COMMENT

7 April is the World Health Day and it falls on the birthday of the World Health Organization (WHO). The theme for the World Health Day 2015 is food safety, declaring that Everyone, everywhere needs safe food, free from microbes, viruses and chemicals.

You can read more about pesticides in the GHM Emerging Issue Brief. The author Erik Jørs writes that the pesticides are responsible for millions of human poisonings and hundreds of thousands deaths each year.

Photo credit: Erik Jørs

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Klaus Winkel, 
Former Head of Department in Danida, looks back in time and tells the story of Danish involvement in the field of international and global health through his own experiences and engagement.

“Support for health has dwindled over the years as a share of Danish development assistance, but this does not necessarily mean that improving health is considered less important. Rather, that it has become crowded out as a result of the ever increasing number of objectives for Danish aid, and that the many determinants of health, outside the health sector, are being addressed by a variety of interventions.”

Download the GHM Invited Commentary: ‘A history of Danish development assistance for global health’.

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The Ebola fog is lifting – next global epidemic to eradicate: Bad Global Management

We produce and consume disasters whether we intend to or not. But it’s generally not the same groups of people that causing disasters and those sacrificing. Disasters, in all their grief, have a capacity to reveal inequalities and injustices of the world (e.g. Katrina did in the US and the earthquake in Haiti). While we wait for the little Ebola virus to give in under the pressure from the international community let us see if this disaster has unearthed hidden disparities in health, ugly faces of the international community or new lessons for global health that we need to address.

In her speech at the 136th executive board meeting of the WHO in 2015, Director-General Margaret Chan said: “Well-functioning health systems holds together the community and protects against crises“, and noted that universal and equal access to health care reduce the effect of social determinants on health.

The current Ebola epidemic has given its own view on why we should invest in health.

Picture: Ebola Graveyard in Gulu, Uganda established after the Ebola epidemic in 2000.

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I had a chance to interview one of the most experienced Ebola nurses in Africa, who had just returned from Liberia. He tells his unique story about the numerous outbreaks he helped to stop and shares his powerful but simple suggestions about global and local preparedness – from a rare practical and comparative perspective. Among his recommendations are: Better selection of health workers, practical training, better management, sharing of experience and closer government attention to social practices and gatherings are essentials…..and prepare for the unexpected, this thing can happen anywhere.

Text by Morten Sodemann

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“Once you’ve poured the water out of the bucket it’s hard to get it back again” (Chinese proverb)

Neither the WHO, DANIDA or any other international donors have an excuse for the uncontrollable behaviour of the Ebola epidemic. There is tons of knowledge and donors have had time to pick it up, just as they have had time to act on it.There are five things donors have ignored, overlooked and misinterpreted.

One is that there is extensive evidence that the quality of care in many public hospitals in West Africa has maintained the same unacceptable level for decades.

The second is that the management of global epidemics requires that there is one strong, competent and financially prepared authority and a functioning global network of researchers, laboratories and epidemiologists as well as the necessary political contacts which could force necessary solutions through. WHO should have been be the global health agency, but has been constrained by the larger countries that would rather give money to health programs they have established themselves. Private actors such as the Gates Foundation have with the world’s acceptance taken over many of the tasks that the WHO previously was in charge of.

Thirdly, WHO has restricted its own opportunity to be able to act quickly with its inappropriate career system that rewards anything but skills and WHO has given too much autonomy to the regional WHO offices resulting in low competencies in some offices.

The fourth factor donors have overlooked is that epidemics move with people and if they change behavior so will the epidemic change behavior – with subsequent unpredictable risk environments.

Finally, WHO and the rest of the world overlooked the fact that while Ebola epidemics previously were known as small Ebola epidemics started by game hunters and farmers in relatively isolated rural areas, it could apparently spread seamlessly in slums or post war zones and defenseless fragile health care systems.

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