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Every year, WHO produces the World health report: the 2005 report concentrated on maternal, neonatal and child health. But what is the value of these reports? Are they ritualistic publications designed to promote WHO, or are they worthy of proper discussion and debate? One would think that given the current crises in global health, the annual report of the UN's primary agency for health would be important. However, unless there is evidence that these reports are taken seriously, discussed and debated, and shown to have an effect, a conclusion might be drawn that they are largely insignificant. And that would consign WHO to a level of insignificance that it does not warrant. In this discussion of the 2005 report, I aim to provoke a response from both WHO and the international health community to demonstrate that the annual World health reports are meaningful. Furthermore, I suggest here that WHO shows its commitment to the recommendations of the 2005 report by monitoring how well recommendations have been taken forward.

Colonialism, which involves the systemic domination of lands, markets, peoples, assets, cultures or political institutions to exploit, misappropriate and extract wealth and resources, affects health in many ways. In recent years, interest has grown in the decolonization of global health with a focus on correcting power imbalances between high-income and low-income countries and on challenging ideas and values of some wealthy countries that shape the practice of global health. We argue that decolonization of global health must also address the relationship between global health actors and contemporary forms of colonialism, in particular the current forms of corporate and financialized colonialism that operate through globalized systems of wealth extraction and profiteering. We present a three-part agenda for action that can be taken to decolonize global health. The first part relates to the power asymmetries that exist between global health actors from high-income and historically privileged countries and their counterparts in low-income and marginalized settings. The second part concerns the colonization of the structures and systems of global health governance itself. The third part addresses how colonialism occurs through the global health system. Addressing all forms of colonialism calls for a political and economic anticolonialism as well as social decolonization aimed at ensuring greater national, racial, cultural and knowledge diversity within the structures of global health. Le colonialisme, qui implique la domination systemique de terres, de marches, de peuples, de ressources, de cultures ou d'institutions politiques dans le but d'exploiter, de detourner et d'extraire des richesses et des ressources, affecte la sante de nombreuses manieres. Ces dernieres annees, la decolonisation de la sante mondiale a suscite un interet croissant, l'accent etant mis sur la correction des desequilibres de pouvoir entre les pays a revenu eleve et les pays a faible revenu, ainsi que sur la remise en question des idees et des valeurs de certains pays riches qui faponnent la pratique de la sante mondiale. Nous soutenons que la decolonisation de la sante mondiale doit egalement aborder la relation entre les acteurs de la sante mondiale et les formes contemporaines de colonialisme, en particulier les formes actuelles de colonialisme d'entreprise et de colonialisme financiarise qui operent par des systemes mondialises detraction de richesses et de profits. Nous presentons un programme d'action en trois parties destine a decoloniser la sante mondiale. La premiere partie porte sur les asymetries de pouvoir existant entre les acteurs de la sante mondiale des pays a hauts revenus et historiquement privilegies et leurs homologues des pays a faibles revenus et marginalises. La deuxieme partie concerne la colonisation des structures et des systemes de la gouvernance mondiale de la sante elle-meme. La troisieme partie traite de la maniere dont le colonialisme se manifeste a travers le systeme de sante mondial. La lutte contre toutes les formes de colonialisme necessite un anticolonialisme politique et economique ainsi qu'une decolonisation sociale visant a garantir une plus grande diversite nationale, raciale, culturelle et des connaissances au sein des structures de la sante mondiale. El colonialismo, que implica la dominacion sistemica de tierras, mercados, pueblos, bienes, culturas o instituciones politicas para explotar, apropiarse indebidamente y extraer riqueza y recursos, afecta a la salud de muchas maneras. En los ultimos anos ha crecido el interes por descolonizar la salud mundial, en particular para corregir los desequilibrios de poder entre los paises de ingresos altos y los de ingresos bajos, y para cuestionar las ideas y los valores de algunos paises ricos que influyen en la practica de la salud mundial. Sostenemos que la descolonizacion de la salud mundial tambien debe abordar la relacion entre los actores de la salud mundial y las formas contemporaneas de colonialismo, en especial las formas actuales de colonialismo corporativo y financiarizado que operan a traves de sistemas globalizados de extraccion de riqueza y especulacion. Presentamos un programa de accion dividido en tres partes para descolonizar la salud mundial. La primera parte se refiere a las asimetrias de poder que existen entre los actores de la salud mundial procedentes de paises de ingresos altos e historicamente privilegiados y sus homologos de entornos de ingresos bajos y marginados. La segunda parte se refiere a la colonizacion de las estructuras y sistemas de la propia gobernanza de la salud mundial. La tercera parte aborda como se produce el colonialismo a traves del sistema sanitario mundial. Abordar todas las formas de colonialismo exige un anticolonialismo politico y economico, asi como una descolonizacion social destinada a garantizar una mayor diversidad nacional, racial, cultural y de conocimientos dentro de las estructuras de la salud mundial. [phrase omitted], Introduction Medicine and public health have always been shaped by social and political values, (1) as evident in efforts to redress social inequities in health, struggles to realize health as [...]

