世界保健機関 World Health Organization
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世界保健機関 | |
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各国語表記
World Health Organization(英語) |
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WHOの旗(蛇と杖のマークはギリシャ神話の医学神アスクレピオスに由来する
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概要 | 専門機関 |
略称 | 英語: WHO フランス語: OMS |
代表 | 陳馮富珍 |
状況 | 活動中 |
活動開始 | 1948年 |
本部 | スイス・ジュネーヴ |
公式サイト | World Health Organization(日本語) World Health Organization(英語) |
United Nations World Health Organisation Portal:国際連合 |
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テンプレートを表示 |
世界保健機関(せかいほけんきかん、英: World Health Organization, WHO、仏: Organisation mondiale de la santé, OMS)は、人間の健康を基本的人権の一つと捉え、その達成を目的として設立された国際連合の専門機関(国際連合機関)である。略称は英語式(WHO)と仏語式(OMS)で異なる。日本をはじめ多くの国では英語略称のWHO(ダブリュー・エイチ・オー)が多用される。(以下「WHO」と表記する。読みについては後述)
1948年設立。本部はスイス・ジュネーヴ。設立日である4月7日は、世界保健デーになっている。
WHOでは「健康」を「完全な身体的、精神的及び社会的 福祉の状態であり、単に疾病又は病弱の存在しないことではない」(WHO憲章前文)と定義しており、非常に広範な目標を掲げている。
そのために、病気の撲滅のための研究、適正な医療・医薬品の普及だけでなく、ベーシック・ヒューマン・ニーズ(BHN)の達成や健康的なライフスタイルの推進にも力を入れている。また組織の肥大化と共に企業との癒着構造が問題として指摘されている。[要出典]
WHOの最高意思決定機関は総会である。総会には加盟国すべてが代表を送ることができる。総会においては3分の2の多数によって条約や協定を制定することができる。この条約は加盟国には強制力はないものの、加盟国はたとえ自国の代表が反対した条約でも18ヶ月以内に国内での採択に向けて何らかのアクションを起こさなければならない。また、総会においては34カ国の委員を3年任期で執行理事会理事に選出し、これによって構成される執行理事会が総会の執行機関となる。また、常設の事務局があり、総会の議決に基づき通常業務を行う。事務局長がWHOのトップとなる。事務局長は総会において選出される。[1]
2016年5月現在、194の国と地域が加盟している[2]。
右の図のように、世界に6つの地域事務局が置かれ、それぞれに管轄地域が与えられている。
代 | 事務局長 | 任期 | 国 | |
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1 | ブロック・チゾム | 1948年 - 1953年 | カナダ | |
2 | マルコリーノ・ゴメス・カンダウ | 1953年 - 1973年 | ブラジル | |
3 | ハルフダン・T・マーラー(英語版) | 1973年 - 1988年 | デンマーク | |
4 | 中嶋宏 | 1988年 - 1998年 | 日本 | |
5 | グロ・ハーレム・ブルントラント | 1998年 - 2003年 | ノルウェー | |
6 | 李鍾郁 | 2003年 - 2006年 | 大韓民国 | |
臨 時 |
アンデルス・ノルドストレム | 2006年 - 2007年 | スウェーデン | |
7 | 陳馮富珍(マーガレット・チャン) | 2007年 - (現職) | 中国・香港 |
全世界的な公衆衛生や健康に関する最初の国際的機関は、1907年12月に発足した国際公衆衛生事務局である。本部をパリに置いたこの機関は、12カ国が「公衆衛生国際事務局設置に関する千九百七年のローマ協定」[3]に調印することによって発足し、当初はヨーロッパだけを対象としたものだったのが、第一次世界大戦の勃発する1914年までには60カ国が参加するまでになっていた。第一次世界大戦後、発足した国際連盟は国際公衆衛生の専門機関を発足させようとしたが、国際公衆衛生事務局は原調印国であるアメリカ合衆国が国際連盟に不参加を決めたため、連盟とは別組織のままで存続することとなった。第二次世界大戦後、新たな健康に関する国際機関の設立が提唱され、1946年7月22日に国連経済社会理事会が世界保健機関の憲章を採択。連盟の保健局や国際公衆衛生事務局を解散して、1948年4月7日に世界保健機関が設立された[4]。 日本は1956年の国際連合加盟に先立つ1951年5月にWHOに加盟した。
WHOの功績の中でももっとも輝かしいものは、天然痘の撲滅に成功したことである。天然痘は非常に高い致死率を持ち世界各地で多大な死者を出した病気であったが、症状が明確に判別できるため対処しやすく、ヒト以外に感染することがないため人間のみの対策で対処でき、さらに種痘による完全な予防法が確立されていたことから、撲滅は原理的には可能であると考えられていた。こうしたことから、1958年に総会でソ連の生物学者ヴィクトル・ジダーノフが提案[5]した「世界天然痘根絶決議」の全会一致の可決で撲滅計画は始まったが、当初は人類すべてへの種痘による撲滅を目指していたため、医療や行政の整っていない発展途上国においては対策が行き届かず、撲滅にはほど遠い状態がつづいていた。そこでよりこの計画を推進するため、1967年には特別予算が組まれるとともに、10年後の1977年までに天然痘を撲滅させることが明確に謳われた。このときに方針が転換され、流行地域において賞金を懸けることで患者を発見し、患者が見つかるとその患者に接触した人物を根こそぎ調べ上げて徹底的にその周囲で種痘を行う、いわゆる封じ込め政策へと移行した[6]。このとき、世界には天然痘の患者が1000万から1500万人いると推定されていた。しかし、この封じ込め政策は功を奏し、患者数は激減していった。1970年代に入ると南アジアと南アメリカで相次いで撲滅が宣言され、1977年にソマリアで発見された患者を最後に天然痘は地球上から姿を消した。そして、患者が発生しなくなってから3年後の1980年、WHO総会は天然痘の撲滅を正式に宣言した。[7]
