I. Appendix
With the outbreak of globalization, the movement of goods, information, and people has been made fairly easy. Unfortunately, however, the movement of infections and diseases has also been made easy. Due to the fact that our world has become very interconnected, multiple organizations have come about to aid these transfers, be it the transfer of information, or public health. One of these organizations is the World Health Organization, a coordinating authority for health was created in parallel to the United Nations and headquartered in Geneva, Switzerland.

In the 19th Century, there was a massive eruption of diseases, most importantly the cholera epidemic. All around Europe, countries were pushing towards an international health convention to try to address the issues at hand, and while many conventions were finally held, there needed to be something more global to set things right. After the First World War plagued the world, the League of Nations came about and created several agencies to help in aiding the world. One of those agencies was the League of Nations Health Organization. The Health Organization was primarily made to control diseases and try to prevent them. However, their successes came to a halt when the second World War broke out. In 1945, when the war had already ended, the United Nations came about and replaced the former League of Nations. The 61 members of the United Nations all signed the constitution of the World Health Organization in 1946, and two years later, on April 7th, 1948, the constitution finally came into force making that day an annual celebration of ‘Health Day’. The Assembly’s first president was Andrija Stampar and their first Director General was Brock Chisholm. Together, having secured a budget of 5 million dollars, they set to enforce public health. Their top priorities at the time was the transfer of STI’s (Sexually Transmitted Infections), malaria, and TB (Tuberculosis), since these were the major diseases that were then haunting the world. Another concern of theirs was nutrition, or rather, the lack of it. Trying to control and prevent these issues became the organization’s main objective. The organization consisted of a mission statement, amongst many others, a main mission was to “act as the directing and coordinating authority on international health work and to assist governments, upon request, to strengthen health services”. Nowadays, all the countries that are members of the United Nation can become members of the World Health Organization by simply accepting its constitution. Currently there are 194 member states of the organization and they are grouped according to their regional distribution. These member states meet annually to fulfill the functions of this organization. These functions include “Setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options; monitoring the health situation and addressing health trend; and providing technical support”. Basically, the organization aims to make this world a better and healthier place to be in. in the years 2012 and 2013, the organization recognized thirteen major areas in which their funds would be distributed.

The World Health Organization consists of three main organs – The World Health Assembly, the Executive Board, and the Secretariat. All of the World Health Organization members are represented in the World Health Assembly, giving each member one vote and the ability to send three delegates. These delegates that are chosen by the member states have to have a national health background preferably, and should definitely be competent for the job. These annual assemblies have mostly been held in the Organization’s headquarters in Geneva and a president is elected by each assembly. During these assemblies, the policies of the organization are determined and agreements are made.

The assembly has ‘quasi-legislative powers’ that are there to regulate important matters that are specified in the Organization’s constitution, and when the assembly adopts that regulation, it is then applied to all member states of the World Health Organization, even the member states that have voted against it. Unless these countries’ governments notify the organization of their formal rejection, the regulations will apply to all members. In their first assembly of 1948, their regulations included “Nomenclature with Respect to Diseases and Causes of Death” and diseases that require its victims to be quarantined. For these regulations to set forth, the assembly becomes a sort of scientific conference where health topics are presented and thoroughly discussed by the nominated delegates, who are, under obligation, health experts.

The Executive Board is made up of 34 members that are qualified in the field of health, and they are elected for a 3 year term. In their main Board meeting, they set the agenda for the forthcoming Health Assembly. This meeting is usually held in January, while a shorter meeting is held in May. The Board’s main functions is to give effect to the decisions and policies of the Health Assembly. As for the Secretariat, it is made up of around 8000 health staff and other experts who work at their headquarters, in different countries, and in six regional offices. The Director General, who is nominated by the Executive Board, heads the Organization. The current Director General is Margaret Chan, and the current Chairman of the Board is Joy St. John. Figure 1.1 below shows the Organization’s “Organogram” Figure 1.1

As mentioned earlier, the World Health Organization is focusing its budget and attention on a particular 13 areas that need immediate concentration. One of these areas is the eradication of polio; a viral and infectious disease that is transferred from one person to the other. This disease can lead to paralysis, breathing problems, and sometimes death. Ever since the Global Polio Eradication was launched, the organization has reduced its cases to 99%. The organization has set HIV/AIDS, TB, and Malaria at the top of their ongoing work to banish it from existing. The Organization also tries to take care of other ‘diseases’, which are non-communicable diseases, mental disorders, and disabilities. Not only does this organization focus on infections and viruses, it also tries to reduce morality and improve health during birth, pregnancy, and adolescence. Other areas they work with include reducing risks of damage through alcohol, tobacco, and drugs. Also, the organization tends to focus on issues that concern nutrition and malnutrition. in many instances in global history, we see the World Health Organization intervening after an emergency takes place; natural or manmade, to try to secure the lives of the people in these areas that are seeking their aid. These ongoing works simply imply that the organization has so far done well for itself, it has gone through several successes, however managed to pile up a couple of setbacks.