This is the first comprehensive study of expenditures on lobbying of the US federal government linked to discussions seeking to shape US policy toward, funding of, and participation in the World Health Organization (WHO). We link corporate lobbying expenditures and coinciding public statements to legislative proposals and other actions to restrict funding to, censure, and undermine confidence in the WHO. We uncover evidence of an intensifying and coordinated effort within a newly organized alliance across producers of commercial milk formulas, other ultra-processed foods, alcoholic beverages, biotechnology and pharmaceuticals, chemicals, plastics, and electronic gaming. Lobbying by the coalition occurs simultaneously with tobacco interests. Targets include WHO global health initiatives to address non-communicable diseases and access to medicines, as well as WHO protocols limiting private sector participation to mitigate conflicts of interest in health policy-making processes. The coalition characterizes its activities in terms of ‘advocacy for WHO reform’ or similar. In 2021, it argued such reforms are necessary for future pandemic response, indicating use of the Covid-19 crisis as leverage. Overall, these findings indicate corporate lobbying not only targets specific WHO processes that conflict with commercial interests, but also works to cast doubt on the integrity and narrow the operational capacities of the global health governance system itself. [ABSTRACT FROM AUTHOR]

The idea of a Framework Convention for Global Health (FCGH), using the treatymaking powers of the World Health Organization (WHO), has been promoted as an opportunity to advance global health equity and the right to health. The idea has promise, but needs more thought regarding risks, obstacles, and strategies. The reform of global health governance must be based on a robust analysis of the political economy out of which the drivers of inequality and the denial of the right to health arise. Some of the published commentary has focused on using the proposed FCGH to institutionalize a paradigm change regarding international aid for health care, i.e., reconceptualizing such aid as obligatory, based on human solidarity rather than strategic considerations, based on global stability and national security. We warn against limiting the project to questions of inter-governmental financial transfers because of the risk of neglecting the underlying structural determinants of health injustice. Such neglect would help to legitimize an unjust and unsustainable global economic regime. We raise further questions about the strategic logic informing any campaign for a FCGH. The governments of the United States and Europe have put considerable effort into weakening WHO through tight donor controls, and it would require heavy pressure to persuade them to sign on to a FCGH. Generating such pressure would require strong popular mobilization around the local and diverse priorities of different communities across the globe, and recognition of a common need for effective regulation at the global level. We argue for a broad-based campaign from which the need for more effective global health regulation (and a FCGH) would emerge as a common theme arising from myriad more specific claims. This type of campaign would respond to local needs, and would also be understood within a global, political, and economic perspective. [ABSTRACT FROM AUTHOR]

Aims: To assess the feasibility of implementing and sustaining the WHO guidelines for inpatient management of severe malnutrition in under-resourced rural South African hospitals, and to identify any constraints. Intervention: Three 2-day training workshops were held in 1998, followed by monthly 1 -day visits for 5 months, ending in March 1 999, in two rural district hospitals with limited resources in Eastern Cape Province, South Africa. Methods: A 12-month observational study was conducted from April 2000 to April 2001 in Mary Theresa and Sipetu hospitals (Eastern Cape Province, South Africa), including 1011 child-hours of observation on the wards, medical record reviews, interviews with carers and staff, and inventories of essential supplies. All admissions (n = 193) for severe malnutrition to the two hospitals were studied. The main outcomes were the extent to which the 10 steps for routine care of severely malnourished children were implemented, proficiency of performance and constraining factors. Results: The hospitals made the changes required in clinical and dietary management, but the tasks were not always performed fully or with sufficient care. Play and stimulation and an effective system of follow-up were not implemented. Doctors' poor knowledge, nurses' inattentiveness and insufficient interaction with carers were constraints to optimal management. The underlying factors were inadequate undergraduate training, understaffing, high doctor turnover and low morale. Conclusions: Guidelines for severe malnutrition are largely feasible but training workshops are insufficient to achieve optimal management as staff turnover and an unsupportive health system erode the gains made and doctors treat cases without having being trained. Medical and nursing curricula in Africa must include treatment of severe malnutrition. [ABSTRACT FROM AUTHOR]

The article provides information about the High Level Taskforce on Innovative International Financing for Health Systems. The two costing models are one led by the World Health Organization (WHO) and the other by the World Bank and the United Nations Children's Fund (UNICEF). The recommended ways to improve international sources of finances include the extension of the mandatory solidarity levy on airline tickets to more countries and the viability of levies connected to tobacco and currency transactions. The author suggests that the Taskforce must expand country-specific discussion and debate about the best ways to support the funding of health systems.

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The authors express their opinion that the health community should help reform global economic governance to promote global health. They explain that the global meeting on the world economy, the G20 summit, does not address the issues of rising poverty, hunger, and the threat to public resources for health services resulting from the economic crisis. The report by the World Health Organization's Commission on the Social Determinants of Health (CSDH) is discussed.