unhealthy agency-


Margaret Chan was quite taken by what she saw on her visit to Pyongyang in 2010. North Koreans had “something which most other developing countries would envy,” she noted: a first-rate medical system with plenty of doctors and nurses. Not only that, there were no obesity problems, she enthused, discussing a country with chronic food shortages where a famine in the mid-1990s had killed hundreds of thousands of people.

The musings of a cretinous fellow traveler or a naïve adventure tourist? No, this bizarre apologia for the world’s most repressive dictatorship was delivered by the director-general of the World Health Organization (WHO), a U.N. agency with an annual budget of around $4 billion.

Chan’s decade-long tenure at the top of the WHO has just ended, and it can fairly be called disgraceful. She practiced what the Associated Press, in a remarkably vituperative article in late May, termed “the art of appeasement.” Over the years, the Hong Kong native praised the governments of North Korea, Turkmenistan, China, Russia, and Zimbabwe—human rights horror shows, all.

It would be one thing if these countries, despite their repressive political systems, actually did deliver high-quality public health. The same year Chan lauded North Korea’s medical system, an Amnesty International report called health services in the country “a horror,” citing understaffed hospitals unable to afford sterilized needles. The country faces huge shortages of medicines, patients often undergo surgery without anesthesia, and there is a tuberculosis epidemic. All of this escaped the director-general’s notice.

One of Chan’s last actions in office was a further slap in the face of democratic values: She refused to allow Taiwanese officials to even observe the World Health Assembly in Geneva in May. This move, taken despite protests from more than 10 countries, was to placate the Chinese government, which deeply resents the democratic island. After all, the very existence of free Taiwan gives the lie to Beijing’s propaganda that Chinese people aren’t “suited” to democracy. North Korea, though, was named a WHO vice president at the summit.

The WHO’s remit is to improve public health, largely by combating communicable disease. Under Chan, the organization badly flubbed its response to one of the worst public health crises in years: the 2014 West African Ebola outbreak. Even though cases were multiplying as early as December 2013, it wasn’t until the following August, when more than 1,000 people had died from Ebola, that the WHO declared an emergency. This sluggish response—”late, feeble, and uncoordinated,” in the words of a prominent public health advocate—likely cost thousands of lives.

Earlier in May, the Associated Press had reported that the WHO was overspending on lavish travel. “The United Nations health agency routinely has spent about $200 million a year on travel expenses, more than what it doles out to fight some of the biggest problems in public health, including AIDS, tuberculosis and malaria combined,” reported the AP. “At a time when the cash-strapped health agency is pleading for more money to fund its responses to health crises worldwide, it has struggled to get its travel costs under control. Senior officials have complained internally that U.N. staffers break new rules that were introduced to try to curb its expansive travel spending, booking perks like business class airplane tickets and rooms in five-star hotels with few consequences.”

This is a shame, because the WHO’s mission is an important one. Diseases know no borders, and it is vital that the response to outbreaks like Ebola be globally coordinated. With Chan’s departure and the respected Ethiopian physician Tedros Adhanom Ghebreyesus taking her place, it is a moment for reform.

Of the roughly $900 million in global government funding that the WHO receives each year, about $100 million is provided by U.S. taxpayers. (The rest of the WHO’s budget is covered by philanthropic donations.) This is what’s known as leverage. The Trump administration should condition further funding on major reforms at the organization: chiefly, more transparency and a respect for democratic rule. That means no praise for repressive dictatorships and no more kowtowing to Beijing’s demands.

source-weekly std, ethan epstein, who, tedros adhanom ghebreyesus


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