A major success in the history of The World Health Organization would be in 1958, when the Deputy Minister of Health of the USSR, Viktor Zhdanov, asked the World Health Organization to set up a plan to finally eradicate smallpox, as it was shamelessly spreading about. A year later, Resolution WHA11.54 was initiated and put into action. The Organization took the necessary methods to try to eradicate it and by 1967, they were contributing an annual amount of 2.4 million to complete their mission of finally shoving that disease out of the way. However, the organization faced a couple of speed bumps, mainly the fact that these smallpox incidents were not being reported. Due to that, the WHO assigned consultants to assist countries in monitoring cases of smallpox and reporting them to the organization to be taken care of. The organization set about in trying to eradicate this depressing disease and after long years of pushing towards an eradication, they finally reached their aim in 1980, making it the first disease in history to be completely taken care of by ‘human effort’.
The organization did however, have a few downfalls. With the success of smallpox eradication, the organization promised that malaria would be next in line to be eradicated. Unfortunately, the organization declared that the disease was resisting and rejecting the drugs that were being created to fight it, and that its eradication was not going as well as they had liked it to. Similarly enough, the eradication of tuberculosis has not yet happened, and these diseases continue to kill thousands of children all over the world. Both diseases are said to have been resisting the drugs and the antibiotics that are being used against them, and while these issues are extremely difficult to control and therefore cannot quite be referred to as a failure, they are still considered to be major set backs for the organization. Due to these ‘setbacks’, the World Health Organization has been criticized for not achieving the goal that they had promised to achieve (with malaria). In our 21st Century world, many diseases are still at large and as we have seen with many cases, these diseases keep changing and it is becoming harder for the organization when it comes to financial problems. Criticisms aside, however, it cannot be argued that the world needs an organizational power to ‘organize’ the health of countries all over the world.
In conclusion, the World Health Organization has been the world’s health agent since the end of WWII. It has provided the world with advice and health procedures that aim to make this world of ours a healthier place. Although the list of achievements is far too long, history has witnessed that this organization has gained popularity through the work that it has done. However, it is still evident that they have had various throwbacks when it came to fully protect the world from the diseases that are killing people by the thousands. Nonetheless, through its multiple successes and failures, the organization continues to have its annual meetings in order to come up with new decisions and regulations that promote better lives for the people of the world at large.
II. The WHO, an Overview With the emergence of the bittersweet concept of globalization came an unwanted amount of manmade deaths as well as natural illnesses and diseases. The leading members of the world put their heads together and came up with a solution known to us now as the United Nations, and from this Global Organization came several branches that aimed to deal with more specific cases concerning the well being of the human race. Before the United Nations came into place, the League of Nations existed, but when it failed to protect the world from international conflicts, another World War took place, which finally lead to the formation of the United Nations, along with several other organizations that dealt with global interests.

Amongst these organizations was the World Health Organization, WHO for short. The WHO’s constitution was first signed in 1946 but finally came into force two years later, ready to embark on missions that aim to better the lives of people all over the world. “WHO took over the responsibility for the International Classification of Disease (ICD), which dates back to the 1850s and was first known as the International List of Causes of Death. The ICD is used to classify diseases and other health problems and has become the international standard used for clinical and epidemiological purposes.”

The organization’s top priorities were issues that plagued the world by the fact that their victims were heading to a fatal destiny, such as Sexually Transmitted Infections (STIs), Tuberculosis (TB) and malnutrition. They made it their mission to assist these people and to provide them with the health services that they so desperately need, especially the people that live in underprivileged countries and don’t often get their voices heard. Margaret Chan, the WHO’s current Director General states that “[their] greatest concern must always rest with disadvantaged and vulnerable groups. These groups are often hidden, living in remote rural areas or shantytowns and having little political voice. WHO works to make these people – and their unmet health needs – more visible and thus worthy of our priority concern.” Today, the WHO deals with multiple health issues and diseases and has set up certain goals that they aim to achieve in the near future. Amongst those goals is to decrease child deaths as well as combating HIV/AIDs. Although these goals are still in progress, the organization hasn’t fully managed to be successful in obtaining them. One huge success for the organization, however, is the absolute eradication of the Smallpox disease in 1979. But what is Smallpox? And how did the World Health Organization come about in eradicating it?

