Saturday, 23 May 2020

WHO’s flawed vision is all about the big picture

Microbes are too common for WHO to worry about.
Microbes are too common for WHO to worry about.
The World Health Organisation is less than enthusiastic about the campaign calling for an inquiry into the origins of COVID-19. Despite strong international pressure, this week’s meeting of the WHO showed that the organisation has little inclination to get to the bottom of this matter. Though it promised to launch an independent evaluation of its response to COVID-19, it made clear that it would not happen any time soon.
A couple of years ago a friend who worked in Geneva for the WHO told me that sometimes she felt this institution was inhabited by a tribe of responsibility-averse zombies. I did not quite grasp what she meant until we all came face-to-face with the WHO’s zombie-like response to the coronavirus pandemic. Sadly, I am now convinced that despite the urgency of having a properly functioning international health organisation, the WHO cannot be reformed.
Many critics have drawn attention to the fact, as far as sclerotic international institutions go, the WHO is in a class of its own. Others have questioned the WHO’s wasteful spending on international travel and on the army of bureaucrats it employs.

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There are also many questions raised about the WHO’s shady political manoeuvring. We should not be surprised by its willingness to devote far more energy to providing a public relations cover to China’s handling of the outbreak of the coronavirus pandemic than in mobilising its resources to fighting this threat to human life.
After all, the WHO has been a fervent supporter of Beijing’s “one-China policy” for some time. It refuses to recognise Taiwan. It also has decided to curry favour with the global anti-Israel crusade. It continually singles out Israel as the main enemy of global health. Israel is the only country that is routinely condemned at the WHO’s annual assemblies. However, the real problem with the WHO is not only its misguided political behaviour or its slothful bureaucratic operational ethos but also its tendency to involve itself in matters that have little to do with the job of co-ordinating the response to global threats to human health.
There are many excellent health professionals and scientists who work with and alongside the WHO. But unfortunately, from the organisation’s inception, the WHO’s leadership was always as interested in politicising the issue of health as in developing medical solutions to the diseases threatening people in the different regions of the world.
From its birth in 1948, the WHO assumed that it possessed an extremely broad remit to not only deal with medical and scientific matters but also with issues to do with people’s lifestyle and behaviour. From the perspective of this organisation, health is much more than the absence of disease. It has embraced a wide definition of health. According to the definition adopted in 1948, health is a “state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. Such a broad definition of health goes way beyond the problems that doctors and medical science can fix.
Many critics of the WHO have failed to grasp the potentially disorienting consequences of a global institution working in accordance with the diffuse and wide remit provided by its definition of health. After all, who can object to the WHO’s goal of a “state of complete physical, mental and social wellbeing”?
In reality, the WHO’s version of the meaning of health speaks to the achievement of happiness rather than of health. Yet health and wellbeing refer to two distinct domains of human experience.
Video grabs from the virtual meeting this week of the WHO’s World Health Assembly. Picture: AFP
Video grabs from the virtual meeting this week of the WHO’s World Health Assembly. Picture: AFP
As most people know, few of us live a blissful life, where we enjoy “a state of complete physical, mental and social wellbeing”. Most people face a variety of existential problems that make them feel anxious, unhappy and sometimes unwell. But these problems of everyday life are not reducible to health problems and should not be of concern to an international health institution. The WHO takes a different view and it often strays from dealing with problems that are susceptible to medical solutions to ones that require cultural and social ones.
Given its interest in a complete state of wellbeing, it is not surprising that the WHO is interested in helping people have a great sex life. In 1975, it invented the term sexual health, which it defined as a “state of physical, emotional, mental and social wellbeing related to sexuality”. It claimed the realisation of this objective required the “possibility of having pleasurable and safe sexual experiences”.
Most people aspire to having “pleasurable” sexual experiences but they also realise its achievement depends on the quality of their relationships and on a variety of influences that bear upon their emotions and passions. The realisation of such experiences has little to do with the health intervention of so-called sexual health experts. The WHO’s transformation of pleas­urable sex into a health issue simply offers this organisation new opportunities to expand its interest into people’s private lives and behaviours.
The WHO’s definitions of health and of sexual health are underpinned by a political commitment to transform health into a quasi-ideology. It was this commitment that motivated Brock Chisholm, the WHO’s first director-general (1948-53), to insist the organisation should be “more than international”, by which he meant it should be freed of accountability to national governments.
Chisholm’s globalist vision coexisted with an aspiration to politicise health to transform the world. At the preparatory meetings leading up to the establishment of the WHO, Chisholm argued that the real issue at stake was not medical but political. He said: “The world is sick and the ills are due to the perversion of man.” He said the “microbe is not the enemy” for the problem was the “barriers of superstition, ignorance, religious intolerance and poverty”. This cavalier attitude towards “the microbe” continues to influence the difficulty that the WHO has in responding to viral epidemics.
Chisholm said since the “psychological evils” of the human condition constituted the main challenge facing the WHO, “the scope of the task” facing this organisation “knows no bounds”. Its lack of restraint has led this institution to medicalise human behaviour to the point that it loses sight of the distinction between the normal existential problems of life and the genuine threat to people’s health. That is why, after failing to respond to the outbreak of COVID-19 in a timely manner, the WHO opted to adopt the classical Freudian displacement activity of lecturing citizens facing a lockdown about the danger of drinking alcohol. In the middle of the pandemic, the WHO issued a circular titled Alcohol Does Not Protect against COVID-19: Access Should Be Restricted During Lockdown. Since it is unlikely that those of us who decided to have a couple of glasses of wine with our meal imagined that having a drink would protect us from COVID-19, it is unclear why this circular was issued. The WHO said publication of its circular was “part of its public health response to COVID-19”.
One would imagine that amid a global emergency, the WHO’s health response would focus on tracking the pandemic, providing advice on how to contain the outbreak and co-ordinating efforts to find an effective vaccine against the coronavirus. Yet the WHO appears to believe that its limited resources are more usefully spent on communicating its wisdom on alcohol consumption.
The clue to the WHO’s erratic behaviour can be found in Chisholm’s claim that the “microbe is not the enemy”. In recent decades this point has been interpreted to mean there is no magic bullet that can solve the problem of health.
From this perspective, the contribution medical science can make to the provision of health has significant limits. Vaccines can help to protect people from a microbe like a virus but there is much more that’s needed for human health. From this standpoint, lecturing people about their lifestyles is no less important than eliminating a disease. That is the main reason the WHO has a regrettable tendency to adopt such a laid-back approach to the outbreak of global emergencies.
The WHO’s reaction to the outbreak of the Ebola virus in West Africa in December 2013 anticipated its casual response to the eruption of COVID-19. It took more than four months after the spread of Ebola was first detected for the WHO to declare the epidemic a public health emergency of international concern. Thankfully it has acted a little bit faster during the course of this emergency. That it refuses to insist that there be a global probe into the COVID-19 outbreak indicates that its attention is on matters that it considers no less important than dealing with a mere microbe.
That is why until its definition of health becomes depoliticised it is unlikely the WHO can be reformed. It is time that world leaders set about launching a replacement for the WHO.
Frank Furedi’s Why Borders Matter: Why Humanity Must Relearn The Art of Drawing Borders will be published by Routledge this summer.

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