You only need to take a quick look at the news headlines to realize that there seems
to be an endless stream of health organizations currently giving advice about what to do and
what to expect during this pandemic.
WHO versus CDC - what do they actually do?
And with so many “official” recommendations out there, who are we actually supposed to
be listening to?
You’d be forgiven for getting these two organizations mixed up, since there is a lot
of overlap between them.
Both the Center for Disease Control and the World Health Organization provide health recommendations
based on expert advice, and they both work with partners - including each other! - to
coordinate and implement public health programs around the world.
But they are very different in terms of how they are structured and how they go about
putting their plans into action - and these differences have the potential to create confusion
and conflict during a major health emergency.
We’ve certainly seen this play out during the current COVID-19 pandemic - think confusion
over testing and conflicting early projections.
But before we dive right in to the drama between the CDC and WHO, let’s take a second to
get familiar with these two public health giants and understand what they actually do.
The CDC is a branch of the U.S. government’s Department of Health and Human Services, and
they answer to the U.S. president, Congress and courts.
The CDC is domestically-oriented, meaning that their focus is on health issues that
affect Americans both at home and abroad, but they still do extensive international
work and have offices around the world.
The CDC was created in nineteen forty-six to wage war on mosquitos - their first mission
was to prevent Malaria outbreaks in the South from spreading across the country.
They were given just ten million dollars and four-hundred employees to undertake this ambitious
goal, but once it was achieved, CDC founder Dr. Joseph Mountin pushed to extend their
responsibilities to all communicable diseases.
Under his visionary leadership the CDC grew from a small, insignificant agency to become
the U.S.’s premiere health promotion, prevention and preparedness agency.
Unlike the CDC, WHO is a non-governmental organization that does not answer to any one
government - instead, WHO is governed by the World Health Assembly, a group of health ministers
fromWHO member states who meet once a year to set policies for the organization.
The WHO is internationally oriented - they work primarily within the United Nations system,
but are also very active all across the globe.
The WHO was established in nineteen forty-eight, and we commemorate the birth of this important
organization every year when we celebrate World Health Day on April seventh.
The WHO now has one-hundred and ninety-four member states across six different regions.
There are a hundred and fifty WHO offices around the world for their more than seven
thousand employees, including medical doctors, public health specialists, scientists, economists
and administrative staff.
The most obvious difference between the CDC and WHO is that the CDC is a branch of the
United States government, while WHO is a non-governmental organization.
Both organizations play an advisory role in public health, but the CDC’s status as a
governmental agency gives them some additional power to actually take action during an emergency,
at least within the U.S.
Another major difference between the two organizations is that the CDC relies on their own internal
experts when making recommendations, while WHO bases their recommendations on the advice
of a panel of independent experts from across their member states.
Despite their differences, WHO and the CDC actually do work very closely together in
the interest of global public health.
The U.S. is a member of the WHO’s Pan American Health Organization, and the WHO Regional
Office for the Americas is located in Washington, D.C.
The CDC is also part of the WHO’s Global Influenza Surveillance and Response System,
or GISRS, which was established in nineteen fifty-two in an effort to keep tabs on the
ever-changing influenza virus.
The goal of the GISRS is to reduce the impact of flu-related diseases through effective
vaccines that contain currently-circulating strains of the virus.
The GISRS holds vaccine composition meetings twice a year to make recommendations on which
strains to include in vaccines for the next flu season.
The U.S. has earned a seat at the table for these meetings because the CDC’s Influenza
Division serves as the largest of six global WHO Collaborating Centers for Surveillance,
Epidemiology and Control of Influenza.
These Collaboration Centers are vital to virus surveillance efforts - they gather and analyze
information and samples from more than one-hundred and forty National Influenza Centers around
the world to track influenza trends and help WHO make appropriate recommendations for vaccines
and other strategies.
This is a great example of how governmental health agencies like the CDC collaborate directly
with WHO in the interest of public health both at home and around the world.
While both organizations work together to determine the best strategies, in the end
the WHO can only make recommendations based on the information they’ve gathered and
the advice of their members.
It’s ultimately up to individual governments and their health agencies - like the CDC - to
decide the best course of action for their own country, and to put those plans into motion.
Okay, now that we understand how these organizations are set up, what do they actually do?
The CDC’s mission statement is to “work twenty-four-seven to protect America from
health, safety and security threats, both foreign and in the U.S.
Whether diseases start at home or abroad, are chronic or acute, curable or preventable,
human error or deliberate attack, the CDC fights disease and supports communities and
citizens to do the same.”
The CDC focuses on three main priorities - Pandemic Preparedness, Eliminating Disease and Ending
Epidemics.
They do extensive research on new and mutated germs, and are very active in the field of
drug-resistant bugs, since this trend is a huge threat to human health both in the U.S.
and around the world.
The CDC also takes on chronic health conditions like cancer and diabetes, and non-disease
epidemics like the opioid crisis, since drug addiction and chronic health issues “rob
Americans of a full life”.
For an example of the CDC in action, let’s look at the current opioid crisis in the U.S.
More than seventy percent of all drug-overdose deaths in twenty-eighteen involved opioids,
often prescription ones.
To tackle this major domestic public health issue, the CDC has created checklists that
doctors can use when considering prescribing opioids and provided guidelines for state-wide
opioid monitoring programs.
