A timely message to legislators regarding WHO and health emergencies

In a world of reportedly multiplying health emergencies, it has become necessary to give up some independence in return for our safety. But if humans are important, then we should also understand the flaws in this trade-off, and decide whether they matter. 

We are told that, in a world of multiplying health emergencies, it has become necessary to give up some independence in return for our safety.  It is a tribute to those backing this agenda through the World Health Organization (WHO) that this message continues to gain credence. But if humans are important, then we should also understand the flaws in this trade-off, and decide whether they matter. 

1. The World Health Organization is not independent, and is significantly privately directed.

Early WHO funding was dominated by ‘assessed’ contributions from countries, based on national income, and WHO decided how to use this core funding to achieve the greatest impact. Now WHO funding is mainly ‘specified’, meaning that the funder may decide how and where the work will be done. WHO has become a conduit through which funders can implement programmes from which they stand to benefit. These funders are increasingly private entities, with the second-largest funder of WHO being the foundation of a software entrepreneur and Pharma investor.

In ceding power to WHO, a state will cede power to the funders of WHO. They can then profit by imposing the increasingly centralised and commodity-based approach that WHO is now taking. 

2. People in democracies cannot be subject to dictatorships.

WHO rightly represents all countries. This means that member states run by military dictatorships or other non-democratic regimes have an equal say at the World Health Assembly (WHA), WHO’s governing body.

In ceding power to WHO, democratic states are therefore sharing decision-making powers over the health of their own citizens with these non-democratic states, some of whom will have geopolitical reasons to restrict a democratic state’s people and harm its economy. While having an equal say in policy-making may be appropriate for a purely advisory organisation, ceding actual power over citizens to such an organisation is obviously incompatible with democracy.

Centralised approaches to health, on the other hand, require communities and individuals to comply with dictates that ignore local heterogeneity and community priorities.

3. WHO is not accountable to those it seeks to control.

Democratic states have systems that ensure that those who are allowed to wield power over citizens do so only at the citizens’ will, and are subject to independent courts in cases of malfeasance or gross and harmful incompetence. This is necessary to address the corruption that always arises, as institutions are run by humans. Like other branches of the United Nations, WHO is answerable to itself and the geopolitics of the WHA. Even the UN Secretariat has limited influence, as WHO operates under its own constitution.

WHO’s lack of accountability is demonstrated in the following examples: No one will be held accountable for the nearly quarter of a million children that UNICEF estimates were killed by policies that WHO promoted in South Asia. And none of the up to 10 million girls forced into child marriage by WHO’s Covid policies will have any path for redress. Such lack of accountability may be acceptable if an institution is simply giving advice, but it is completely unacceptable for any institution that has powers to restrict, mandate, or even censor a country’s citizens.

4. Centralisation through WHO is poor policy by incompetent people.

Before the influx of private money, WHO focused on high-burden endemic infectious diseases, such as malaria, tuberculosis, and HIV/AIDS. These are strongly associated with poverty, as are diseases arising from malnutrition and poor sanitation. Public health experience tells us that addressing such preventable or treatable diseases is the best way to lengthen lives and promote sustainable good health. These diseases are most effectively addressed by people on the ground who have local knowledge of behaviour, culture, and disease epidemiology, and this approach involves empowering communities to manage their own health. WHO once emphasised such decentralisation, advocating for the strengthening of primary care. It was consistent with the fight against fascism and colonialism, which characterised the era during which WHO arose

Centralised approaches to health, on the other hand, require communities and individuals to comply with dictates that ignore local heterogeneity and community priorities. Malaria is not an issue for Icelandic people, for example, but it absolutely dwarfs the impact of Covid-19 in Uganda. Both human rights and effective interventions require local knowledge and direction. WHO pushed mass Covid vaccination onto sub-Saharan Africa for nearly two years in their most expensive programme to date, whilst knowing that a large majority of the population were already immune, half were under 20 years of age, and deaths from each of malaria, tuberculosis and HIV/AIDS utterly dwarfed Covid-19 mortality. 

WHO staff are rarely experts. Experience during the 2009 Swine flu and West African Ebola outbreaks demonstrated that. Many have spent decades sitting in an office and have minimal experience in programme implementation or practical disease management. Country quotas and the nepotism associated with large international organisations mean that most countries will have far greater expertise within their borders than exists in a closeted bureaucracy in Geneva.

5. Real pandemics are not common, and are not becoming more common.

Pandemics due to respiratory viruses, as WHO pointed out in 2019, are rare events. They have occurred about once per generation over the past 120 years. Since the advent of antibiotics (for primary or secondary infections), mortality has dropped dramatically. 

An increase in mortality recorded during Covid-19 was complicated by definitions, such as dying ‘with’ versus ‘of’ Covid. In fact, the average age of death was over 75 years, death from Covid was unusual in healthy people, and the global infection mortality rate was not greatly different from influenza. In contrast, tuberculosis, malaria, HIV/AIDS and most other common infections kill at a much younger age, imparting a greater burden in life years lost.

In summary

It makes no sense to grant a foreign-based, poorly unaccountable institution powers that contradict democratic norms and good public health policy; more so when this institution has limited expertise and a poor track record, and is directed by private interests and those of authoritarian governments. This is obviously counter to what a government in a democracy is supposed to do.

This is not a matter of domestic political rivalries. However, the public relations departments of the prospective beneficiaries of this perpetual health emergency project would like us to believe it is. We are currently funding the dismantling of our own independence. We are ceding our human rights to a small group who stand to benefit from our impoverishment, financed from a war chest accrued through the pandemic that just ended. 

We don’t have to do this. It is as straightforward to see through this as it should be to stop it. All that is needed is clarity, honesty, and a little courage.


David is a clinical and public health physician with a PhD in population health and background in internal medicine, modelling and epidemiology of infectious disease. Previously, he was Director of the Global Health Technologies at Intellectual Ventures Global Good Fund in the USA, Programme Head for Malaria and Acute Febrile Disease at FIND in Geneva, and coordinating malaria diagnostics strategy with the World Health Organization.

Publisher’s note: The opinions and findings expressed in articles, reports and interviews on this website are not necessarily the opinions of PANDA, its directors or associates.

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