天然痘を撲滅したWHOが次に撲滅の目標に定めたのは急性灰白髄炎(ポリオ)だった。1988年には「世界ポリオ撲滅計画(Global Polio Eradication Initiative)」が開始され、2000年までのポリオ撲滅が謳われた。しかしその後計画は難航し、2016年現在、いまだパキスタン、アフガニスタン、ナイジェリアの3か国においてポリオ患者が発生している状態となっている。このほか、1995年には「アフリカ・オンコセルカ症対策計画(African Programme for Onchocerciasis Control)」が開始され、オンコセルカ症(河川盲目症)の撲滅が進められている。
2009年から10年にかけての新型インフルエンザの世界的流行に際し、WHOのマーガレット・チャン事務局長は「今、すべての人類が脅威にさらされている」として、新型インフルエンザをすべての人類の脅威とする広報を行った。その後、新型インフルエンザが弱毒性である事が発覚するも、顕著な感染や死亡の被害が著しい事態を想定した警告であるフェーズレベル6/6と警告し、パンデミック(世界的大流行)を宣言した。 しかし「すべての人類の脅威」とまで宣言された新型インフルエンザは、他の季節性インフルエンザと大差ないレベルのインフルエンザで被害も小さなものであった[8]。一連のWHOの誤報を重く見た欧州議会は、パンデミック宣言に至った経緯の調査に踏み出す事態となった。
欧州議会のボーダルク前保健衛生委員長は、WHOの宣言は偽のパンデミックであったとして問題提起をしている。WHOの意思決定には製薬会社の意向が大きく影響した可能性が高いとしている。製薬会社は研究所などで働く科学者へ大きな影響力を持っており、この事と今回WHOが広く科学者の意見を求めた事がその影響力を強める原因になったと語っている。一方、新型インフルエンザワクチン製造なども行い、世界最大規模の製薬会社であるグラクソ・スミスクライン社(英国)は、製薬会社がWHOのパンデミック宣言に影響を与えているなどの認識は誤りであるとインタビューに応えている。[9]
2010年1月になるとワクチンが世界的に余剰状態となり、キャンセルや転売が相次ぐ事態となっている。
1959年に結んだIAEAとの規定では、「IAEA(原発推進を掲げている)の許可なしに、放射線の影響における科学論文を公表してはならない」となっている[10]。WHO議長はこの事について「WHOがIAEAに従属しているので、健康は原子力に従属する」と発言している[11]。
英語式略称の WHO は「ダブリュー・エイチ・オー」とイニシャル読みするのが正しく、「フー」とアクロニム読みにはしない。しかし、辞書によっては「フー」という表記も見られる[12][13]。
[ヘルプ] |
ウィキメディア・コモンズには、世界保健機関に関連するカテゴリがあります。 |
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World Health Organization |
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Flag of the World Health Organization
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Abbreviation | WHO OMS |
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Formation | 7 April 1948; 68 years ago (1948-04-07) |
Type | Specialized agency of the United Nations |
Legal status | Active |
Headquarters | Geneva, Switzerland |
Head
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Margaret Chan, Director General |
Parent organization
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United Nations Economic and Social Council (ECOSOC) |
Website | www |
The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, headquartered in Geneva, Switzerland. The WHO is a member of the United Nations Development Group. Its predecessor, the Health Organization, was an agency of the League of Nations.
The constitution of the World Health Organization had been signed by 61 countries on 22 July 1946, with the first meeting of the World Health Assembly finishing on 24 July 1948. It incorporated the Office international d'hygiène publique and the League of Nations Health Organization. Since its creation, it has played a leading role in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; the mitigation of the effects of non-communicable diseases; sexual and reproductive health, development, and aging; nutrition, food security and healthy eating; occupational health; substance abuse; and driving the development of reporting, publications, and networking.