They also do extensive public outreach to raise awareness about the dangers of opioid
drugs.
The CDC does similar outreach work around other public health issues, like smoking,
diabetes and contagious diseases, but in the end it’s up to individual states to implement
and manage the strategies recommended by the CDC.
WHO’s mission statement - “Better health for everyone, everywhere” - may be more
catchy than the CDC’s, but it’s simplicity understates the massive challenge they’re
taking on.
Whereas the CDC focuses mainly on keeping Americans healthy, the WHO’s vision is to
improve the health of every single person in the world.
The WHO has a broader focus than the CDC, since they are concerned about all areas of
global health, not just diseases.
WHO programs are in place all over the world to address global issues like clean water
and sanitation, universal health care systems, and quality healthcare for children, pregnant
women, elderly people and the disabled.
That said, disease initiatives are a huge part of the WHO’s mandate.
According to the WHO’s research, up to seventy percent of all deaths worldwide are the result
of chronic diseases like cancer, heart disease and diabetes.
Chronic diseases are a huge threat to human health and longevity, but communicable diseases
that can spread from person to person are a constant threat, and a major focus of the
WHO.
When it comes to communicable diseases and pandemics, the WHO works very closely with
their member states’ governmental agencies, like the CDC, to complete research and analysis,
decide on recommendations, and implement programs to fight the disease.
The WHO is also very hands-on during pandemics and other health emergencies, playing a vital
role by creating and distributing preparedness guidelines, tracking and monitoring outbreaks,
and ensuring safe delivery of essential health services and equipment to fragile areas.
One of the best examples of WHO at work is their role in eradicating smallpox.
For nearly fifteen years, WHO spearheaded the global fight against the smallpox virus,
leading the charge on vaccination campaigns, virus surveillance and prevention measures.
Their hard work paid off, and in nineteen eighty, smallpox was the first disease to
be declared eradicated on a global scale.
The WHO does a lot of on-the-ground work, especially in less developed countries, but
they don’t have the same power that governmental agencies like the CDC have to force countries
to adhere to their recommendations.
They work closely with their member states to come to a consensus about the best approach
to tackling global health emergencies, but their members are under no obligation to follow
the WHO’s recommendations.
Not only is their goal of better global health extremely ambitious, but in most cases they
have to accomplish it by convincing people and governments to choose to listen to their
advice - no easy task in today’s highly politicized world!
Now that we understand the basic differences between the two organizations, let’s take
a look at an example of them in action and compare WHO versus CDC in the context of the
COVID-19 pandemic.
It’s important to remember that the WHO and the CDC are partners in the fight against
COVID-19.
They may not always agree on everything, but they are both working towards the same goal
of keeping the world healthy and safe.
When it comes to COVID-19, there are plenty of things that the WHO and the CDC do agree
on.
Both organizations have made it clear that social distancing and frequent hand washing
are currently the only effective ways we have of fighting the spread of COVID-19, at least
until a vaccine becomes available.
Both the CDC and WHO are providing guidelines for preventing and treating COVID-19 directed
at health care workers, travellers, businesses and the general public.
The main goal for both the CDC and WHO is to raise awareness about COVID-19 and spread
the word about what we can do as individuals and as countries to help contain it.
There have been plenty of disagreements, too.
Perhaps the most notable is the drama surrounding the COVID-19 testing kits.
On January seventeenth, WHO published protocols with instructions for manufacturing COVID-19
tests based on research from Germany.
That very same day, a top U.S. health official announced that the CDC had already developed
an early version of their own test, not based on the WHO’s protocols.
By February sixth, the WHO had shipped more than two-hundred and fifty thousand tests
to more than seventy labs around the world.
Meanwhile, the U.S. was struggling with defective tests, creating a huge backlog of cases awaiting
testing.
WHO spokesperson Tarik Jasarevic confirmed to CNN that WHO had not provided any tests
to the U.S., but he made it clear that this was not an intentional slight - in fact, the
U.S. doesn’t ordinarily rely on WHO’s test since they have the capacity to develop
and manufacture their own diagnostic tests, leaving more of the WHO’s resources available
for countries who need them.
The U.S. has finally been able to start testing for COVID-19 in every state, but valuable
time was lost and tensions are still high between the two health organizations.
Dr. Anthony Fauci, the U.S.’s top infectious disease doctor, was asked if the U.S. should
have used the WHO tests.
He responded: “If you look back and Monday-morning quarterback, it would have been nice to have
had a backup.
But what the CDC has done over many, many years when we have things like this is to
develop their own test, which is always a really good test.”
Whenever the world is faced with a crisis, there will always be conflicting information
and opinions.
Your best bet is to check the WHO and CDC websites regularly to see exactly what they’re
saying.
Review their information and pay special attention to the things that they do agree on.
Where they conflict, you should look to your local government or health organization to
confirm which guidelines apply to you.
So there you have it - WHO vs. CDC.
Between the WHO’s global network and the CDC’s on-the-ground research, both these
organizations are vital to the current fight against COVID-19, and to global health in
general.
Although they compliment each other and even work together, they are very different, but
at least now you actually know what they do!
Now be sure to check out “COVID-19 vs. H1N1 Swine Flu - How Do They Compare?”, or maybe
you’ll like this other video instead.