The role of WHO in Global health
Universiteit Hasselt,
Belgium
12 March 2013
Dr Mike Mbizvo, ex-Director
Department of Reproductive Health and Research (RHR), WHO
WHO Governance and Structure
2
WHO's definition of health
“Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or
infirmity.”
Source: WHO’s Constitution
WHO’s mission is global and permanent
“The mission of WHO is the attainment by all peoples of
the highest possible level of health”
Source: WHO’s Constitution
The Core Functions of WHO

providing leadership on matters critical to health and engaging in
partnerships where joint action is needed

shaping the research agenda, and stimulating the generation,
dissemination and application of valuable knowledge

setting norms and standards, and promoting and monitoring their
implementation

articulating ethical and evidence-based policy options

providing technical support, catalysing change and building
sustainable institutional capacity

monitoring the health situation and assessing health trends.
The World Health Assembly is WHO's supreme
decision-making body

World Health Assembly (WHA) appoints the Director-General
upon the recommendation of the Executive Board

Reviews and approves the proposed Programme Budget

Considers reports of the Executive Board (EB) on technical
and health matters, in addition to programme budgetary
matters

Comprises delegates from all 193 Member States. Many
Ministers of Health attend.
ONE WHO - three levels of action

Headquarters
– Global Service Centre
– Director General = "DG"

Regional Offices
– Regional Director = "RD"

Country Offices
– WHO Country Representatives = "WR"
WHO's Global Presence
Last but not least, WHO is people.
Over 7000 public health experts
including doctors, epidemiologists,
scientists, managers, administrators
and other professionals from all
over the world work for WHO in 150
country offices, six regional offices
and at the headquarters in Geneva,
Switzerland.
•♦
•♦Global Service Centre
Hierarchy levels

Headquarters Office (HQ)
– Cluster
– Department
– Team (some exceptions in GMG)

Regional Offices (RO)
– Division
– Team

Country Offices
WHO's Regional Offices (RO)

Regional Committee governs the
work of each region

"RD" Regional Director
WHO is present in many countries



150 Country offices
“WR” = WHO Representative is
responsible for WHO’s activities in the
countries by supporting the government
in the planning and management of
national health programmes
HWCO = Heads of WHO Country Offices
Seven "Clusters" in HQ
HQ Headquarters
HQ/ODG Office of the Director-General
HQ/ General Management Cluster
HQ/FWC Family, Women's and Children's Health
HQ/HIS Health Systems and Innovation
HQ/HSE Health Security and Environment
HQ/HTM HIV/AIDS, TB Malaria and Neglected
Tropical Diseases
HQ/IER Information, Evidence and Research
HQ/NMH Noncommunicable Diseases and Mental Health
HQ/PEC Polio, Emergencies and Country Collaboration
HQ/FWC Family, Women's and Children's Health
HQ/FWC Family, Women's and Children's Health
PMNCH
HQ/ALC Ageing and Life Course
HQ/MCA Maternal, newborn, child and adolescent
health
HQ/IVB Immunization, Vaccines
and Biologicals
IVR
HQ/RHR Reproductive Health and
Research
HRP
How it began … World Health Assembly
“REQUESTS the Director-General to develop
further the programme proposed:
(a) in the fields of reference services, studies
on medical aspects of sterility and fertility
control methods and health aspects of
population dynamics; …”
(WHA Resolution 18.49; 1965)
14
How it has evolved
1965:
Human Reproduction Unit within
existing Division of Family Health
(WHA Resolution 18.49; 1965)
1972-1988:
WHO (Expanded) Special Programme of
Research, Development and Research Training
in Human Reproduction
1988-2012:
UNDP/UNFPA/WHO/World Bank
cosponsored Special Programme
(WHA Resolution 41.9; 1988)
2012-present
UNDP/UNFPA/UNICEF/WHO/World Bank
cosponsored Special Programme
UNAIDS becomes PCC permanent member
15
HRP’s governance
PCC
15-18 members
Standing Committee
Scientific and Technical Advisory Group
STAG
ex-officio members
(GAP, RAPs, RP2
and PCC Chairs)
Temporary advisers
16
STAG mandate
 Review, from a scientific and technical
standpoint, the content, scope and dimensions
of the Special Programme, including the
research areas covered and approaches to be
adopted
 Recommend priorities within the Special
Programme, including the establishment and
disestablishment of task forces, and all
scientific and technical activities related to the
Special Programme
cont'd…
17
…cont'd
STAG mandate
 Provide PCC and the Standing Committee with
a continuous and independent evaluation of the
scientific and technical aspects of all activities
of the Special Programme
 Review the plans of action and the budget for
financial periods prepared by the Executing
Agency and make proposals to the Standing
Committee for possible reallocation of
resources within the scientific and technical
component of the Special Programme during
each financial period
18
HRP’s scientific and
technical advisory bodies
STAG
Scientific and Ethical
Review Group (SERG)
+ Specialist Panels
18+ experts
Research Proposal
Review Panel (RP2)
Gender and Rights
Advisory Panel (GAP)
Toxicology Panel
Regional Advisory Panels:
-
African and Eastern Mediterranean Regions
Americas
Eastern Europe and Central Asian Republics
Asia and Western Pacific
19
Scope of STAG mandate and membership
 In 1999, PCC endorsed the recommendation
of STAG to expand its mandate to review
the activities of RHR as a whole, rather than
just HRP (provided no financial implications
to HRP)
 Membership:
 Temporary advisor status
 3 years if approved by SC and PCC
 3 final years if approved by SC and PCC
 Regional, expertise and gender balance
20
"Because of the good credibility of
the Programme and WHO in
general, HRP's research results
have a greater influence on
reproductive health policies and
standards than the research of
any other organization."
(External Evaluation of HRP,
Final Report, 2008)
21
Department of Reproductive Health and
Research (RHR)

