Some countries didn’t even know the regulations existed, his group reported. Others lacked laws critical to responding to outbreaks, such as those that allow quarantines.
Changing these regulations would require “years of negotiation,” said Dr. Wieler, noting that the latest set took a decade to complete. Instead, one of the main recommendations of his committee was to increase the accountability of countries for their commitments, including a pandemic treaty and regular readiness review that would involve other countries.
The independent panel also proposed the establishment of an international council, led by heads of state, to raise awareness of health threats and oversee a multi-billion dollar funding program to which governments would contribute based on their capabilities. It would promise quick payouts to countries struggling with a new outbreak and give them an incentive to report.
“There will only be the political will to do these things if something catastrophic happens,” said Dr. Mark Dybul, one of the panel members. These recommendations came in part from his experience as head of the President’s Emergency Program for AIDS Relief, known as Pepfar, and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Dr. However, Wieler, who led the other international review, said that creating new institutions, rather than focusing on improving existing ones, generally increases costs, makes coordination difficult, and reduces the W.H.O.
The panels’ recommendations after global emergencies were sometimes followed up. The Ebola outbreak in 2014 and 2015 led to the creation of W.H.O.’s health emergencies program to strengthen the agency’s role in managing health crises and to provide technical guidance. A report released earlier this month found that the new program had received “increasingly positive feedback” from countries, donors and partner agencies as it tackled dozens of health and humanitarian emergencies.
The WHO. before and after the Ebola outbreak, “basically two different agencies,” said Dr. Joanne Liu, a former MSF international president and a member of the independent panel. Dr. Liu was one of the most astute critics of W.H.O. during the Ebola response, and she saw a “significant improvement” in how quickly the agency had declared an international emergency this time.