The WHO is responsible for the World Health Report, a leading international publication on health, the worldwide World Health Survey, and World Health Day (7 April of every year). The head of WHO is Margaret Chan.
The 2014/2015 proposed budget of the WHO is about US$4 billion.[1] About US$930 million are to be provided by member states with a further US$3 billion to be from voluntary contributions.[1]
During the 1945 United Nations Conference on International Organization, Dr. Szeming Sze, a delegate from China, conferred with Norwegian and Brazilian delegates on creating an international health organization under the auspices of the new United Nations. After failing to get a resolution passed on the subject, Alger Hiss, the Secretary General of the conference, recommended using a declaration to establish such an organization. Dr. Sze and other delegates lobbied and a declaration passed calling for an international conference on health.[2] The use of the word "world", rather than "international", emphasized the truly global nature of what the organization was seeking to achieve.[3] The constitution of the World Health Organization was signed by all 51 countries of the United Nations, and by 10 other countries, on 22 July 1946.[4] It thus became the first specialised agency of the United Nations to which every member subscribed.[5] Its constitution formally came into force on the first World Health Day on 7 April 1948, when it was ratified by the 26th member state.[4] The first meeting of the World Health Assembly finished on 24 July 1948, having secured a budget of US$5 million (then GB£1,250,000) for the 1949 year. Andrija Stampar was the Assembly's first president, and G. Brock Chisholm was appointed Director-General of WHO, having served as Executive Secretary during the planning stages.[3] Its first priorities were to control the spread of malaria, tuberculosis and sexually transmitted infections, and to improve maternal and child health, nutrition and environmental hygiene. Its first legislative act was concerning the compilation of accurate statistics on the spread and morbidity of disease.[3] The logo of the World Health Organization features the Rod of Asclepius as a symbol for healing.[6]
IT established an epidemiological information service via telex in 1947, and by 1950 a mass tuberculosis inoculation drive (using the BCG vaccine) was under way. In 1955, the malaria eradication programme was launched, although it was later altered in objective. 1965 saw the first report on diabetes mellitus and the creation of the International Agency for Research on Cancer. WHO moved into its headquarters building in 1966. The Expanded Programme on Immunization was started in 1974, as was the control programme into onchocerciasis – an important partnership between the Food and Agriculture Organization (FAO), the United Nations Development Programme (UNDP), and World Bank. In the following year, the Special Programme for Research and Training in Tropical Diseases was also launched. In 1976, the World Health Assembly voted to enact a resolution on Disability Prevention and Rehabilitation, with a focus on community-driven care. The first list of essential medicines was drawn up in 1977, and a year later the ambitious goal of "health for all" was declared. In 1986, WHO started its global programme on the growing problem of HIV/AIDS, followed two years later by additional attention on preventing discrimination against sufferers and UNAIDS was formed in 1996. The Global Polio Eradication Initiative was established in 1988.[7]
In 1958, Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox, resulting in Resolution WHA11.54.[8] At this point, 2 million people were dying from smallpox every year. In 1967, the World Health Organization intensified the global smallpox eradication by contributing $2.4 million annually to the effort and adopted a new disease surveillance method.[9][10] The initial problem the WHO team faced was inadequate reporting of smallpox cases. WHO established a network of consultants who assisted countries in setting up surveillance and containment activities.[11] The WHO also helped contain the last European outbreak in Yugoslavia in 1972.[12] After over two decades of fighting smallpox, the WHO declared in 1979 that the disease had been eradicated – the first disease in history to be eliminated by human effort.[13]
In 1998, WHO's Director General highlighted gains in child survival, reduced infant mortality, increased life expectancy and reduced rates of "scourges" such as smallpox and polio on the fiftieth anniversary of WHO's founding. He, did, however, accept that more had to be done to assist maternal health and that progress in this area had been slow.[14] Cholera and malaria have remained problems since WHO's founding, although in decline for a large part of that period.[15] In the twenty-first century, the Stop TB Partnership was created in 2000, along with the UN's formulation of the Millennium Development Goals. The Measles initiative was formed in 2001, and credited with reducing global deaths from the disease by 68% by 2007. In 2002, The Global Fund to Fight AIDS, Tuberculosis and Malaria was drawn up to improve the resources available.[7] In 2006, the organization endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe, which formed the basis for a global prevention, treatment and support plan to fight the AIDS pandemic.[16]
The WHO's Constitution states that its objective "is the attainment by all people of the highest possible level of health".[17]
WHO fulfills its objective through its functions as defined in its Constitution: (a) to act as the directing and co-ordinating authority on international health work (b) to establish and maintain effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups and such other organizations as may be deemed appropriate (c) to assist Governments, upon request, in strengthening health services (d) to furnish appropriate technical assistance and, in emergencies, necessary aid upon the request or acceptance of Governments (e) to provide or assist in providing, upon the request of the United Nations, health services and facilities to special groups, such as the peoples of trust territories (f) to establish and maintain such administrative and technical services as may be required, including epidemiological and statistical services (g) to stimulate and advance work to eradicate epidemic, endemic and other diseases (h) to promote, in co-operation with other specialized agencies where necessary, the prevention of accidental injuries (i) to promote, in co-operation with other specialized agencies where necessary, the improvement of nutrition, housing, sanitation, recreation, economic or working conditions and other aspects of environmental hygiene (j) to promote co-operation among scientific and professional groups which contribute to the advancement of health (k) to propose conventions, agreements and regulations, and make recommendations with respect to international health matters and to perform.
