Dr. Obijiofor Aginam discusses the World Health Organization.

Dr. Aginam is Professor of International Law at Carleton University. His work focuses on law and globalization, global governance of infectious diseases and public health, as well as North-South relations.

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Note: The opinions presented are not necessarily those of the Government of Canada.

WHO overview	3 minutes	Quicktime
WHO - Legislative powers	2 minutes	Quicktime
Multilaterlism	3 minutes	Quicktime

(Video players are available here: QuickTime | Windows Media)

Transcript:

WHO overview

In 1945, the year the UN was founded, there was a need to create autonomous or semi-autonomous international organizations within the system to focus on specific issues. So the WHO is really one of the eldest. There was a conference in 1946 in New York, which was attended by many countries, and the constitution of the WHO was adopted at that conference. Eventually, the states that participated in that conference ratified it and it came into force in 1948. So it was founded in 1948, and since then, it has grown to one of the largest membership of states of the specialized agencies. As of this year, it has 194 countries. Other specialized agencies, like the International Maritime Organization, the International Civil Aviation Organization and UNESCO, don’t have as many member states as the WHO. Countries place a lot of importance on health issues. That’s one of the reasons why the WHO has a larger membership base than other specialized agencies.

In terms of the organs, the highest policy organ of the World Health Organization is called the World Health Assembly (WHA). It is composed of all health ministers of the 194 member states. They meet every year in Geneva in May and they pass a lot of resolutions on policies for the organization. In addition to this, there is also the Executive Board, which has about 32 member states. They pave the way for the World Health Assembly sessions. They meet about two times a year. And there is the Secretariat, which is headed by the Director General of the organization. So there are just three organs in the WHO.

As the Centre for Coordination of International Health Work, the WHO deals with issues of surveillance of non-communicable diseases, exchange of medical information, research, labelling of pharmaceuticals. It has the power, under article 21 of its constitution, to adopt regulations, binding regulations, on certain transnational health threats. It also has the power to just adopt recommendations that are not binding, and it has the power to serve as a forum where member states can get together and negotiate international treaties.

WHO – Legislative powers

Article 19 of the WHO constitution covers the power of countries, the capacity to make treaties. There’s nothing innovative about that; countries get together and negotiate agreements. They do this all the time – within the UN system, and outside.

Article 21 covers regulations, legally binding regulations. So it doesn’t involve negotiation by states, by members of the WHO. The World Health Assembly can adopt a set of regulations by a 2/3 majority. What this means is that the WHO Secretariat can draft a regulation, and send it to the World Health Assembly for adoption and it creates legal obligation. If a set of regulations are adopted, normally, states have the option of opting-out within a particular timeframe. If states don’t opt-out, the regulations are binding. This is very innovative. It’s called an “international legislative process”, because the international organization is legislative. It’s like a Parliament.

And there’s article 23 that deals with recommendations; it can give recommendations on anything, which doesn’t create a legal obligation.

So it’s not in every constitution or charter of an international organization that you see this kind of very innovative power to get things done. Whether this is a good or bad thing is open to debate. The WHO has used this power only once in its history since 1948. Article 21 was used during the adoption of the international health regulations; a set of standards initially created during international sanitary conferences in Europe in the second half of the 19th century.

Multilateralism

The WHO has been critiqued for being bureaucratic, slow to address global health emergencies, etc. These are some of the same criticisms levelled at the UN, for example. There are examples where the WHO has worked multilaterally: the eradication of smallpox, and an array of projects on diseases affecting developing countries. The WHO has come up with a good number of studies on transnational disease surveillance. They also have provided a platform, a context, an environment, for states to explore public health from a multilateral perspective.

There’s nothing that prevents Canada from discussing HIV/Aids directly and bilaterally, with South Africa for instance. But some of these transnational problems, especially in the health context, are no longer bilateral problems, between just two or three countries. You need a more global approach. Just like the former DG of the WHO used to argue, “We can’t adopt national or bilateral solutions to global problems”. So if something poses a global challenge, then you have to try to devise global solutions to it, otherwise it won’t work. Therefore aspects of HIV/AIDS, the global TB crisis, etc. need to be addressed in a multilateral setting.

Dr. Aginam's articles:
  "International Law and Communicable Diseases" (2002) Bulletin of the World Health Organization, Vol. 80, No.12, pp. 946-950.
  "Salvaging Our Global Neighbourhood: Critical Reflections on the G8 Summit and Global Health Governance in an Inter-dependent World" (2004) Law, Social Justice and Global Development, Vol.1.
  "The Nineteenth Century Colonial Fingerprints on Public Health Diplomacy: A Postcolonial View" (2003) Law, Social Justice and Global Development, Vol.1.