Depuis plus de 75 ans, l’Organisation mondiale de la santé (OMS) joue un rôle déterminant dans la fourniture de soins de santé à l’échelle mondiale, en aidant les gouvernements et les groupes d’entraide à dispenser des soins vitaux. Qu’il s’agisse des vaccins, de la réaction rapide ou de l’endiguement des crises sanitaires, notre monde serait bien différent sans ses interventions.
Cependant, depuis quelque temps, l’organisation est dans la tourmente, la prise de décision devenant de plus en plus délicate et les tensions internes ayant atteint un point d’ébullition.
Depuis des années, des questions se posent sous la surface, avec des préoccupations concernant la centralisation croissante de l’organisation. Bien que beaucoup aient considéré ces problèmes comme de la politique interne, compte tenu de l’importance de l’OMS dans l’écosystème mondial des soins de santé, lorsque la prise de décision échoue, c’est la vie des gens qui est en jeu.
En janvier de cette année, des informations faisant état de licenciements massifs ont commencé à circuler. L’élection de Donald Trump – qui a une aversion notoire pour le directeur général de l’OMS, le Dr Tedros Adhanom Ghebreyesus – signifiait que l’organisation devait faire face à un déficit budgétaire soudain et massif. Sous la direction de Trump, les États-Unis ont retiré plus d’un milliard de financement à l’OMS et, en juillet, l’organisation prévoyait de supprimer 20 % de ses effectifs.
Le personnel est en colère, car les membres les plus jeunes ont été les plus touchés par les réductions, ce qui a donné lieu à des accusations selon lesquelles les licenciements étaient moins axés sur les coûts que sur les personnes les plus éloignées du centre du pouvoir. De nombreuses personnes ont été réaffectées ou tout simplement licenciées sans explication ni alternative claire en termes de parcours ou de fonction. Des rapports provenant de l’intérieur de l’organisation indiquent que cela a conduit à une culture de plus en plus toxique, les gens devant se battre pour garder leur emploi. Dans une lettre communiquée à Health Policy Watch et adressée au Dr Tedros, celui-ci est averti que “‘Il ne s’agit pas d’efficacité, il s’agit de savoir qui est protégé et qui est sacrifié'”.
Il s’agit d’une accusation révélatrice qui sous-tend une réalité inquiétante : au cœur de l’organisation, il s’agit moins d’une coalition de dirigeants désintéressés et compétents fondée sur le mérite que d’une hiérarchie d’exclusion où le pouvoir et la pertinence sont directement liés au statut et à l’intitulé du poste.
Aujourd’hui, plus de 800 membres du personnel ont déposé une motion de défiance à l’égard du processus de réduction des effectifs et demandent un réexamen indépendant du processus. Le Dr Tedros devra faire preuve de prudence. L’aliénation continue du personnel risque de transformer une agence de santé mondiale, dont la mission première est de collaborer et de coordonner les résultats en matière de santé, en un environnement fondamentalement toxique où les employés sont contraints de défendre leurs moyens de subsistance comme ils le peuvent.
Alors que ce problème se poserait indépendamment du moment, il survient à un moment où la désinformation médicale mondiale est en hausse ; entre l’affirmation largement démentie de Donald Trump selon laquelle le paracétamol provoque l’autisme et le taux d’utilisation des vaccins qui atteint un niveau record dans le monde entier, la main ferme de la direction de l’OMS n’a jamais été aussi importante.
Il est donc regrettable que le personnel n’ait pas été motivé pour collaborer et innover afin de pouvoir continuer à apporter un soutien vital dans le monde entier. Comme le dit l’adage, la pourriture commence à la tête, et pour que l’OMS réussisse à traverser ce changement, une nouvelle direction pourrait non seulement faire toute la différence, mais aussi être cruciale.
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