WHO currently defines its role in public health as follows:[18]
The 2012–2013 WHO budget identified 5 areas among which funding was distributed.[20] Two of those five areas related to communicable diseases: the first, to reduce the "health, social and economic burden" of communicable diseases in general; the second to combat HIV/AIDS, malaria and tuberculosis in particular.[20]
In terms of HIV/AIDS, WHO works within the UNAIDS network and considers it important that it works in alignment with UNAIDS objectives and strategies. It also strives to involve sections of society other than health to help deal with the economic and social effects of the disease.[21] In line with UNAIDS, WHO has set itself the interim task between 2009 and 2015 of reducing the number of those aged 15–24 years who are infected by 50%; reducing new HIV infections in children by 90%; and reducing HIV-related deaths by 25%.[22]
Although WHO dropped its commitment to a global malaria eradication campaign in the 1970s as too ambitious, it retains a strong commitment to malaria control. WHO's Global Malaria Programme works to keep track of malaria cases, and future problems in malaria control schemes. WHO is to report, likely in 2015, as to whether RTS,S/AS01, currently in research, is a viable malaria vaccine. For the time being, insecticide-treated mosquito nets and insecticide sprays are used to prevent the spread of malaria, as are antimalarial drugs – particularly to vulnerable people such as pregnant women and young children.[23]
WHO's help has contributed to a 40% fall in the number of deaths from tuberculosis between 1990 and 2010, and since 2005, it claims that over 46 million people have been treated and an estimated 7 million lives saved through practices advocated by WHO. These include engaging national governments and their financing, early diagnosis, standardising treatment, monitoring of the spread and impact of tuberculosis and stabilising the drug supply. It has also recognised the vulnerability of victims of HIV/AIDS to tuberculosis.[24]
WHO aims to eradicate polio. It has also been successful in helping to reduce cases by 99% since the Global Polio Eradication Initiative was launched in 1988, which partnered WHO with Rotary International, the US Centers for Disease Control and Prevention (CDC) and the United Nations Children's Fund (UNICEF), as well as smaller organizations. It works to immunize young children and prevent the re-emergence of cases in countries declared "polio-free".[25]
Another of the thirteen WHO priority areas is aimed at the prevention and reduction of "disease, disability and premature deaths from chronic noncommunicable diseases, mental disorders, violence and injuries, and visual impairment".[20][26]
The WHO estimates that 12.6 million people died as a result of living or working in an unhealthy environment in 2012 – this accounts for nearly 1 in 4 of total global deaths. Environmental risk factors, such as air, water and soil pollution, chemical exposures, climate change, and ultraviolet radiation, contribute to more than 100 diseases and injuries. This can result in a number of pollution-related diseases.
WHO works to "reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy aging for all individuals".[20][27]
It also tries to prevent or reduce risk factors for "health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets and physical inactivity and unsafe sex".[20][28][29]
WHO works to improve nutrition, food safety and food security and to ensure this has a positive effect on public health and sustainable development.[20]
The WHO promotes road safety as a means to reduce traffic-related injuries.[30]
WHO has also worked on global initiatives in surgery, including emergency and essential surgical care,[31] trauma care,[32] and safe surgery.[33] The WHO Surgical Safety Checklist is in current use worldwide in the effort to improve patient safety.[34]
The World Health Organization's primary objective in natural and man-made emergencies is to coordinate with Member States and other stakeholders to "reduce avoidable loss of life and the burden of disease and disability."[20]
On 5 May 2014, WHO announced that the spread of polio is a world health emergency – outbreaks of the disease in Asia, Africa and the Middle East are considered "extraordinary".[35][36]
On 8 August 2014, WHO declared that the spread of Ebola is a public health emergency; an outbreak which is believed to have started in Guinea, has spread to other nearby countries such as Liberia and Sierra Leone. The situation in West Africa is considered very serious.[37]
WHO addresses government health policy with two aims: firstly, "to address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches" and secondly "to promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health".[20]
The organization develops and promotes the use of evidence-based tools, norms and standards to support member states to inform health policy options. It oversees the implementation of the International Health Regulations, and publishes a series of medical classifications; of these, three are overreaching "reference classifications": the International Statistical Classification of Diseases (ICD), the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Health Interventions (ICHI).[38] Other international policy frameworks produced by WHO include the International Code of Marketing of Breast-milk Substitutes (adopted in 1981),[39] Framework Convention on Tobacco Control (adopted in 2003)[40] and the Global Code of Practice on the International Recruitment of Health Personnel (adopted in 2010).[41]
In terms of health services, WHO looks to improve "governance, financing, staffing and management" and the availability and quality of evidence and research to guide policy making. It also strives to "ensure improved access, quality and use of medical products and technologies".[20] WHO - working with donor agencies and national governments - can improve their use of and their reporting about their use of research evidence.[42]
The remaining two of WHO's thirteen identified policy areas relate to the role of WHO itself:[20]
