health Systems and Policies. The Ministry for Foreign Affairs provided 5 million euros in non-earmarked funding to WHO Core Voluntary Contribution Account, placing Finland as the sixth largest donor in this category, and supported Covid-19 Strategic Prevention and Response plan with 1 million euros in 2021.
The Permanent Mission in Geneva defends Finland’s interests and promotes issues important for Finland bilaterally and together with EU and Nordic countries. The Permanent Mission maintains close contacts with WHO Secretariat and also follows, within available resources, the discourse and trends of global health policy, including at the UN General Assembly. Active participation in the different preparatory meetings and consultations has a central role in the everyday work of the Permanent Mission, which receives its instructions from the Ministry of Social Affairs and Health.
UN HIV/AIDS programme UNAIDS
HIV/AIDS as a development challenge
The HIV/AIDS epidemic in the 1990s became the most visible global health challenge. As the impact of the disease for sustainable development was understood, the UN HIV/AIDS Programme UNAIDS (layout.types.url.description)was established in 1993 and became functional in 1993. UNAIDS is in charge of promoting and monitoring the implementation of the UN HIV/AIDS declarations. UNAIDS coordinates and partially fundsthe work of the eleven cosponsoring UN organisations (ILO, UNDP, UNESCO UNFPA UNHCR, UNICEF, UNODC, UN Women, WFP; WHO and the World Bank) according to an agreed division of labour. UNAIDS has brought HIV/AIDS to the global political agenda, not only as a health issue, but also as a wider factor that has an impact on societal and economic development, human rights, security and stability.
Since 2019, the Director General of UNAIDS has been Winnie Byanyima from Uganda. UNAIDS is governed by the Programme Coordination Board (PCB). The Board has 27 members, 22 of which represent Member States and five the civil society, the latter without the right to vote. The PCB discusses programmatic and administrative issues, as well as special themes. The co-sponsoring organizations have the right to attend and speak. Member States work as constituencies. Finland, Denmark and Norway form one of the constituencies, which works closely with the constituency of Austria, Iceland, Sweden and Switzerland. The two constituencies promote good governance for example by having shared statements in most of the PCB agenda items.
Finland and UNAIDS
Finland represented its constituency as a PCB member in 2018–2019.
Womens’ and girls’ rights, prevention of new infection in the control of the HIV/AIDS epidemic and a human rights based approach, including sexual and reproductive rights and services and access to comprehensive sexuality education, are Finland’s priorities in UNAIDS.
Finland supported UNAIDS from development funding until 2016. The reduced funding in recent years has forced the programme to seek measures to become more efficient.
After negative publicity on harassment, bullying and abuse of power, UNAIDS has become an example for the UN on organisational cultural change and on how to improve the procedures to be followed in such situations.