Slow WHO? Debunking an Unhealthy Self-fulfilling Prophecy
Adam Talsma
December 22, 2023
835 words
The World Health Organization (WHO) is again mired in another slow process, this time in negotiating
a pandemic treaty amongst its member states. Is this just further proof of WHO as slow, ineffective
and no longer relevant?
After all, the WHO was founded six generations ago by architects that built-in arrangements that were
relevant back then. Going by the theory of path dependency, as more time passes, the more these
arrangements structure human behavior, compound inertial forces, and make the WHO ever more
resistant to divergent outcomes.
Thus, history, many argue, is the main reason why WHO is unable to fulfill its mandate as the
directing and coordinating authority on international health. It not only cannot keep pace with fast-
moving emergencies, it cannot even handle slow-moving crises, such as HIV. Rather than investing in
an organization that kills innovation, we should create and trust in other global organizations. Freed
from the shackles of history, they can adopt less-hierarchical organizational forms, generate novel
solutions, and get ahead of the curve.
I disagree. While the ‘slow WHO’ argument will resonate with anyone who has worked in or with the
WHO, myself included, it is built on the same faulty logic that brought us where we are today. Instead,
I argue that WHO is actually a dynamic forum for innovation and a wellspring of novelty. Because of
this, investing in strengthening its capacity should be our highest priority.
First, the faulty logic. The argument that the WHO is slow and ineffective is a self-fulfilling prophecy. It
makes reality conform to an initial, false belief. When politicians and other influencers label WHO as
slow and ineffective, this leads to reduced contributions from member states and less public trust.
These, in turn, slow down WHO, and make it less effective.
In reality, WHO is actually a dynamic forum for innovation. For instance, the WHO produces and
diffuses novel approaches as a matter of routine, develops institutions that enable innovation, and
fosters novel governance partnerships.
As the head of a WHO unit in its Geneva secretariat put it:
“The primary job, across the organization, is to look at novel approaches and ask: does this
approach add more improvement than the next approach, and do we have the confidence to
recommend this approach?”
WHO units play routine roles across the innovation ecosystem, from defining needs, research and
development, and producing, adapting and implementing policy.
WHO has also demonstrated its ability to reimagine even its core capabilities in ways that enable
routine production of novelty. A good example of this is WHO staff creating a new way of developing
international health guidelines. The resulting process has been institutionalized across the
organization, and increased the number and strength of WHO-generated policies.
Moreover, the WHO is a space where novel global partnerships for governing health often emerge.
This was on display during the COVID-19 pandemic, but WHO has forged over 80 public-private
global governance partnerships over the years.
To understand why this is, we need to recognize that innovation is in fact a key source of power for
the WHO. The power of innovation lies in its ability to create and select between different futures.
Innovation is, after all, defined as constructing something neither present nor anticipated by anyone in
a given context.
At the heart of it, WHO wields innovation because it does not have the power to change existing
member state policy; the way it has influence is by introducing new policies.
WHO’s position as the central node in a dense global health landscape makes it conducive to
innovation. Novelty emerges through spillover across multiple intertwined social networks.
Multifunctional actors, like WHO, that play different roles and link many networks, are natural hubs for
innovation.
One way that WHO wields influence through innovation is by defining global standards and ‘norms’
that many contexts are far from achieving. The larger the gap between the norm and the reality, the
more impetus for novelty to emerge—and the more WHO is positioned to invent approaches to
address the gap.
Curiously, all of these features that make WHO innovative, have existed since its founding. Thus,
perhaps WHO has always been a dynamic wellspring for novelty. If that sounds as counterintuitive to
you as it does to me, perhaps we have been sold an unhealthy self-fulfilling prophecy.
If we truly want to see health for all in a rapidly changing context, our first priority should be to invest
in a healthy WHO. WHO will generate novel partnerships, and, when healthy, it will play a stronger
role in ensuring the political support needed to achieve results.
While the level of investment by member states has been abysmal for decades, recent progress
towards more support is encouraging. This increases the likelihood of a pandemic treaty that
governments do abide by. More broadly, this bolsters WHO’s routine production of novelty and
innovation.
With the right support, sustained over time, we can debunk the slow WHO self-fulfilling prophecy and
restore public trust around the ‘dynamic WHO’ that has been there all along.
About the author:
Adam is a PhD student in International Relations/Political Science at IHEID. He researches innovation
in international relations and development. He has worked with the World Health Organization and
supported innovation efforts globally and in a number of countries.