Created in November 1998

Composed of two pre-existing entities

UNDP/UNFPA/WHO/World Bank Special
Programme of Research, Development and
Research Training in Human Reproduction (HRP)

WHO Division of Reproductive Health (Technical
Support) (RHT)
RHR = HRP+RHT (PDRH)
22
Mission of HRP
To help people lead healthy
sexual and reproductive lives
Vision statement
The attainment by all peoples
of the highest possible level of
sexual and reproductive health
23
The WHO global reproductive
health strategy adopted by WHO's
192 Member States in May 2004
(Resolution WHA 57.12)
24
Opportunity
UN Secretary General's Global Strategy for
Women's and Children's Health
Role of UN agencies
Components

Define norms, regulations and guidance to

Country-led health plans
underpin efforts

Comprehensive,

Help countries align their national practices
integrated package of
essential interventions and  Work together and with others to strengthen
services
technical assistance to scale-up

Integrated care

Encourage links between sectors and
integration with other international efforts

Health systems
strengthening

Support systems that track progress and
identify funding gaps

Health workforce capacity
building

Generate and synthesize research-derived
evidence and provide a platform for sharing

Coordinated research and
best practices, evidence on cost-effective
innovation
interventions and research findings
RHR/HRP core functions

Identifying gaps and priorities and shaping the global SRH
research agenda

Providing leadership on matters critical to improving SRH
through knowledge generation, synthesis and management

Supporting national research, research and technical capacity
strengthening and engaging in relevant partnerships

Development of clinical standards, norms and related policy
and technical guidance documents

Articulating ethical and evidence-based options for policy
formulation and programme development to improve SRH, in
collaboration with regional and country offices

Monitoring and evaluation of SRH situations and trends,
advocacy, catalysing change and supporting intervention
delivery
HRP Objectives

Generating new knowledge in SRH

Synthesizing research evidence

Strengthening research capacity

Developing evidence-based guidelines

Strengthening research policy dialogue
RHR/HRP functions within
thematic areas of the WHO Global
Reproductive Health Strategy
Improving quality of and access to
Family planning

Document needs and preferences of
users and potential users

Develop new and improved methods

Assess safety and efficacy of existing
methods

Develop, keep up-to-date and promote
evidence-based practice guides for
family planning including infertility
29
Improving
maternal and perinatal health

Improve knowledge on magnitude/burden of
leading causes of mortality and morbidity

Identify, develop, adapt and evaluate best
practices in maternal and perinatal health

Conduct research to improve quality of
maternal and newborn care and promote
utilization of findings

Develop, keep up-to-date and promote
evidence-based clinical practice guides for
maternal and perinatal health
30
Eliminating unsafe abortion
and improving postabortion care

Generate and synthesize scientifically sound evidence
on the prevalence of, and mortality related to, unsafe
abortion to assist programmes/policies

Support research to identify interventions for the
prevention of unsafe abortion and for postabortion
care

Undertake research to improve methods of safe
abortion and promote quality of care

Develop, keep up-to-date and promote guidelines for
provision of safe abortion, management of abortion
complications and provision of postabortion care
31
Combating STIs / RTIs

Establish and disseminate evidence for new and
improved STI and RTI prevention and control strategies

Facilitate microbicide testing, registration (and
introduction)

Conduct research on prevention of MTCT of HIV and
other STIs, on cervical cancer screening and on
introduction of HPV vaccines

Develop, keep up-to-date and promote implementation of
guidelines and tools for STI and RTI policy, programmes,
care and surveillance

Ensure linkages with HIV prevention (e.g. STI control,
male circumcision, prevention of MTCT of HIV and
syphilis)
32
Promoting adolescent sexual and
reproductive health

Support research on factors that affect sexual and
reproductive health outcomes, including operations
research on the optimal provision of information and
services to adolescents

Strengthen research capacity and attention to
implementation of findings

Ensure that technical and managerial tools and
advocacy materials produced by the Department also
address the unique sexual and reproductive health
needs of adolescents (“mainstreaming”)
33
Addressing gender issues and
reproductive rights

Assess laws, policies, practices

rights-based approach to maternal and newborn health

assist countries to improve the legal, policy and regulatory
environment for sexual and reproductive health

Coordinate multinational research aimed at abandonment of
female genital mutilation and vaginal practices

Continue analyses of data from multicountry study on violence
against women

Mainstream gender and reproductive rights issues in the
Department’s work

Develop guidance for health sector on response to violence
against women

Contribute to understanding of relationship between human rights
and sexuality and sexual health
34
Research capacity strengthening




Strengthen the research capacity of
investigators and infrastructure in
developing countries
Support researchers to conduct studies
based on national priorities in SRH and
facilitating their participation in regional and
global research
Promote dissemination and utilization of
research results and evidence-based
guidelines in SRH programmes and
services
Develop strategies to plan, implement,
monitor and evaluate programmes to
advance SRH
35
Strengthening national research and technical capacity:
an ongoing HRP commitment
Long-term Institutional
Development
Development
grant
grant
(LID)
Resource Maintenance
and
Capital grant
Service Guidance
Centre grant
Research Training
Grant
grant
(RTG)
RCS
RCS
Re-entry grant
Competitive
Intra-regional
Research grant
Small Supplies
grant
Courses, Workshops,
Seminars grant
36
Thank you
"Societies and the political leaders
who govern them must first decide
that the health of women matters.
Public health can do something of
course. We can promote better
access to sexual and reproductive
health services … we can map out
technical strategies for reducing
maternal deaths"
Margaret Chan, Director-General, WHO
http://www.who.int/reproductivehealth/en/
37
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HQ/FWC Family, Women`s and Children`s Health