Wednesday, September 10, 2008

[EQ] Diseases Know No Frontiers: How effective are Intergovernmental Organisations in controlling their spread?

Diseases Know No Frontiers:
How effective are Intergovernmental Organisations in controlling their spread?


Volume I: published 21 July 2008

Published by the Authority of the House of Lords – UK London : The Stationery Office Limited


PDF file [79p.] at:


Available online at:


“…..The twentieth century witnessed remarkable advances in many parts of the world in standards of public health and in the conquest of killer diseases, such as smallpox and poliomyelitis. However, during the second half of the century the advent of globalisation (in particular, increased international trade and travel) and changes in human lifestyles (for example, greater human-animal contact) have enabled new infections to emerge and to spread much more rapidly around the world. The onset of HIV in the 1980s and the outbreaks of SARS and avian influenza in the 1990s are striking, but by no means the only, examples. On average, a previously unknown infectious pathogen emerges somewhere every year. At the same time a number of infectious diseases, including some—such as tuberculosis and malaria—which were previously close to eradication, have developed resistance to antibiotics and in their resistant form they are much more difficult to treat. These problems cannot be tackled solely by States within their own borders: effective intergovernmental action is needed.

In recent years there has been a substantial and welcome upsurge in funding for infectious disease control from governmental, intergovernmental, charitable and private sources. At the same time, however, there has been a significant increase in the number of organisations involved, with the result that the landscape of international health has become, in the Government's words, "crowded and poorly coordinated". We have taken evidence from many of these organisations, and it is clear to us that, while there is an urgent need for rationalisation of effort, it is unrealistic to think in terms of imposing coordinating structures from above. The process has to be evolutionary rather than revolutionary, but it needs leadership. There is no doubt in our mind, and in the minds of most of those from whom we have taken evidence, that that leadership function must rest with the World Health Organisation (WHO) and that, given appropriate strengthening of its management arrangements, WHO's remit and resources should be developed in order to encourage and support collaboration and rationalisation among the many actors on the international health stage….”



“…In this chapter we review the interaction of the various actors on the international health stage, particularly those concerned with infectious disease control. We look in some detail at the role of the World Health Organisation (WHO) and then turn to address a number of the key issues which have arisen during our inquiry, including the synergy with which the various bodies are working under the existing system and the case and scope for some rationalisation of global health governance.

Intergovernmental Organisations Committee - First Report - July 2008.






The Wider Picture


Population Growth





Horizontal and Vertical

Prevention and Treatment

A Moving Target

Access to Medicines

Box 1: The GAVI Alliance


Natural or Intentional?—The Threat from Bioterrorism



The Field of Players

Figure 1: The Institutional Labyrinth of International Health

Box 2: The Global Fund to fight AIDS, Tuberculosis and Malaria


The World Health Organisation

Box 3: The World Health Organisation

The Role of WHO

Times are Changing

Box 4: The Gates Foundation


Box 5: The International Health Regulations

Box 6: Global Outbreak Alert and Response Network



WHO and Europe


Synergy and Coordination

Human and Animal Health

Tuberculosis and HIV/AIDS

Inter-organisational Collaboration


Global Health Governance

The Need for Improvement

How Can It Be Done?

International Health Partnership (IHP)

A Global Compact for Infectious Diseases

Networked Governance




Bilateral Funding

Table 1: UK Government contributions to Intergovernmental Organisations involved in Infectious Disease Control


Multilateral Funding

A Comprehensive Approach



Infectious Diseases

International Health: The Institutional Labyrinth

Accountability and Management


APPENDIX 1: Ad Hoc Committee on Intergovernmental Organisations

APPENDIX 2: Call for Evidence

APPENDIX 3: List of Witnesses

APPENDIX 4: Principal International Organisations who are involved in or whose activities are relevant to controlling the spread of infectious diseases (not exhaustive)



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