III. Smallpox, and Introduction Smallpox is a very serious and contagious infectious disease that sometimes ends in a fatal result. The disease is caused by the variola virus that emerged in human populations thousands of years ago. It is generally transmitted by face-to-face contact as well as direct contact with bodily fluids or contaminated objects such as bedding or clothing Smallpox is rarely transmitted through air in a closed setting as humans are the only hosts for this virus. When a person is diagnosed with smallpox, the first stage of it is the heightened fever, which is not that contagious, however, the infected person is most contagious when the rash breaks out all over their body. The disease is thought to have originated in Egypt of India around 3 millenniums ago, and the first case evidently comes from the Egyptian Pharaoh Ramses V whose mummified body shows signs of a ‘spotted’ disease on his skin. Shortly after the Egyptian Pharaoh’s case, smallpox travelled along the trade routes in Africa, Asia, and Europe, eventually reaching the Americas in the 1500s, and because of the fact that Indigenous people had to natural immunity to the disease, 90 percent of their deaths was because of the disease. In Europe alone, the disease killed 60 million lives in the 18th century, and around 300 million people globally in the 20th century. Right when this disease came about, people have put their brains together to try to find a ‘cure’ or a vaccination, and finally in 1796, Edward Jenner, and English doctor discovered that “inoculation using closely related cowpox could protect against smallpox.” His discovery opened up many doors for future vaccination programs, and in 1967, a year where 10 to 15 million people were infected by the disease, the World Health Organization launched a global eradication program that found its success in 1979.

IV. WHO intervenes? As mentioned earlier, the World Health Organization launched a worldwide eradication program to fight off the Smallpox disease and try to help as many people as they could to finally rid the world from this epidemic that was taking the lives of many people. At the end of the 1960s the disease was still endemic in Africa and Asia, campaigns, surveillance and prevention measures aimed to locate the disease’s ‘hotspots’ in order to better inform the people that have been infected by this disease. Before 1967, the eradication strategy consisted of mass vaccinations, evidently, this strategy was not as successful as they hoped it would be in places where the infected victims were present in large numbers. Instead, they set up outdoor clinics and hired health workers to better inform the victims of this disease. They worked on vaccinating children, sailors, and women to prevent the disease from overflowing. in 1969, the World Health Organization published “Smallpox : a Pictorial Guide to Diagnosis”, a brochure to help patients identify the symptoms. in 1971, the organization issued small recognition cards with pictures of victims that have been infected with smallpox in order to warn people of the infectious disease that has been spreading around. They hired health workers to walk around showing these cards and posters to people from ill-informed villages and asking them if they have seen cases such as the one on the posters. Health workers would also go around schools and ask children if they can report similar cases and if they have seen anyone with these symptoms so they could try to help. In 1975 in Bangladesh, rewards were promised to anyone who would give out information about places where these cases have emerged. By doing so, the World Health Organization was trying to prevent this disease from spreading any further and from people who have fallen prey to this disease from transmitting it to the people around them. As for surveillance methods, the World Health Organization provided equipment to collect specimens from smallpox patients to take to the laboratory to be examined. The surveillance team members would go around asking families questions about potential smallpox cases that are invisible to the public. “Smallpox Detectives” were assigned to trace trails of evidence on the outbreak of the infection. The Smallpox Eradication Program team had to cope with difficult working conditions as they were assigned to work in places were the monsoon season was at its peak and there were limited road access to villages in remote areas. Nonetheless, the team members managed to find effective means of coping with their situation to speed up the eradication process.
V. Success Unfortunately enough, the personnel hired were in limited numbers, but despite these limitations, the progress of the eradication campaign was noticeable. Within two years, 17 of the 21 countries in the region were free of smallpox. In the beginning of the 1970s, there was a major disruption to the program’s success, Bangladesh lost its smallpox-free status because of the refugees that were fleeing the civil war, Botswana fell victim to the epidemic, and Iran and Iraq fell into its trap once again. By the end of 1973, all were back on track except for Bangladesh, which caused the campaign to further intensify its work and focus their efforts on the last five remaining countries: Bangladesh, India, Nepal, Pakistan, and Ethiopia. In the next months momentum was raised and the campaign continued on its road to success. The organization took on several approaches and the one approach that seemed to succeed the most was that of a military-like approach, because it survived in the most difficult of circumstances. Massive efforts were made to isolate the cases and to vaccinate everyone that was present in the area. By the end of 1976, thousands of health staff managed to stop the transmission in Ethiopia, and although the epidemic transferred back to Somalia, the numbers were very low and it was evident that it was coming to an end. In 1977, after 10 years, 9 months, and 26 days since the start of the eradication campaign, the last case was reported in Somalia, and in 1980, the disease was finally declared eradicated by the World Health Assembly (WHA). Figure 1.2 below is a graph showing the rise and fall of the cases of smallpox from the years 1920 – 2010. We can see that the world first started to take notice at the end of the First World War, and it was sort of going on a roller coaster ride, with its ups and downs. Then how in the years after World War II broke out there was a heightened escalation of the disease, but then it started going down because of the World Health Organization’s efforts at eradicating it. And then it hit a final downfall at the end of the 1970s to never rise again.
Figure 1.2