The WHO along with the World Bank constitute the core team responsible for administering the International Health Partnership (IHP+). The IHP+ is a group of partner governments, development agencies, civil society and others committed to improving the health of citizens in developing countries. Partners work together to put international principles for aid effectiveness and development cooperation into practice in the health sector.[43]
The organization relies on contributions from renowned scientists and professionals to inform its work, such as the WHO Expert Committee on Biological Standardization,[44] the WHO Expert Committee on Leprosy,[45] and the WHO Study Group on Interprofessional Education & Collaborative Practice.[46]
WHO runs the Alliance for Health Policy and Systems Research, targeted at improving health policy and systems.[47]
WHO also aims to improve access to health research and literature in developing countries such as through the HINARI network.[48]
Each year, the organization marks World Health Day and other observances focusing on a specific health promotion topic. World Health Day falls on 7 April each year, timed to match the anniversary of WHO's founding. Recent themes have been vector-borne diseases (2014), healthy ageing (2012) and drug resistance (2011).[49]
The other official global public health campaigns marked by WHO are World Tuberculosis Day, World Immunization Week, World Malaria Day, World No Tobacco Day, World Blood Donor Day, World Hepatitis Day, and World AIDS Day.
As part of the United Nations, the World Health Organization supports work towards the Millennium Development Goals.[50] Of the eight Millennium Development Goals, three – reducing child mortality by two-thirds, to reduce maternal deaths by three-quarters, and to halt and begin to reduce the spread of HIV/AIDS – relate directly to WHO's scope; the other five inter-relate and have an impact on world health.[51]
The World Health Organization works to provide the needed health and well-being evidence through a variety of data collection platforms, including the World Health Survey covering almost 400,000 respondents from 70 countries,[52] and the Study on Global Ageing and Adult Health (SAGE) covering over 50,000 persons over 50 years old in 23 countries.[53] The Country Health Intelligence Portal (CHIP), has also been developed to provide an access point to information about the health services that are available in different countries.[54] The information gathered in this portal is utilized by the countries to set priorities for future strategies or plans, implement, monitor, and evaluate it.
The WHO has published various tools for measuring and monitoring the capacity of national health systems[55] and health workforces.[56] The Global Health Observatory (GHO) has been the WHO's main portal which provides access to data and analyses for key health themes by monitoring health situations around the globe.[57]
The WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), the WHO Quality of Life Instrument (WHOQOL), and the Service Availability and Readiness Assessment (SARA) provide guidance for data collection.[58] Collaborative efforts between WHO and other agencies, such as through the Health Metrics Network, also aim to provide sufficient high-quality information to assist governmental decision making.[59] WHO promotes the development of capacities in member states to use and produce research that addresses their national needs, including through the Evidence-Informed Policy Network (EVIPNet).[60] The Pan American Health Organization (PAHO/AMRO) became the first region to develop and pass a policy on research for health approved in September 2009.[61]
On 10 December 2013, a new WHO database, known as MiNDbank, went online. The database was launched on Human Rights Day, and is part of WHO's QualityRights initiative, which aims to end human rights violations against people with mental health conditions. The new database presents a great deal of information about mental health, substance abuse, disability, human rights, and the different policies, strategies, laws, and service standards being implemented in different countries.[62] It also contains important international documents and information. The database allows visitors to access the health information of WHO member states and other partners. Users can review policies, laws, and strategies and search for the best practices and success stories in the field of mental health.[62]
The WHO regularly publishes a World Health Report, its leading publication, including an expert assessment of a specific global health topic.[63] Other publications of WHO include the Bulletin of the World Health Organization,[64] the Eastern Mediterranean Health Journal (overseen by EMRO),[65] the Human Resources for Health (published in collaboration with BioMed Central),[66] and the Pan American Journal of Public Health (overseen by PAHO/AMRO).[67]
The World Health Organization is a member of the United Nations Development Group.[68]
As of 2015[update], the WHO has 194 member states: all of them Member States of the United Nations except for the Cook Islands and Niue.[69] (A state becomes a full member of WHO by ratifying the treaty known as the Constitution of the World Health Organization.) As of 2013[update], it also had two associate members, Puerto Rico and Tokelau.[70] Several other countries have been granted observer status. Palestine is an observer as a "national liberation movement" recognised by the League of Arab States under United Nations Resolution 3118. The Holy See also attends as an observer, as does the Order of Malta.[71] In 2010, Taiwan was invited under the name of "Chinese Taipei".[72]
WHO Member States appoint delegations to the World Health Assembly, WHO's supreme decision-making body. All UN Member States are eligible for WHO membership, and, according to the WHO web site, "other countries may be admitted as members when their application has been approved by a simple majority vote of the World Health Assembly".[69]
