Earmarking Global Health Security: The Effect of WHO’s Funding System in Its Responses to Ebola and COVID-19

다국어 초록 (Multilingual Abstract)

The international organizations have been experiencing a continuous increase of voluntary contributions in recent years. The World Health Organization (WHO), also observing this trend, serves as an extreme case with access to less than 20 percent of flexible funds. As leader of global health security, WHO has played a fundamental role in responding to health emergencies by taking the leadership in the shaping of health agendas, provision of technical assistance and coordination of responses. However, the organization’s limitations were prominently highlighted during the West African Ebola Epidemic in 2014, which was larger in scale than previous outbreaks. The reactive responses were attributable to the lack of flexible funds, impeding the rapid mobilization of resources and proper responses during emergencies. This financially-distorted mobilization issue has been further solidified during the COVID-19 pandemic, adding onto the ongoing financial frustrations. Therefore, with the consideration of the long-persisted problem of financial stress largely accounted for by the continuous rise of voluntary funds, this research investigates the challenges to proactive WHO response through the cases of Ebola and COVID-19 outbreaks, as well as the consequent trajectory of WHO financing through the Path dependence theory.

참고문헌 (Reference)

1 Moon, S., "Will Ebola Change the Game? Ten Essential Reforms before the Next Pandemic. The Report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola" 386 (386): 2,204-2,221, 2015

2 Kmietowicz, Z, "Who Will Review Its Response to Ebola Once Outbreak Is Under Control" 349 : 2014

3 Council on Foreign Relations(CFR), "What does the World Health Organization Do?"

4 Eichenauer, V. Z., "What Determines Earmarked Funding to International Development Organizations? Evidence from the New Multi-bi Aid Data" 12 (12): 171-197, 2017

5 Castaldi, C., "Understanding Change: Models, Methodologies, and Metaphors" Palgrave Macmillan 99-128, 2005

6 Sridhar, D., "Trojan Multilateralism : Global Cooperation in Health" 4 (4): 325-335, 2013

7 Meier, B. M., "The World Health Organization in Global Health Law" 48 (48): 796-799, 2020

8 Council on Foreign Relations(CFR), "The WHO and China : Dereliction of Duty"

9 Aust, H. P., "The WHO Foundation and the Law of International Organizations: Towards Better Funding for Global Health?" 19 : 332-364, 2022

10 Karl, T. L, "The Paradox of Plenty : Oil Booms and Petro-States" University of California Press 1997

11 Capoccia, G, "The Oxford Handbook of Historical Institutionalism" Oxford University Press 89-106, 2016

12 Mahoney, J., "The Oxford Handbook of Contextual Political Analysis" Oxford University Press 454-471, 2009

13 Sewell, W. H, "The Historic Turn in the Human Sciences" University of Michigan Press 245-280, 1996

14 Ruger, J. P., "The Global Role of the World Health Organization" 2 (2): 1-11, 2009

15 Mahn, T, "The Financing of Development Cooperation at the United Nations: Why More Means Less" German Development Institute/Deutsches Institut für Entwicklungspolitik (DIE) 2012

16 Kalra, S., "The Emergence of Ebola as a Global Health Security Threat : From ‘Lessons Learned’ to Coordinated Multilateral Containment Efforts" 6 (6): 164-177, 2014

17 Browne, S., "Sweden’s Financing of UN Funds and Programmes : Analyzing the Past, Looking to the Future" Expertgruppen för Iståndsanalys 2017

18 Collier, R., "Shaping the Political Arena: Critical Junctures, the Labor Movement, and Regime Dynamics in Latin America" Princeton University Press 1991

19 Hinjoy, S., "Self-assessment of the Thai Department of Disease Control’s Communication for International Response to Covid-19 in the Early Phase" 96 : 205-210, 2020

20 World Health Organization(WHO), "Report of the Ebola Interim Assessment Panel" World Health Organization 2015

21 Gostin, L. O., "Reimagining Global Health Governance in the Age of Covid-19" 110 (110): 1,615-1,619, 2020

22 Mahoney, J., "Path Dependence in Historical Sociology" 29 : 507-548, 2000

23 Ruggie, J. G., "Multilateralism : The Anatomy of an Institution" 46 (46): 561-598, 1992

24 Graham, E. R., "Money and Multilateralism : How Funding Rules Constitute IO Governance" 7 (7): 162-194, 2015

25 Goldstone, J. A., "Initial Conditions, General Laws, Path Dependence, and Explanation in Historical Sociology" 104 (104): 829-845, 1998

26 Pierson, P., "Increasing Returns, Path Dependence, and the Study of Politics" 94 (94): 251-267, 2000

27 Baumann, M., "How earmarking has become self-perpetuating in United Nations Development Co-Operation" 39 (39): 343-359, 2020

28 Reinsberg, B., "Handbook on the Economics of Foreign Aid" Edward Elgar 527-554, 2015

29 Kapur, D, "Governing Globalization: Issues and Institutions" Oxford University Press 334-355, 2002

30 Davies, S. E, "Global Politics of Health" Polity 2010

31 Heymann, D. L., "Global Health Security : The Wider Lessons from the West African Ebola Virus Disease Epidemic" 385 (385): 1,884-1,901, 2015

32 Daugirdas, K., "Financing the World Health Organization" 16 (16): 299-338, 2019

33 Gostin, L. O., "Financing the Future of WHO" 399 (399): 1,445-1,447, 2022

34 Yamey, G., "Financing Global Common Goods for Health : When the World is a Country" 5 (5): 334-349, 2019

35 Philips, M., "Ebola : A Failure of International Collective Action" 384 (384): 1,181-, 2014

36 Gostin, L. O., "Ebola : A Crisis in Global Health Leadership" 384 (384): 1,323-1,325, 2014

37 Baumann, M, "Earmarked funding for multilateral development cooperation: asset and impediment" German Development Institute/Deutsches Institut für Entwicklungspolitik (DIE) 2020

38 BBC, "Coronavirus: Trump accuses who of being a ‘puppet of China.’"

39 Schmid, L. K., "Blessing or Curse? The Effects of Earmarked Funding in UNICEF and UNDP" 27 (27): 433-459, 2021

40 Global Preparedness Monitoring Board(GPMB), "A World at Risk : Annual Report on Global Preparedness for Health Emergencies" Global Preparedness Monitoring Board 2019