Privatising the World Health Organisation

As expected, the Tobacco Control Blog ended last week's World Conference on Tobacco and Health in Singapore with a glowing appraisal of Director General's leadership of the conference, and spiritual leadership of the whole tobacco control movement.

Before the conference the Framework Convention Alliance was less optimistic that headway could be made against the tobacco industry's many empires. They are now excited about a huge donation promised by Michael Bloomberg ($220 million), which will enable them to focus efforts to implement the Framework Convention on Tobacco Control in less developed countries.

The Framework Convention on Tobacco Control is the only international treaty under the auspices of the World Health Organisation. Quite why tobacco control came to be the only health topic worthy of a global treaty is no doubt a matter of historical record.

A report in last month's Third World Resurgence by Tom Fawthrop discusses whether the WHO is 'under siege from the private sector', in part because of the high costs of its activities. It opens by pointing out that Bill Gates addressed the last meeting of member states, describing this as 'symbolic of the crisis facing the United Nations' World Health Organization'. I would add that Bloomberg's donation to the tobacco control cause last week was also symbolic. Gates represents the ultra-wealthy 'globalists', who seek to influence global health policy.

Fawthrop discusses whether Margaret Chan is sufficiently aware of potential conflicts of interest arising from big shots in the corporate world seeking involvement in this field. He lists the wide range of private interests attending the NCD summit last September, noting the concern from professional groups and NGOs at the level of private interest present. He also goes into the recent history, claiming that the World Health Organisation was sidelined in the 1980s by the World Bank, which imposed drastic health cuts as part of its Structural Adjustment Programmes (conditions for financial help), and privatised what was left.

WHO is still sidelined today, as the architects of global governance, the World Economic Forum, seeks 'a new governance paradigm': a complete rethink, in their words:

The model of development characterised by donors and recipients is dead ... In place we need to think about collective responsibility. A world where an increasing number of stakeholders should have a role in shaping and making policy is a given. Governance does not equal governments alone.

Doesn't it sound lovely? We're all in it together! But Fawthrop points out that the WEF does not include medical personnel, patients or the general public among its stakeholders.

It recommends the use of public–private partnerships to meet the provision of health needs. In my book that means that the public will have to pay for projects that will maximise benefit to the shareholders of private companies, and if that means public borrowing, then the general public pays interest, as well as paying for any services that are not free at the point of use. The private corporations win, the banks win and the public benefits only if it can afford to. Countries are quite capable of running a system like that without being supervised by a global 'health authority'.

I used to be starry eyed about the World Health Organisation, before I became aware of its role in tobacco control. But any global authority will become prey to corporations, because they represent business opportunities, and this is what health issues offer them. Without adequate checks to ensure that global health rather than shareholder profits will be the bottom line we might as well not have a global health authority at all.