In addition, the UN observer organizations International Committee of the Red Cross and International Federation of Red Cross and Red Crescent Societies have entered into "official relations" with WHO and are invited as observers. In the World Health Assembly they are seated alongside the other NGOs.[71]
The World Health Assembly is the legislative and supreme body of WHO. Based in Geneva, it typically meets yearly in May. It appoints the Director-General every five years, and votes on matters of policy and finance of WHO, including the proposed budget. It also reviews reports of the Executive Board and decides whether there are areas of work requiring further examination. The Assembly elects 34 members, technically qualified in the field of health, to the Executive Board for three-year terms. The main functions of the Board are to carry out the decisions and policies of the Assembly, to advise it and to facilitate its work.[73]
The regional divisions of WHO were created between 1949 and 1952, and are based on article 44 of WHO's constitution, which allowed the WHO to "establish a [single] regional organization to meet the special needs of [each defined] area". Many decisions are made at regional level, including important discussions over WHO's budget, and in deciding the members of the next assembly, which are designated by the regions.[74]
Each region has a Regional Committee, which generally meets once a year, normally in the autumn. Representatives attend from each member or associative member in each region, including those states that are not fully recognised. For example, Palestine attends meetings of the Eastern Mediterranean Regional office. Each region also has a regional office.[74] Each Regional Office is headed by a Regional Director, who is elected by the Regional Committee. The Board must approve such appointments, although as of 2004, it had never overruled the preference of a regional committee. The exact role of the board in the process has been a subject of debate, but the practical effect has always been small.[74] Since 1999, Regional Directors serve for a once-renewable five-year term.[75]
Each Regional Committee of the WHO consists of all the Health Department heads, in all the governments of the countries that constitute the Region. Aside from electing the Regional Director, the Regional Committee is also in charge of setting the guidelines for the implementation, within the region, of the health and other policies adopted by the World Health Assembly. The Regional Committee also serves as a progress review board for the actions of WHO within the Region.
The Regional Director is effectively the head of WHO for his or her Region. The RD manages and/or supervises a staff of health and other experts at the regional offices and in specialized centers. The RD is also the direct supervising authority—concomitantly with the WHO Director-General—of all the heads of WHO country offices, known as WHO Representatives, within the Region.
Region | Headquarters | Notes | Website |
---|---|---|---|
Africa | Brazzaville, Republic of Congo | AFRO includes most of Africa, with the exception of Egypt, Sudan, Djibouti, Tunisia, Libya, Somalia and Morocco (all fall under EMRO).[76][77] The Regional Director is Matshidiso Moeti. | AFRO |
Europe | Copenhagen, Denmark. | EURO includes Europe, Israel, and former USSR, except Liechtenstein.[77] | EURO |
South-East Asia | New Delhi, India | North Korea is served by SEARO.[78] | SEARO |
Eastern Mediterranean | Cairo, Egypt | Eastern Mediterranean Regional office includes the countries of Africa that are not included in AFRO, as well as the countries of the Middle East, except for Israel. Pakistan is served by EMRO.[79] | EMRO |
Western Pacific | Manila, Philippines. | WPRO covers all the Asian countries not served by SEARO and EMRO, and all the countries in Oceania. South Korea is served by WPRO.[80] | WPRO |
The Americas | Washington D.C., USA. | Also known as the Pan American Health Organization (PAHO), and covers the Americas.[81] The Regional Director is Carissa F. Etienne. | AMRO |
Name | Years of Tenure |
---|---|
Margaret Chan | since 2006 |
Anders Nordström* | 2006 (acting) |
Lee Jong-wook | 2003–2006 |
Gro Harlem Brundtland | 1998–2003 |
Hiroshi Nakajima | 1988–1998 |
Halfdan T. Mahler | 1973–1988 |
Marcolino Gomes Candau | 1953–1973 |
Brock Chisholm | 1948–1953 |
*Acting Director-General following the death of Lee Jong-wook while in office |
The head of the organization is the Director-General, elected by the World Health Assembly.[73] The current Director-General is Margaret Chan, who was first appointed on 9 November 2006[83] and confirmed for a second term until the end of June 2017.[84]
WHO employs 8,500 people in 147 countries.[85] In support of the principle of a tobacco-free work environment the WHO does not recruit cigarette smokers.[86] The organization has previously instigated the Framework Convention on Tobacco Control in 2003.[87]
The WHO operates "Goodwill Ambassadors", members of the arts, sport or other fields of public life aimed at drawing attention to WHO's initiatives and projects. There are currently five Goodwill Ambassadors (Jet Li, Nancy Brinker, Peng Liyuan, Yohei Sasakawa and the Vienna Philharmonic Orchestra) and a further ambassador associated with a partnership project (Craig David).[88]
The World Health Organization operates 147 country offices in all its regions.[89] It also operates several liaison offices, including those with the European Union, United Nations and a single office covering the World Bank and International Monetary Fund. It also operates the International Agency for Research on Cancer in Lyon, France, and the WHO Centre for Health Development in Kobe, Japan.[90] Additional offices include those in Pristina; the West Bank and Gaza; the US-Mexico Border Field Office in El Paso; the Office of the Caribbean Program Coordination in Barbados; and Northern Micronesia office.[91] There will generally be one WHO country office in the capital, occasionally accompanied by satellite-offices in the provinces or sub-regions of the country in question.
