WHO's in charge of world health?

The World Health Organisation is the chief body of the United
Nations responsible for global health problems. It is charged with
monitoring the state of the health of the six billion citizens of
Earth, and with stepping in with cures, remedies and preventatives
when warranted. The health of the world is far from excellent, and
the same may be said of the WHO. Today is the start of the UN body's
annual meeting. It is discouraging to see that instead of coming to
grips with the agency's problems and shortcomings, its bureaucrats
are set to discuss a series of relatively unimportant matters which,
at best, will make a relatively few healthy people more healthy.

In the year of tsunami recovery, with its anti-malaria programme
faltering and the most important Aids initiative on the brink of
failure, the WHO will focus this week on quite different matters.
There is a Global Initiative to kick off, for example _ on diet,
physical activity and health. This is a project for middle-class
people with wide choices, and will provide recommendations on meals
and exercise. Then there are the projects on road safety, destroying
smallpox samples, finance and relations with non-governmental
organisations. There will be an entire conference session on the
health conditions in Israel-occupied territories, but there will not
even be one for all of Africa, the centre of the two most important
and failing WHO policies.

The WHO has spent untold funds _ perhaps to be accounted this week _
on a much-needed Aids programme called 3 by 5. The aim, when this
project began several years ago, was to have three million diagnosed
HIV/Aids victims in developing countries taking effective, anti-
retroviral drugs by the end of 2005. It sounded like a realistic
goal, given that five million new patients are diagnosed each year
with the virus or syndrome. But it hasn't worked out that way. A
devastating article in the current edition of the British medical
journal Lancet lists a few of the shortcomings. Just 30 of the
targeted 50 nations have been covered at all. The needed 400 WHO
staff currently stands at 112. Dr Jim Yong Kim, WHO director of the
Department of HIV/Aids, predicts recalcitrant governments in India,
Nigeria and _ of course _ South Africa make it almost impossible
even to achieve the modest goal of three million patients.

But here is the worse news. Of four million HIV/Aids victims in
Africa, just 325,000 or 8% will be under effective medical treatment
in the unlikely case that the 3 by 5 programme suddenly accelerates
to success by New Year's Eve. Without South Africa on board, tens of
thousands of Africans will be doomed to death by Aids because of the
failure of the WHO project. And now officials have determined the
knock-off anti-retroviral drugs from Indian firms are not at all
``bio-equivalent'' to the expensive, patented drugs they copied.
This will not be a subject for discussion at the WHO gathering this
week.

Nor is the deeply troubled anti-malarial programme called RMB, for
``roll back malaria''. Experts including, again, the Lancet have
harshly criticised RMB, centred in Africa as are most of the million
deaths to malaria each year. They say RMB has been such a failure it
may even have increased the number of victims. WHO teams were found
pushing outdated, ineffective drugs such as chloroquine and
sulphadoxine-pyrimethamine. Malaria does not appear on the WHO
meeting's agenda.

After the Dec 26 tsunami, the WHO began its work only on Jan 18, and
then in conjunction with a US government field team. There are
profound health problems throughout the African continent, where two
of the most prominent and important basic health-care plans are
floundering and facing failure. Yet the annual WHO assembly
beginning today is to focus on issues such as ``social health
insurance'', breastfeeding and an examination of the plight of the
Palestinians. These and dozens of other issues are important in
certain ways, and deserve national or regional attention. But the
WHO is, literally, the world's health organisation. Its Geneva
meeting gives the impression the WHO is either, willy-nilly,
flitting from issue to issue, or ignoring its most important
mandates.

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