These days nothing the United Nations touches turns to gold. Even for specialized agencies that theoretically could do good work.
When the SARS epidemic was hop scotching across the globe, the World Health Organization (WHO) purported to be in the forefront of efforts to develop treatments and find a cure for the disease. But the WHO was reluctant to send staffers to Taiwan, hard-hit due to its extensive commercial and economic ties with China. For the WHO, politics was more important than health. A better name for the WHO might be the World Harm Organization.
Taipei is not a member of the WHO because most nations, including the U.S., formally consider it to be part of China. And China objected to any WHO teams traveling to Taiwan. The mainland Chinese government promised to care for residents across the Taiwan Strait -- as it was lying to its own people about the scope of the SARS epidemic at home. With no thanks to the WHO or Beijing, Taiwan avoided a disastrous outbreak.
Unfortunately, like most U.N. agencies, the WHO's activities have long been captive to a highly political agenda. For instance, earlier this year the organization claimed that a third of childhood deaths in Europe were due to environmental causes.
It's a preposterous claim. European analysts Jaap Hanekamp and Julian Morris observe: "few of these deaths were actually caused by problems generally associated with 'the environment.' Out of 100,000 total deaths, 75,000 were caused by accidents -- e.g. drowning, fires, falls and other hazards of childhood. Of the remaining 25,000 deaths, nearly all of them in poor countries such as Turkey and Russia, most were caused by a combination of dirty water, poor sanitation, malaria and indoor air pollution."
But the facts didn't stop the WHO. It was particularly upset about the presumed threat of global warming, which, it claimed, would result in "more widespread and severe" deaths due to diarrhea, floods, malaria, and nutritional problems. Yet, Hanekamp and Morris archly observe, "No scientific evidence was offered to support these claims -- perhaps because none exists."
NEVERTHELESS, THE WORLD HEALTH organization is advancing its so-called Children's Environment and Health Action Plan for Europe which, naturally, advocated more regulations over technology, such as fossil fuels, pesticides, and plastics. The result will be to make us all poorer, yet wealth is one of the most important determinants of health. Wealthier societies are better able to care for those who are most vulnerable to illness.
For instance, the pesticide DDT is one of the most effective mechanisms to kill mosquitoes, which spread malaria. Cheaper energy lowers the cost of producing food. Important medical devices are made from plastics. Under the guise of promoting the "precautionary principle," the WHO is ignoring problems that today kill millions while fretting over worst-case scenarios for the future that are unlikely ever to occur. Simply providing clean water and improving sanitation would do more to help Third World peoples than do most of the WHO's highly publicized initiatives.
The WHO has organized the "Roll Back Malaria" program, along with UNICEF, the World Bank, and the U.S. Agency for International Development. Unlike global warming, malaria actually does kill. Yet the WHO has been spending scarce resources on two drugs which have been found to be no longer effective in Africa. Other choices are available, but so far the WHO bureaucracy hasn't bothered to adjust.
Moreover, complain Robert Bate and Richard Tren, respectively a British and a South African health care analyst, "Roll Back Malaria partners are unwilling to fund interventions that work but upset environmentalists, such as indoor insecticide spraying." Although widespread outdoor use of DDT years ago did have adverse environmental consequences, poor nations throughout Africa and South Asia are literally begging for assistance in undertaking carefully targeted indoor spraying.
IT'S HARD TO KNOW IF anyone died because the WHO chose to kowtow to Beijing rather than cooperate with Taipei's advanced health care system. So far the WHO's "Children Action Plan" hasn't had any ill effect since it has not been implemented. Failing to fund effective anti-malaria measures does kill. Equally important, organization missteps involving the treatment of AIDS has harmed untold numbers of poor people in poor countries.
The HIV/AIDS epidemic has swept Africa, infecting tens of millions of people. The numbers overwhelm, leading to a sense of helplessness. There's only one reason far more people haven't died: the incredible pharmaceutical advances over the last two decades. But the WHO actually has impeded distribution of effective medications.
Treating AIDS is one of the organization's primary responsibilities. Its "3 by 5" initiative is supposed to treat three million people by 2005. Yet last year the WHO was forced to remove several foreign copies of patented AIDS drugs by the Indian firms Cipla and Ranbaxy from its list of pre-qualified medicines.
As millions have suffered and died of HIV/AIDS political activists worldwide have attacked the drugmakers. Yet without research-driven pharmaceutical companies, we would live in the pre-1987 world, when there were no treatments for AIDS and the diagnosis was a death sentence. Rather than being willing to pay the price for innovative new drugs, the WHO has promoted foreign knock-offs. Ideology above effectiveness, the agency said yet again.
It turns out that the copies couldn't be certified as biologically equivalent or safe. Thus, they endangered the people who were taking them. The inadequate drugs also risked encouraging the AIDS virus to mutate into strains resistant to all medicines. Moreover, diverting treatment dollars into inferior pharmaceuticals reduced the financial incentive for drug companies to develop newer and better products.
It's an appalling record, one of "Bad decisions, missed deadlines and bogus AIDS drugs," complains Waldemar Ingdahl, Director of Eudoxa, a Swedish think tank: "Africans and the poor should not be treated with bad medicine."
The WHO needs a thorough overhaul. Director-General Lee Jong-wook, chosen less than a year ago, needs to assert control over an organization gone badly astray. Most important, it must choose good health over bad politics.
The world faces enormous health care challenges. It's time the WHO lived up to its promise, promoting health rather than harm.
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