Despite its success, the Eradication Campaign came at a high price. For developing countries, it is estimated that 10 million a year was spent on vaccinations alone. In Industrialized countries such as the United States, money was spent to reassure that the disease will not spark up again in the future, and so an estimate of 92.8 million was spent on making sure this epidemic doesn’t come knocking on their doors ever again. Putting these large numbers aside, the campaign turned out to be heavily successful as it wiped off a disease that was killing people by huge numbers. Much of this program’s success goes back to the “political commitment and leadership” of the World Health Organization, obviously, along with other contributors. The best results proved to be where the WHO staff had people supervising the area, constantly reviewing their work in order to resolve the problems. Their work showed pure commitment and it motivated the rest of the staff that was helping out, especially when work got a little rough in poor areas. The campaigns were also flexible in order to adapt to different cultures and geographical situations, this was another point that aided the success of the WHO’s approach. The use of the already existing health care services helped in their journey to success because it provided a place to set up their vaccination work and provided a larger number of helpful staff members. The whole campaign issued by the WHO proved to be very successful due to all these factors at hand.

VI. Other Players It should come as no surprise that there were many players involved in this campaign other than the World Health Organization. In the early stages of the formation of the World Health Organization, the fight to eradicate smallpox was far from popular. In 1958, however, the deputy health minister of the Soviet Union, Professor Victor Zhdanov, proposed a 10 year campaign to eradicate the disease and he promised that the Soviet Union would donate 25 million vaccine doses to initiate the program. A year later, the Russian proposal was passed and the campaign set forth. However, with the coming years, political and financial supports were short in supply as the campaign heavily relied on donations, and the effort hardly looked like it was going to be successful. In 1965, the US government became the WHO’s largest contributor and promised to provide more support to the campaign. The US support alongside the Soviet Support pushed Dr. M G Candau, the director general at the time, to reenergize the campaign. Towards the end of the campaign, it was evident that the success of the eradication campaign fell in the hands of the United States’ CDC (Centers for Disease Control) and the Soviet Union’s help.

VII. A Biased Opinion In my opinion, I believe that the issue was resolved in a very acceptable manner, the World Health Organization came up with strategies to combat the disease and these strategies proved to be successful. The WHO managed to put together a team of responsible leaders to take on the tasks and set to work. One thing that they failed in doing was eradicating this disease sooner than they did. In many reports, it is said that the Eradication Program was not as efficient as it proved to be in the end. The Organization failed to speed up the process and it took them years before they set their words and promises into actions.

Nevertheless, the process in general offered many future lessons for Organizations all over the globe. This successful tale taught us that there are efficient ways of collecting and storing data as well as applying strategies to tackle a situation. It also taught us that when the International Community puts its hands together and joins forces, a great outcome will take place. After this successful eradication, the World Health Organization gained more confidence in its journey to rid the world of deathly diseases. Their next goals are to rid the world of Malaria, Malnutrition cases, and to find methods to get rid of HIV/AIDs. Not only did this success bring optimism to the Organization, it also increased people’s confidence in the organization itself.

The eradication of smallpox has made it one of the greatest achievements of humankind. It inspired a whole generation of professionals that are concerned with public health to start up campaigns to further improve global health. Although this success journey was a long and complicated one, it proves that when an Organization has good leaders and motivated professionals amongst each other, issues are dealt with faster and in a more convenient matter. The World Health Organization is now taking this confidence and using it to achieve other successful results when tackling other global issues at hand, and hopefully, with the contributions of volunteers as well as financial supporters, the organization will set forth on maximizing their success in achieving their necessary goals.

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Graphs: http://www.earth-policy.org/images/uploads/graphs_tables/highlights19_smallpox.PNG http://www.gfmer.ch/TMCAM/WHO_Minelli/A2_fichiers/image002.gif