A Special Role for the World Health Organization in the Creation of a Living, Breathing Global Health Governance Constitution

This article argues for a “living, breathing” Global Health Governance Constitution, which would be initiated by a World Health Governance Forum (“Forum”) convened by the World Health Organization (WHO). The content of the new constitution would result from the contributions of the various public health actors. A “Board of Editors,” consisting of officials from the WHO and other stakeholders, would then review contributions and produce a non-binding instrument or modus vivendi. This instrument would be subject to continuous review, with “special temporary revisions” and “opinions” produced on a rolling-basis by the Board of Editors based on opensource contributions and comments submitted by stakeholders. Every year, the Forum would reconvene to comprehensively review the terms of the modus vivendi. The “living, breathing” Global Health Governance constitution would complement the existing governance arrangements and offer a structure for current and future action in the field of public health. The attainment by all peoples of the highest possible level of health represents a truly noble aim, and it is to this objective that the World Health Organization (WHO) devotes its energy, time and resources. Eradicating disease, advising on health effects, providing life-saving medicines, facilitating access to life-sustaining services, caring for the sick and wounded, creating an environment where people can live good, vibrant, and productive lives—these are the things that bring out the best in humanity. With them, we are able to live larger and do more. As the indispensable actor in the field of public health, the WHO contributes to the attainment of this objective in myriad ways. Its universal membership makes it the preeminent venue for intergovernmental relations on issues of health. Its response teams deploy to contain outbreaks of infectious disease and attend to the victims of disaster. Its disease-specific programs take action to eradicate life-threatening illnesses such as HIV/AIDS, tuberculosis, and malaria. Its advocacy and education programs confront chronic disease at all stages of development. Its uniform prescription drug rules ensure consistent access to pharmaceuticals by assigning a single, international name to each chemical compound. Its food safety and medical quality standards protect individuals from ingesting harmful or noxious substances. Its pollution-monitoring mechanisms keep tabs on the natural environment and provide information on corresponding health impacts. Under its Constitution, the organization is charged with no less than twenty-two, clearly articulated functions 1 falling into two broad categories— the direction and coordination of international health work, and technical cooperation with member-states on issues of mutual interest. In this role the organization works tirelessly to deliver health to all humankind. 2 Despite these praiseworthy aims and ambitions, the complexities of today’s institutional health environment pose unique challenges to the WHO’s operations. When the organization was formed in 1948, the political structures supporting the institutions of public health could rightly be called international. Nation-states served