Ümit Kartoğlu
Vaccines saved millions, but they also revealed who mattered most. As the world divided between those who had and those who waited, WHO’s voice of equity grew faint.
Few episodes have tested the moral core of the World Health Organization as severely as the inequities exposed during the COVID-19 vaccine rollout. I ask Dr. Monir Islam whether WHO failed in its mandate to promote fairness. His answer is sober.
“Vaccine inequity during COVID-19 exposed the deep power imbalances in global health, and unfortunately, WHO was not equipped or empowered to confront them decisively,” he says. “While WHO helped launch the COVAX facility and made consistent calls for equity, the reality is that it lacked the political leverage to compel powerful countries or pharmaceutical companies to prioritize global solidarity over national interest and profit. Many wealthy nations bypassed multilateral mechanisms altogether and negotiated directly with manufacturers, hoarding supply while low-income countries waited.”
That quiet tragedy, the arithmetic of privilege, played out across continents. Behind the polished press briefings, WHO found itself hemmed in by political caution. “Internally,” Dr. Islam recalls, “WHO leadership, particularly under the current Director-General, was reluctant to publicly confront major powers or companies in strong terms. The organization chose a diplomatic approach, perhaps to preserve dialogue and cooperation. But this came at a cost: a loss of moral authority and a missed opportunity to take a bold stand in defence of equity.”
He adds that inequity is not only a matter of supply. “Moreover, it is not only the availability of vaccines that determines outcomes, the more difficult and often overlooked challenge is achieving effective vaccination. This involves ensuring adequate cold chain infrastructure, trained human resources, reliable transport systems, and, critically, individual and community understanding and acceptance.”
The problem, he reminds me, is systemic: “All of this requires substantial and sustained funding, which many countries simply do not have. These systemic barriers mean that even when vaccines are delivered, the most underserved populations remain at risk, further compounding inequity.”
His conclusion is one of both frustration and hope: “As someone who has spent decades inside WHO, I believe the institution’s cautious political culture and lack of financial independence severely limit its ability to challenge powerful interests. Equity cannot be an aspiration, it must be a non-negotiable principle, even when inconvenient. That will require not just better mechanisms, but stronger, more principled leadership and greater political independence.”
WHO’S CONTESTED MORAL AUTHORITY
The question that haunts many of us who have worked within the system is whether the WHO still holds the moral authority to lead global health. That authority, once taken for granted, was built on neutrality, scientific credibility, and a sense of shared humanity that transcended borders. It was WHO’s moral capital, not its legal power, that made it the world’s conscience during crises like smallpox eradication or the battle against polio.
But in the years since COVID-19, that authority has been tested, and in some eyes, diminished. Accusations that WHO was too deferential to powerful states or too slow to act decisively during the pandemic hardened into a perception of bureaucratic timidity. Nationalist and far-right movements seized on these doubts, portraying the organization as a globalist instrument detached from ordinary citizens.
Rising nationalism has reframed health as a matter of sovereignty rather than solidarity. The idea of shared responsibility is giving way to the politics of self-protection. Funding crises, politicized governance, and donor dominance have further eroded WHO’s ability to serve as an independent moral arbiter.
Still, the organization retains one irreplaceable advantage: its capacity to convene 194 Member States under a single mandate. That ability to bring the world’s governments together – however fractious – remains its moral asset. The challenge is whether WHO can reclaim that legitimacy through reform, transparency, and courage.
When I ask Dr. Islam whether WHO still possesses moral authority, he does not hesitate. “WHO’s moral authority has been deeply tested, and while it has not been entirely lost, it is no longer taken for granted,” he says. “When I joined WHO over two decades ago, it was widely seen as a neutral, science-driven, and values-based organization. It spoke with moral clarity on issues of equity, health rights, and global solidarity. That image has faded in recent years, particularly under a leadership culture that has sometimes prioritized diplomacy over integrity and concentrated authority at the top.”
Yet his faith in the institution endures. “Despite recent shortcomings, I strongly believe that WHO is still needed, perhaps now more than ever, especially as a platform to give voice to low-income countries and ensure they are not left behind in times of crisis. WHO remains the only global health institution with universal membership, technical expertise, and the mandate to coordinate pandemic response across countries.”
He speaks from lived experience. “Its presence in over 140 countries allows it to play a vital role in supporting national systems, especially where domestic capacity is limited. I have seen firsthand how WHO can provide timely and life-saving technical support during emergencies, and how it often serves as a trusted partner where other institutions are absent.”
But he offers a warning: “The moral authority to lead the world through the next pandemic is not guaranteed. It must be rebuilt through reform and principled leadership. During COVID-19, WHO’s ability to act with independence and clarity was weakened by political pressures, funding dependencies, and a leadership culture that at times prioritized diplomacy over decisive action. The organization’s top-heavy structure, expanded under the current Director-General, has raised questions about political motivations and the efficiency of resource use. The growing number of politically appointed senior roles, often with unclear technical mandates, risks diminishing credibility and distracting from WHO’s core mission.”
He pauses, then adds quietly: “Yet, these are problems of structure and leadership, not of purpose. The world still needs WHO: as a guardian of science, a coordinator of international health action, and, crucially, as the voice and defender of low- and middle-income countries in a global system too often dominated by powerful interests. WHO can reclaim its moral leadership, but it must recommit to transparency, technical excellence, and equity, and embrace reform not as criticism, but as a path to renewal. So, can WHO still lead? Yes, but only if it reclaims that moral authority by acting with greater courage, independence, and accountability. The next pandemic will demand not only technical capacity, but moral clarity. WHO must rediscover its voice, not as a political actor, but as the world’s health conscience.”
I echo Dr. Islam’s view: WHO’s moral authority is not extinguished, only obscured. Whether it can rise again depends on whether it can evolve from being a symbol of global governance into a true champion of health solidarity – one grounded in equity, humility, and trust.
Tomorrow – Rebuilding the World’s health conscience: If WHO is to survive, it must reform not only its structure, but its soul.
