Is the World Health Organization Part of the Problem?

Brian Doherty has an excellent, scathing attack on the World Health Organization for the January 2002 issue of Reason which argues that the organization is a bureaucratic nightmare more interested in self-preservation than actually doing something about improving health in the developing world.

Doherty writes that when the WHO was founded after World War II it had a substantive impact on health, especially in the developing world. WHO played a major role in tackling a number of infectious diseases, culminating with its role in the eradication of small pox in 1977.

But after the victory over small pox, WHO started turning away from focusing on infectious disease in the developing world to most First World concerns. First under Director General Hiroshi Nakajima and then Gro Harlem Brundtland, WHO began to turn away from infectious disease. Doherty writes,

In a world still fighting infectious disease, Brundtland’s WHO has issued statements, studies, and reports on such topics as blood clots in people who sit still on airplanes too long, helping people remain active while aging, the hazards of using cell phones while driving, the importance of debt relief for poor countries, how tobacco is “a major obstacle to children’s rights,” and rates of alcohol abuse among European teens.

Doherty is especially troubled by the recent WHO analysis of world health problems which relied on a measurement called the disability adjusted life year. The idea behind the DALY is that someone suffering from a severe illness or disability is living a lower quality of life than someone who is not. But WHO’s attempt to quantify produced bizarre results whereby, for example, WHO claims that 16 percent of the years lost to disability in sub-Saharan Africa come from mental illness. Any organization that thinks mental illness is one of the major health problems facing that region, however, is crazy.

Doherty’s article finishes with a stark reminder of just how ineffective WHO is and how misguided its focus on things like years lost to disability are,

Nothing condemn’s WHO’s current agenda more than some of its own pronouncements. In a 1999 press release, WHO declared that six illnesses accounted for 90 percent of all infectious disease deaths among people under 44 years: malaria tuberculosis, measles, diarrheal diseases, acute respiratory infections (including pneumonia), and AIDS. The same press release declared that “the tools to prevent deaths from each of these six diseases now cost under $20 per person at risk, and in most cases under $0.35. Yet these diseases still caused over 11 million deaths in 1998.”

. . . we have WHO declaring that 11 million deaths — 90 percent of all infectious disease deaths for people under 44 years — could have been easily prevented with an expenditure of, at its lowest, $3.9 million, and at its highest, $220 million. That is, anywhere from 0.4 percent to 20 percent of WHO’s budget for one year.

What does WHO spend its money on instead? Doherty cites an analysis of WHO’s 1994-95 budget that found WHO spent as much on its meetings and its executive board as it did on immunizations, tuberculosis and diarrheal diseases combined. Seventy percent of its budget went to administrative overhead and its Geneva headquarters.


WHO Cares? The World Health Organization cares more about its own life than the lives of the poor. Brian Doherty, Reason, January 2002.

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