IHI has had a long and productive relationship with the World Health Organization (WHO). We have seen firsthand the WHO’s crucial importance for the future of health across the planet, especially for those living in low- and middle-income countries. This experience is why IHI joins hundreds of other leaders in academia, science, and law around the world who condemn the threat to take away US financial contributions to the WHO.

The US administration has initiated a legal process to withdraw its membership from the WHO. If this action is not successfully challenged, substantial US contributions to the WHO budget will be halted by mid-2021.

The WHO has been criticized for its slow recognition of the severity and spread of COVID-19, and for its hesitant endorsement of evidence for technical aspects of the pandemic’s spread and treatment. No doubt there will be detailed analysis of the WHO response, with resultant sober conclusions and recommendations for future action. These possible missteps, however, should not keep us from recognizing the WHO’s crucial role in guiding the international response to the current pandemic or its broad stewardship of global health since its inception in 1948.

The threat to the WHO comes at a time when IHI is working closely with them to develop their emerging interest in using science for more effective implementation of its global health efforts. This current collaboration builds on work started many years ago. At the height of the AIDS epidemic in 2003, for example, IHI President Emeritus and Senior Fellow Don Berwick and former IHI Vice President Joe McCannon worked with the WHO on its 3 by 5 initiative to provide three million people living with HIV/AIDS in low- and middle-income countries with life-prolonging antiretroviral treatment by the end of 2005. They worked with Jim Yong Kim, who was then adviser to the director-general of the WHO, and a young doctor, Kedar Mate, who is now IHI’s new President and CEO. The 3 by 5 initiative was the WHO’s most ambitious rapid implementation initiative to date and was a catalyst for other global efforts, including the US government’s PEPFAR program that resulted in the highly successful global response to the HIV epidemic.

More recently, IHI’s working relationship with the WHO developed further through my secondment to the organization in 2015. I worked at the WHO headquarters to help design a QI plan to decrease maternal and newborn deaths by 50 percent in five years. In 2017, the WHO convened 10 countries to work as a learning network of national health systems to test and scale up the first WHO multi-nation implementation plan to meet this ambitious goal. It was the first to be based on IHI’s collaborative improvement design. The expanding WHO network of countries undertaking this work will now receive further technical support from IHI and others through the recent five-year USAID MOMENTUM (or Moving Integrated, Quality Maternal, Newborn, and Child Health and Family Planning and Reproductive Health Services to Scale) award. Sodzi Sodzi-Tettey, IHI’s Head of Africa Region, and I have also worked with our WHO counterparts in safety and systems delivery to support the emergence and deployment of the WHO’s guidance on National Quality Policy and partnered with the WHO on a IHI Board-supported investment to bring safety methods to African health systems.

Since its inception, the WHO has played a crucial role in convening, synthesizing, and guiding the deployment of global health knowledge and IHI plans to continue sharing our ideas, experience, and expertise to support its goals. In fact, IHI is part of a small group of organizations invited to attend a workshop convened by the WHO to co-design global guidance to avert the potential global catastrophe of the disruption of non-COVID essential services, including maternity care. As COVID-19 is now taking hold in some of the world’s poorer countries, the WHO needs our unwavering support, not threats to its existence that would have disastrous consequences for many of the planet’s most vulnerable citizens.

Pierre M. Barker, MD, MBChB, is IHI's Chief Global Programs and Partnerships Officer.