17.5 International Health: WHO, Global Agencies & SDG 3
Key Takeaways
- The World Health Organization (WHO), founded in 1948 as a UN specialised agency, is the directing and coordinating authority for international health; its headquarters is in Geneva and it operates through six regional offices and 194 Member States.
- Sustainable Development Goal 3 ('Ensure healthy lives and promote well-being for all at all ages') sets the 2030 global health agenda with targets including UHC, ending the TB/HIV/malaria epidemics, and reducing maternal and under-5 mortality.
- Key global health agencies include UNICEF (children), UNFPA (reproductive health), World Bank (health financing), Gavi (vaccines), the Global Fund (TB/HIV/malaria) and the Bill & Melinda Gates Foundation — each financing or delivering specific programmes.
- The International Health Regulations (IHR 2005) are a legally binding framework requiring Member States to detect, assess, notify and respond to public-health events of international concern (e.g. outbreaks, vaccine-derived polio).
- Primary Health Care, declared at Alma-Ata (1978) and reaffirmed at Astana (2018), remains the global strategy for achieving Universal Health Coverage and the SDGs.
17.5 International Health: WHO, Global Agencies & SDG 3
High-Yield Core Concept: The PSM syllabus lists International Health as a distinct topic. CMS questions test the role and identity of the major global health agencies and the targets of Sustainable Development Goal 3.
1. The World Health Organization (WHO)
Founded 7 April 1948 as a UN specialised agency; headquarters in Geneva; six regional offices (SEARO covers India); 194 Member States. The World Health Assembly (decision-making body, all Member States) sets policy; the Director-General leads the Secretariat.
Functions: international health leadership, normative guidance, disease surveillance and outbreak response, health statistics (ICD, WHA reports), technical assistance, emergency response (declares Public Health Emergency of International Concern under the IHR).
Financing: assessed Member State contributions + voluntary contributions.
2. Sustainable Development Goals (2015–2030)
The UN 2030 Agenda has 17 SDGs; SDG 3 — 'Ensure healthy lives and promote well-being for all at all ages' — carries the core health targets:
| Target | Goal |
|---|---|
| 3.1 | Reduce global maternal mortality ratio to <70 per 100,000 live births |
| 3.2 | End preventable deaths of newborns and children <5 (≤12 per 1,000 live births; ≤25 neonatal) |
| 3.3 | End the epidemics of HIV, TB, malaria and neglected tropical diseases |
| 3.4 | Reduce premature mortality from NCDs by one-third (mental health) |
| 3.7 | Universal access to sexual and reproductive health-care services |
| 3.8 | Achieve Universal Health Coverage (UHC) |
| 3.9 | Reduce deaths from air/water/soil pollution and hazardous chemicals |
The SDGs replaced the Millennium Development Goals (2000–2015); health now appears across multiple SDGs (nutrition, WASH, cities, climate).
3. Other Global Health Agencies
| Agency | Mandate |
|---|---|
| UNICEF (1946) | Child survival, nutrition, immunisation, education |
| UNFPA (1969) | Sexual & reproductive health, family planning, maternal health |
| World Bank | Health-system financing, IDA/IBRD loans for health programmes |
| UNAIDS | Coordinated HIV/AIDS response across UN agencies |
| Gavi, the Vaccine Alliance (2000) | Immunisation in low-income countries, new-vaccine introduction |
| The Global Fund (2002) | Financing for TB, HIV/AIDS and malaria programmes |
| Bill & Melinda Gates Foundation | Major private funding for vaccines, polio, malaria, NTDs |
| PEPFAR | US President's Emergency Plan for AIDS Relief |
4. International Health Regulations (IHR 2005)
A legally binding agreement (196 States Parties) to prevent and respond to acute public-health risks that cross borders. Core capacities:
- Detect — national surveillance systems.
- Assess & notify — notify WHO within 24 hours of any event constituting a Public Health Emergency of International Concern (PHEIC) (e.g. COVID-19, Ebola, polio, mpox).
- Respond — coordinated national response and WHO support.
States must maintain core capacities at points of entry (ports, airports, ground crossings).
5. Primary Health Care: Alma-Ata → Astana
Alma-Ata Declaration (1978) defined PHC as essential health care made universally accessible through community participation, intersectoral coordination and appropriate technology — 'Health for All by 2000'.
Astana Declaration (2018) reaffirmed PHC as the route to UHC and the SDGs, adding digital health, comprehensive primary care and political commitment.
Universal Health Coverage (UHC) means all people access needed quality health services without financial hardship — the SDG 3.8 target and a WHO strategic priority.
6. India in Global Health
India hosts the WHO South-East Asia Regional Office (SEARO) in New Delhi and is a major vaccine producer (serum and biologics supplying global immunisation). National programmes (NTEP, NVBDCP, NHM/Ayushman Bharat) align with SDG targets; India contributes to polio eradication (certified free 2014), yaws elimination target, and trachoma elimination.
7. Disease Elimination & Eradication: Global Milestones
Global health agencies pursue a hierarchy of goals that candidates should distinguish:
| Term | Definition | Examples |
|---|---|---|
| Eradication | Permanent worldwide reduction to zero | Smallpox (1980) — the only human disease eradicated |
| Elimination | Reduction to zero in a defined region | Polio (certified in WHO regions), measles in some countries |
| Elimination as public-health problem | Below a threshold | Leprosy (<1/10,000) eliminated as a public-health problem globally (2000) |
| Control | Reduction to locally acceptable burden | TB, HIV, malaria ongoing control programmes |
Polio eradication — the Global Polio Eradication Initiative (WHO, Rotary, CDC, UNICEF, Gates) drove wild-polio cases into the hundreds; the South-East Asia Region (including India) was certified polio-free in 2014. India's pulse-polio campaigns and surveillance are a flagship contribution.
Neglected Tropical Diseases (NTDs) — WHO targets ~20 NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, trachoma, yaws). India runs mass drug administration for lymphatic filariasis and targets yaws and trachoma elimination.
Measles & rubella — MR elimination goals drive catch-up campaigns; India's national MR campaign targets measles elimination.
These goals tie directly to SDG 3.3 and to India's national programmes — a CMS question may ask which disease has been eradicated (smallpox) versus eliminated (polio regionally, leprosy as a public-health problem).
Key Takeaways for the CMS Candidate
- WHO founded 1948, Geneva; the World Health Assembly is its governing body.
- SDG 3 (2015–2030) targets: maternal mortality <70, end TB/HIV/malaria epidemics, UHC (3.8), reduce NCD mortality by one-third.
- Global Fund = TB/HIV/malaria; Gavi = vaccines; UNICEF = children; UNFPA = reproductive health.
- IHR 2005 governs PHEIC notification within 24 hours.
- PHC strategy: Alma-Ata 1978 → Astana 2018; route to UHC.
Which global health agency is specifically mandated to finance programmes against tuberculosis, HIV/AIDS and malaria?
Under SDG 3, what is the 2030 target for the global maternal mortality ratio?