The Ebola epidemic and the war in Syria have cast a spotlight on the inadequacies of the United Nations as it tries to operate in a globalised world with a power structure that hasn't changed since 1945.
To many who know the UN well, the organisation has grown bloated with age, is underfunded and shows few signs of righting itself.
That was evident when an internal report by the UN health agency revealed that cronyism and incompetence in its leadership may have contributed to the spread of Ebola.
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Since the UN was born after World War II, it has grown from 51 members to 193. As it approaches its 70th anniversary next year, it is hobbled by bureaucracy, politics and an inability among its five most powerful members to agree on many things, including how to bring peace to Syria.
"If you can imagine any big multinational corporation keeping its structures the same as in 1945, it would have been destroyed by now in the marketplace," said Patricia Lewis, a nuclear physicist who led the United Nations Institute for Disarmament Research.
The paralysis shows in the debate over what the UN itself should be. Most nations agree that the 15-member Security Council, the UN's most powerful body, must adapt to address threats to international security. Yet all reform proposals are repeatedly rejected.
"Those who wield the power don't want to lose the power and they don't want to share it," said Lewis, who is now at the Chatham House think tank in London.
The five permanent members of the council who can cast vetoes, the US, Russia, China, Britain and France, ultimately call the shots.
One result is that Russia, a close ally of Syria, has blocked all Western resolutions that would pressure President Bashar Assad to end the conflict there.
Certainly the UN has had some success in its primary mission to stop "the scourge of war." A record 130,000 UN peacekeepers are deployed in 16 hotspots, and it has responded to an unprecedented four simultaneous, top-level humanitarian crises: Iraq, Syria, Central African Republic and South Sudan.
UN spokesman Stephane Dujarric argues that the UN has adapted since its founding. He said Secretary-General Ban Ki-moon has worked with member states "to make the system more flexible and even more responsive" to needs in many areas, including collective security, international transport, health and human rights.
But inefficiency, inaction and sometimes paralysis extend through a sprawling system that includes 15 autonomous agencies such as the World Health Organization; 11 other funds such as UNICEF; and numerous other bodies.
