Hearing from the WHO

Editorial
Copyright 2000 Wall Street Journal Europe
August 3, 2000

When the World Health Organization is mad at you, it publishes a 248-page report. A new report sharply condemns cigarette-makers for "subverting the efforts of the World Health Organization to control tobacco use" by trying to "discredit" the agency and cut its budget. The report takes a few cracks at us, as well.

In short, a ponderous U.N. bureaucracy, aptly abbreviated WHO, has discovered that its targets sometimes fight back. The WHO wants to limit smoking world-wide and tobacco firms want to defend their shareholders' interests. Sounds like both sides are doing what comes naturally.

There is very little that is new in this sometimes tendentious report, released with great fanfare yesterday afternoon. It is mostly based on the some 35 million documents that tobacco companies have had to make public in a welter of lawsuits over the past several years. The "incriminating" documents date from 1988.

Still, the report is an important story -- albeit not for the reasons that so many journalists seem to think. The report reveals that the agency is still thin-skinned about criticism. That doesn't augur well for its own long-term health. One persistent critic, Paul Dietrich, told us yesterday that the WHO hired private detectives to trail him and gather dirt.

The WHO seems perplexed by such artifacts of Western democracy as the right of free expression. Journal editorial pages, which in the 1990s printed some of Mr. Dietrich's critiques, come in for more than their share of WHO complaints in this report. The WHO's effort to subtly associate Mr. Dietrich's articles and this newspaper with the tobacco industry is most unbecoming.

There is in fact very little new to be said about the health hazards associated with tobacco use. They have been thoroughly documented in the press -- including this newspaper -- and medical literature, including the now-famous U.S. Surgeon's General report that is the basis for the warnings on cigarette packs required by U.S. law. The WHO has thus spent a lot of time and money attacking an industry that is already under heavy fire in the press, in lawsuits by smoking "victims" and from state attorneys general in the U.S. So the WHO, which could be more arduously pursuing the difficult work of trying to eradicate sources of epidemics, is wasting its resources on what Americans call "beating a dead horse."

We must of course ask ourselves why. The only answer that satisfies is that this much-criticized agency is trying to demonize its critics by associating them with a pariah industry, tobacco. In fact, most of its critics have nothing to do with that industry and neither do the questions they have raised over the years about whether the WHO had simply become a talk shop while epidemics rage throughout the world.

In the mid-1990s, the WHO was investigated for poor accounting practices by the U.S. and several European governments. The prestigious British Medical Journal wondered if the agency was doomed to "flounder in a morass of petty corruption and ineffective bureaucracy." At about the same time, Mr. Dietrich in these pages pointed out that the WHO was increasing the budget for conferences by 73% while slashing funds for some vaccinations in poor countries. The agency's own reports admitted that infectious diseases were rising because "vigilance had been relaxed." Millions die every year from infectious diseases -- most of those lives could be saved by a vaccine that costs less than $1 per dose.

We understand that the WHO did clean up its bookkeeping in response to the 1990s complaints. And it also has stepped up spending for vaccinations, we're told. So maybe the critics did some good. Instead of excoriating them, the WHO should consider them free consultants.

If the WHO wants to join the anti-tobacco chorus, it's OK with us. But protecting world health is a question of priorities. Money and time is limited. Next week the WHO and other organizations will hold a conference that will help set up a global anti-smoking regime (another conference, yet). "They want to pressure governments to raise the cigarette tax," said Roger Bate, a fellow at the Cambridge, U.K.-based European Science and Environment Forum.

But when the WHO director Gro Brundtland calls smoking the "biggest global health threat" and adds that "by the year 2010 tobacco is going to be the biggest disease burden globally," we wonder about the WHO's priorities. Has anyone at the WHO heard about the AIDS scourge in Africa?

Smoking is not a disease; it is a dangerous choice. A disease is a hostile form of biology. Dealing with real diseases is hard work, requiring the organizational capacity to mount effective public health programs. Writing a report based on well-known facts or calling a conference to massage those facts is something any deskbound bureaucrat can do. The WHO would win more respect if it paid more heed to complaints that it is essentially a do-nothing organization.