The country office is headed by a WHO Representative (WR). As of 2010[update], the only WHO Representative outside Europe to be a national of that country was for the Libyan Arab Jamahiriya ("Libya"); all other staff were international. Those in the Region for the Americas, they are referred to as PAHO/WHO Representatives. In Europe, WHO Representatives also serve as Head of Country Office, and are nationals with the exception of Serbia; there are also Heads of Country Office in Albania, the Russian Federation, Tajikistan, Turkey, and Uzbekistan.[91] The WR is member of the UN system country team which is coordinated by the UN System Resident Coordinator.
The country office consists of the WR, and several health and other experts, both foreign and local, as well as the necessary support staff.[89] The main functions of WHO country offices include being the primary adviser of that country's government in matters of health and pharmaceutical policies.[92]
The WHO is financed by contributions from member states and outside donors. As of 2012[update], the largest annual assessed contributions from member states came from the United States ($110 million), Japan ($58 million), Germany ($37 million), United Kingdom ($31 million) and France ($31 million).[93] The combined 2012–2013 budget has proposed a total expenditure of $3,959 million, of which $944 million (24%) will come from assessed contributions. This represented a significant fall in outlay compared to the previous 2009–2010 budget, adjusting to take account of previous underspends. Assessed contributions were kept the same. Voluntary contributions will account for $3,015 million (76%), of which $800 million is regarded as highly or moderately flexible funding, with the remainder tied to particular programmes or objectives.[94]
In recent years, the WHO's work has involved increasing collaboration with external bodies.[95] As of 2002[update], a total of 473 non-governmental organizations (NGO) had some form of partnership with WHO. There were 189 partnerships with international NGOs in formal "official relations" – the rest being considered informal in character.[96] Partners include the Bill and Melinda Gates Foundation[97] and the Rockefeller Foundation.[98]
In 1959, the WHO signed Agreement WHA 12–40 with the International Atomic Energy Agency (IAEA). The agreement states that the WHO recognises the IAEA as having responsibility for peaceful nuclear energy without prejudice to the roles of the WHO of promoting health. However, the following paragraph adds that "whenever either organization proposes to initiate a programme or activity on a subject in which the other organization has or may have a substantial interest, the first party shall consult the other with a view to adjusting the matter by mutual agreement".[99] The nature of this statement has led some pressure groups and activists (including Women in Europe for a Common Future) to believe that the WHO is restricted in its ability to investigate the effects on human health of radiation caused by the use of nuclear power and the continuing effects of nuclear disasters in Chernobyl and Fukushima. They believe WHO must regain what they see as "independence".[100][101][102]
In 2003, the WHO denounced the Roman Curia's health department's opposition to the use of condoms, saying: "These incorrect statements about condoms and HIV are dangerous when we are facing a global pandemic which has already killed more than 20 million people, and currently affects at least 42 million."[103] As of 2009[update], the Catholic Church remains opposed to increasing the use of contraception to combat HIV/AIDS.[104] At the time, the World Health Assembly President, Guyana's Health Minister Leslie Ramsammy, condemned Pope Benedict's opposition to contraception, saying he was trying to "create confusion" and "impede" proven strategies in the battle against the disease.[105]
The aggressive support of the Bill & Melinda Gates Foundation for intermittent preventive therapy of malaria triggered a memo from the former WHO malaria chief Akira Kochi.[106]
Some of the research undertaken or supported by WHO to determine how people's lifestyles and environments are influencing whether they live in better or worse health can be controversial, as illustrated by a 2003 joint WHO/FAO report on nutrition and the prevention of chronic non-communicable disease,[107] which recommended that sugar should form no more than 10% of a healthy diet. The report led to lobbying by the sugar industry against the recommendation, to which the WHO/FAO responded by including in the report this statement: "The Consultation recognized that a population goal for free sugars of less than 10% of total energy is controversial". It also stood by its recommendation based upon its own analysis of scientific studies.[108] In 2014, WHO reduced recommended sugar levels by half and said that sugar should make up no more than 5% of a healthy diet.[109]
In 2007, the WHO organized work on pandemic influenza vaccine development through clinical trials in collaboration with many experts. A pandemic involving the H1N1 influenza virus was declared by Director-General Margaret Chan in April 2009.
