What WHO is helping

to achieve in India
Kelly Wright, 16 July 2012 Asia, Health
India has been polio free since January 2011. Before the launch of polio
immunisation campaigns in 1995, an estimated 50,000 to 100,000 polio
cases were being reported annually, so thats quite an achievement. The
near-eradication of polio in India was made possible by the strong
ownership of the Government of India, and by the efforts of a number of
actors in the health sector, including World Health Organisation (WHO),
The United Nations Childrens Fund (UNICEF) and Rotary International.

Com
munity health worker, Rebati, gives baby Adilya polio and other life
saving vaccinations. Picture: Pippa Ranger/DFID

What I was in Delhi to ask about was how important was the contribution
of the World Health Organisation in particular?
The answer is, pretty crucial. We were told so not just by the WHO
country team, but also by national and state government partners,
medical officers and the mothers of children benefitting from the
immunisation programme
including Dr Pooja Sarin who proudly presented to us the clinic she
runs in Mehrauli, Delhi. As she spoke she referred to a well-thumbed
copy of the WHO Immunisation Handbook for Medical Officers. She also
ended with a ringing endorsement of Indias state-run facilities, which
should all be compliant with WHO guidelines and global best practice;
My children were vaccinated in this clinic. I would always bring them to
state-run clinics over private ones because I know that they follow WHO
guidelines.
What WHO had produced on polio eradication was a set of practical
guidance and training, specific to the Indian national context, for
immunising all children against polio. WHO delivered the technical
advice and expertise to help make the Governments target of attaining
polio free status a reality. Importantly, what WHO and Indian medical
staff learned along the way is also now being shared with other countries
battling the same foe, for example during a recent WHO delegation to
Nigeria.

Protecting the next generation.

Picture: Caroline Irby/ DFID
Immunisation programmes, including against polio, are of course just
one aspect of the organisations work in India.
The recently agreed WHO Country Cooperation Strategy has improved
health and equity in India at its heart with three key objectives i)
supporting an improved Government of India role in global health; ii)
promoting access to and utilisation of affordable, efficiently networked
and sustainable services for the whole population; and iii) helping to
confront the new epidemiological reality of India. WHO, along with
agency partners in the UN Country Team, prioritises its delivery in
the nine states in India with the highest proportion of people living in
poverty Odisha, Bihar, Chattisgarh, Madhya Pradesh, Jharkhand, Uttar
Pradesh, Maharashtra, Assam and Rajasthan.
How WHO delivers on such an important set of objectives goes to the
heart of what the UK and DFID expects from our development funding to
the agency. India was an incredibly valuable context in which to consider
the impact that a normative and standard setting agency like WHO can
and should be having. These agencies play a vital role providing
technical expertise, neutral advice and convening power, data and

analysis, to help governments to meet international standards, and to

deliver progress against MDG targets and on government poverty
reduction and development plans. In India, WHO provides something
that only agencies like this can considerable support over a long time
period to achieve significant outcomes that have wide a ranging impact.
It took 15 years to near-eradicate polio in India following the initial
adoption of WHO guidelines in 1995. The process was non-linear, with
successes and setbacks, where anything less than full, robust support
would have been insufficient.
To continue to succeed in this role, WHO needs to ensure that it is
focusing on its proven comparative advantage, and monitoring its
organisational effectiveness and delivery of results to demonstrate value
for money from the funding it receives. DFID will be looking closely at
these things when refreshing the Multilateral Aid Review (MAR)
assessment of WHO next year.
So are the global standards and guidelines, researched and drafted in
Geneva and across the world, important for achieving great things in
world health? This was one tick in the credit column.