United States accused of interference ahead of vote for next WHO chief
United States accused of interference ahead of vote for next WHO chief
Posted: 2006/11/07
‘’The U.S. government has a direct role in every significant decision made in Geneva, and even close to a veto role,'’ said Dr. Richard Horton, editor of the influential medical journal, The Lancet International Herald Tribune
(AP) - GENEVA: The World Health Organization is convening this week to pick its next leader, and some leading public health officials are worried the new chief may not have the strength to stand up to Washington on drug and sexual health policy. Critics say WHO has been largely controlled behind the scenes by the United States — its biggest donor, and one which many contend is intent on promoting the interests of its pharmaceuticals industry and the Bush administration’s ideological line on issues like abortion.
Leading public health experts and senior WHO officials told The Associated Press that Washington consistently interfered with policy under the U.N. agency’s last director-general, Dr. Lee Jong-Wook, who died in May. "The U.S. government has a direct role in every significant decision made in Geneva, and even close to a veto role," said Dr. Richard Horton, editor of the influential medical journal, The Lancet. Horton also sits on an independent advisory panel for WHO.
In one prominent case, the United States recently requested the suppression of a book commissioned by WHO that criticized U.S. free trade agreements for jeopardizing poor countries’ access to cheap medicines. In a letter to WHO’s acting director-general, a senior official from the U.S. Department of Health and Human Services said the report "spuriously" characterized of U.S. trade policy. WHO has yet to make a decision on the U.S. demand. "Standing up to the U.S. is not the easiest thing to do at the WHO," said Sisule Musungu, a Kenyan intellectual property specialist, who co-authored the report with a former WHO staffer.
The episode has sparked concern from two U.S. Democrats, Senator Edward Kennedy and Representative Henry Waxman, who have called for an investigation into how American trade agreements threaten the health of people in developing countries. "Attempting to suppress a report because it is critical of U.S. trade policy is unacceptable," Kennedy wrote in a letter to Mike Leavitt, Secretary of Health and Human Services. "We need more — not less — analysis of the factors affecting global public health."
Contenders for the top job include former Hong Kong director of health and WHO insider Dr. Margaret Chan, Mexican Health Minister Dr. Julio Frenk, and longtime WHO Kuwaiti official, Dr. Kazem Behbehani. After three days of closed-door deliberations, WHO’s executive board, comprised of 34 representatives from 193 member states, will announce the new leader on Wednesday.
For many, the clearest sign of U.S. meddling under Lee’s tenure came in January, when WHO’s top official in Thailand was stripped of his post after he said in an editorial that a U.S.-Thai free trade agreement would jeopardize Thai access to cheap drugs, leading to the deaths of hundreds of thousands of AIDS patients. The official, Dr. William Aldis was swiftly dispatched to the WHO’s regional office in New Delhi, India, and was given no explanation for his demotion.
Aldis was authorized by WHO rules to write the editorial, which largely followed the lines of WHO policy on generic AIDS drugs. Several Asian newspapers complained about American interference, and the transfer was the subject of articles in Britain’s Financial Times accusing the U.S. of bullying the international organization and endangering the lives of AIDS patients. "This was an example of an instance where there was probably pressure from a certain member state, in this case the U.S., and unfortunately, WHO was not able to take a clear stance in defending health issues," said Dr. Tido von Schoen-Angerer, of Medecins Sans Frontieres, which works closely with WHO.
Several senior WHO officials, speaking on condition of anonymity because of the sensitivity of the issue, told The Associated Press that American opposition to Aldis was indeed behind his removal. The United States denies it had anything to do with Aldis’ transfer. "We had no role in that," said Bill Hall, a spokesman for the U.S. Health and Human Services Department.
Though Hall says Washington formally complained to the WHO about the editorial, he said no suggestions were made about disciplining Aldis. The Bush administration has challenged ideologically charged WHO programs such as needle exchanges and condom distribution. Republican policies have had a "chilling" effect on condom distribution in Africa, a WHO official who works on HIV/AIDS said on condition of anonymity because of the sensitivity of the topic. Bush has made more money available for AIDS research than any previous American president, but that largesse has not been extended to programs in reproductive and sexual health. "As soon as the word ‘abortion’ appears, there is likely to be severe scrutiny from the Director-General’s office," said a WHO official who works on reproductive health issues and spoke on condition of anonymity because he is not authorized to speak to the media.
In the case of Thailand, experts say, WHO’s AIDS policy has wideranging implications. Thailand has often been praised as a success story in its approach to tackling AIDS — producing cheap, generic versions of anti-retrovirals. More than 80,000 people depend on these life-prolonging treatments and AIDS deaths have dropped by nearly 80 percent in the last decade.
Advocacy groups say a free trade agreement with the United States could jeopardize all that: in exchange for increased trade with Washington, Thailand would be obliged to tighten its intellectual property laws, making it harder to produce generic drugs without the consent of the company holding the patent. Normally, there is great flexibility under World Trade Organization rules for manufacturing generic drugs for domestic use.
Since the publication of Aldis’ editorial, the Thailand-U.S. free trade agreement has been stalled — largely because of the attention drawn to what the pact would do to Thailand’s strategy on fighting AIDS. For some who have worked at the top echelons of WHO, the imprint of the U.S. has been unmistakable. "A huge number of decisions at WHO were affected by the U.S. And the ones that weren’t were in areas in which the U.S. didn’t have a particular interest, like whether the leprosy department should be in Geneva or Delhi," said Dr. Jim Yong Kim, former WHO AIDS director.
In reproductive health, Washington allegedly has delayed the approval of lists of essential medicines for countries because they included drugs that could induce abortions. In malaria control, WHO’s recent endorsement of the use of the controversial pesticide DDT was seen by some in the malaria world as a capitulation to the American industries that produce it since other equally effective alternatives exist.
