Holding WHO Accountable

The World Health Organization has a poor track record, but the most recent blunder beggars belief. by 

Henry Miller and Jeff Stier City Journal April 18, 2022

The Covid-19 pandemic should be a wakeup call that there is something very wrong—irreparable, even—at the World Health Organization. This revelation shouldn't come as a surprise. After all, the WHO is a constituent of the relentlessly incompetent and politicized United Nations.

From the beginning, government officials, health experts, and analysts have raised concerns about the WHO's bungled response to the coronavirus, accusing the organization of misplaced trust in the Chinese government, which initially tried to conceal the outbreak in Wuhan. Taro Aso, Japan's deputy prime minister and finance minister, even derided the WHO as the "Chinese Health Organization." Rather than taking Beijing to task for its attempted cover-up, WHO director-general Tedros Adhanom Ghebreyesus praised Chinese president Xi Jinping for his "very rare leadership" and lauded the Chinese Communist Party's "transparency" in responding to the virus. Few would dispute that Tedros and the WHO acted tardily in declaring a global health emergency and, thereafter, a pandemic. But the most recent WHO blunder beggars belief.

Medicago, a Canadian company, developed a Covid vaccine synthesized in the Nicotiniana plant, a relative of tobacco. In clinical testing, the vaccine proved 71 percent effective against all variants studied prior to the emergence of Omicron and 75 percent effective against the Delta variant. Canada's department of health approved the vaccine for domestic use in February, but its global distribution has encountered an unexpected obstacle: the WHO won't consider approving the vaccine for wider use because of the manufacturer's ties to U.S.–Swiss tobacco company Philip Morris International, which owns a roughly one-third equity stake in Medicago.

Wealthy countries currently have a plentiful supply of Covid vaccines, but the WHO's authorization of the Medicago vaccine, Covifenz, is critical to expanding vaccine access in low- and middle-income countries, as it would qualify the vaccine for inclusion in the organization's COVAX global vaccine program. Access to Covifenz would particularly help countries lacking sophisticated medical infrastructure because, unlike some of the other Covid vaccines, Covifenz doesn't require storage in an ultra-cold freezer. Medicago might find a workaround—Philip Morris could divest itself from partial ownership of the company, for instance—but the WHO's current intransigence denies relief to countries its COVAX program is designed to aid.

This most recent folly should prompt the United States, as the WHO's biggest donor, to conduct a thorough review of the organization's competence and values. Global public health is consistent with American interests not only because we are a generous people but also because, as Covid has reminded us, public-health battles not won overseas will find their way to our shores. We would be derelict to contribute money to public-health organizations without mandating good stewardship.

American taxpayers are the largest contributors to the WHO's approximately $2 billion budget. Like other UN organizations, the WHO is plagued by wasteful spending, disregard for transparency, incompetence, and a failure to adhere to even basic democratic standards. Its Western Hemisphere subsidiary, the Pan American Health Organization, supports antidemocratic regimes and actually "weakens public health rather than strengthening it," according to a Wall Street Journal article.

The WHO's history is rife with ineptitude and ethically compromised dealings. Under its polio eradication policy in Syria, for example, health-care workers were allowed to work only with the brutal, corrupt regime of Syrian president Bashar Assad but not in rebel-held areas. Thus, while the WHO effectively contained polio within government territory, the disease spread throughout rebel areas. The WHO has also been widely condemned for failing to raise the alarm about the dangers of Ebola in West Africa in 2014. The WHO's International Agency for Research on Cancer (IARC) is known to promulgate alarmist reports frequently contradicted by regulators worldwide. When a U.S. congressional committee attempted to investigate (well-founded) charges of corruption and conflicts of interest within the agency, the IARC rebuffed the effort.

What explains the WHO's dubious track record? Look to the structure of the UN.

First, the UN is essentially a monopoly. "Consumers" of UN products and services cannot punish the organization by patronizing competitors. To the contrary, inadequacy is too often rewarded with additional resources. Unlike in the private sector, where failed projects get shut down, bureaucrats often champion and clamor to expand programs that clearly don't work.

Second, UN officials are rewarded for making the bureaucratic machinery run—for producing reports, guidelines, white papers, and agreements, and for holding meetings—regardless of whether their efforts prove effective. Bureaucrats typically sacrifice quality and veracity for consensus.

Third, no authority holds the UN accountable, and no electorate can oust UN officials when they act contrary to the public interest.

Finally, the organization is no meritocracy. Leadership candidates' country or region of origin seems to be valued more highly than their qualifications, and countries seconding staff to the WHO understandably don't send their best talent.

The United States' funding of UN activities exceeds that of every other country. In 2020, the U.S. contributed more than $11 billion, which accounted for just under one-fifth of funding for the organization's collective budget. Unless an effective oversight and auditing entity can be created to oversee the WHO, the U.S. should discontinue its funding and instead support an entity that we can hold accountable for protecting global public health—a mission both worthy and necessary, as Covid reminds us.

Henry I. Miller, a physician and molecular biologist, is a senior fellow at the Pacific Research Institute. He was the founding director of the Office of Biotechnology at the U.S. Food & Drug Administration. Jeff Stier is a senior fellow at the Taxpayers Protection Alliance.

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