By the post-pandemic period critics claimed the WHO had exaggerated the danger, spreading "fear and confusion" rather than "immediate information".[110] Industry experts countered that the 2009 pandemic had led to "unprecedented collaboration between global health authorities, scientists and manufacturers, resulting in the most comprehensive pandemic response ever undertaken, with a number of vaccines approved for use three months after the pandemic declaration. This response was only possible because of the extensive preparations undertaken in during the last decade".[111]
Following the 2014 Ebola outbreak in West Africa, the organization was heavily criticized for its bureaucracy, insufficient financing, regional structure, and staffing profile.[112]
An internal WHO report on the Ebola response pointed to underfunding and lack of "core capacity" in health systems in developing countries as the primary weaknesses of the existing system. At the annual World Health Assembly in 2015, Director General Margaret Chan announced a $100 million Contingency Fund for rapid response to future emergencies,[113][114] of which it had received $26.9 million by April 2016 (for 2017 disbursement). WHO has budgeted an additional $494 million for its Health Emergencies Programme in 2016-17, for which it had received $140 million by April 2016.[115]
The program was aimed at rebuilding WHO capacity for direct action, which critics said had been lost due to budget cuts in the previous decade that had left the organization in an advisory role dependent on member states for on-the-ground activities. In comparison, billions of dollars have been spent by developed countries on the 2013-16 Ebola epidemic and 2015-16 Zika epidemic.[116]
The WHO has a Framework Convention on Tobacco implementation database which is one of the only mechanisms to help enforce compliance with the FCTC.[117] However, there has been reports of numerous discrepancies between it and national implementation reports on which it was built. As researchers Hoffman and Rizvi report "As of July 4, 2012, 361 (32·7%) of 1104 countries' responses were misreported: 33 (3·0%) were clear errors (eg, database indicated “yes” when report indicated “no”), 270 (24·5%) were missing despite countries having submitted responses, and 58 (5·3%) were, in our opinion, misinterpreted by WHO staff".[118]
The seat of the organization is in Geneva, Switzerland. It was dedicated and opened in 1966.
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国試過去問 | 「097G007」「104G033」「100G010」「098G004」「102B002」「111E030」「095A011」「104E035」「109B004」「099D012」「106E017」「107E005」「113C001」 |
リンク元 | 「100Cases 33」「国際連合」「プライマリヘルスケア」「たばこ規制枠組条約」「世界保健機関」 |
関連記事 | 「W」「who」 |
B
※国試ナビ4※ [097G006]←[国試_097]→[097G008]
CE
※国試ナビ4※ [104G032]←[国試_104]→[104G034]
D
※国試ナビ4※ [100G009]←[国試_100]→[100G011]
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※国試ナビ4※ [098G003]←[国試_098]→[098G005]
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※国試ナビ4※ [102B001]←[国試_102]→[102B003]
A
※国試ナビ4※ [111E029]←[国試_111]→[111E031]
C
※国試ナビ4※ [095A010]←[国試_095]→[095A012]
A
※国試ナビ4※ [104E034]←[国試_104]→[104E036]
D
※国試ナビ4※ [109B003]←[国試_109]→[109B005]
D
※国試ナビ4※ [099D011]←[国試_099]→[099D013]
B
※国試ナビ4※ [106E016]←[国試_106]→[106E018]
E
※国試ナビ4※ [107E004]←[国試_107]→[107E006]
B
※国試ナビ4※ [113B049]←[国試_113]→[113C002]
国際連合は、国際連盟の反省をふまえて第二次世界大戦時の戦勝国である連合国 (第二次世界大戦) (United Nations) が中心となる。1945年10月24日に、アメリカ合衆国のカリフォルニア州サンフランシスコで発足した。最初の加盟国(原加盟国)は51ヵ国であった。
日本はテンプレート:和暦12月18日に80番目の加盟国となった。2006年6月末現在、国際連合の加盟国数は192ヵ国。最も新しい加盟国は、モンテネグロ(2006年6月28日加盟)である。国際連合の本部は、アメリカ合衆国のニューヨーク市マンハッタン島にある。
国際連合本部ビル(オスカー・ニーマイヤーを中心とした建築家国際委員会が設計)は老朽化しており、新館を建築家・槇文彦が設計予定。ただし、国際連合の資金難により計画は滞っている。
…
国連児童基金, UNICEF 国連パレスチナ難民救済事業機関, UNRWA 国連難民高等弁務官事務所, UNHCR 世界食糧計画, WFP 国連訓練調査研究所, UNITAR 国連貿易開発会議, UNCTAD 国連開発計画, UNDP 国連人口基金, UNFPA 国連環境計画, UNEP 国連大学, UNU 婦人の向上のための国際訓練研究所, INSTRAW 国連人間居住センター, UNCHS
.