Knock, knock, WHO’s there? Yes
| 27 Jan 2021
By Chitra Subramaniam | 27 Jan 2021
The World Health Organization (WHO)’s apex body, the Executive Board ended a week of meetings on Tuesday. You probably didn’t hear about it. That puts you in the same category of the majority of the people in the world who hear nothing about the agenda items on the table ranging from chronic diseases to budgets to non-state actors. The media largely gave it a miss – experience has taught them that asking questions to and of the WHO is futile. The organization picks journalists mostly in London and Washington to put out word ignoring Geneva-based journalists. A recent survey of Geneva based journalists covering the United Nations (UN) gave the WHO a thumbs down when it came to media relations.
Media is not the problem with the WHO. Mediocrity is and barring a few officials, the organization is replete with time-servers and inadequately qualified people whose absence of domain knowledge has come to the fore during the pandemic.
This EB, one would have thought would be different. There’s a raging pandemic and vaccines are being rolled out to the satisfaction of none. Most recently European countries stopped short of spying on the manufacturers to see if they had sold previously booked stocks to other countries. In short, trust upon which public health is based, it running dismally low between governments and within organizations. Now would have been the time for the UN’s top health body to steady the global dialogue. It didn’t and the reason is obvious – the WHO was not set up to operationalize public health, It was an agenda setting and policy guidance organization, a job it has lost by being all things to all countries and increasingly bowing to powerful countries at the cost of weaker ones. In fact, the WHO is looking for an agenda.
During the EB countries spent considerable time (and public money) listening to each other’s COVID19 plans and problems. Like good pupils, they lauded the efforts of the Director General Tedros Ghebreyesus whose role in the early days of the pandemic remain controversial. There was very little substantive discussion on access to vaccines. That debate is raging at the World Trade Organization (WTO) situated at a stone’s throw from the WHO. On paper, both organizations are cooperating. In fact, it is not uncommon to hear a diplomat from country A to make a plea for vaccines for all at the WHO and say the opposite at the WTO.
Sadly – yes, sadly – the COVID19 focus has stolen time away from so many other health issues that are piling up and being placed on the back burner. People with chronic diseases-from HIV/AIDs and TB to cancer, diabetes and mental health-have been left to wait for access to care and early indications are that many are suffering at levels last seen decades ago. Progress on addressing Non Communicable Diseases (NCDs) that was on the EB agenda is going backwards in most Low and middle income countries like India. Funds for support are being cut in favor of pandemic work. As the vaccine eventually reaches most people and provides protection there is concern that populations are set to emerge less healthy than they were before the pandemic. Less activity, eating unhealthily, reduced social engagement and more smoking leave adults at greater risk for cancers, heart disease, diabetes, and chronic lung diseases.
This was predictable. Yet WHO failed to do more than give a nod to the rising toll of non-COVID morbidity, and soon, mortality. In fact, they are set to make matters worse.
One of the last items on the agenda of this 148th session of the EB is an “innocuous” item dealing with expert committees. One of these comes from the Tobacco Regulatory group. The recommendations listed are replete with words like ban, prohibit and restrict referring to e-cigarettes and heated tobacco products.
The report is incomplete and should not be supported in its current form. It fails to provide the science base for the recommendations and fails to provide the 9 working papers that allegedly led to the recommendations. Rather, the secretariat claims these will be made available at some unspecified time in future.
EB members representing governments who believe policies and recommendations should be informed by science, should refuse to “note” the report until full details are made public so they can be studied. Letting this slide through as the EB ends, will leave a report that calls for the very means of ending smoking to be banned just as 100 million users of such products now have substantially reduced their risks and at a time when a further 1 billion tobacco users (80% of them in LMICs) could benefit from such products.
One hopes that governments who sit on the committee will demand more information on the science and the benefit of tobacco harm reduction.