The World Health Organisation has been criticised a lot lately. There have been plenty of reasons for that, including its farcical initial response to Covid and its origins. But criticism of the WHO did not begin with Covid – it has been growing for some years now. Indeed, many are now asking whether the organisation has reached its use-by date.
When the WHO was first established, in 1948, preventable diseases were common with health care often unavailable. Its programs focused on developing countries, with sanitation and vaccination as major priorities. The eradication of smallpox and the near eradication of measles, rubella and polio have been major successes.
Many of its current campaigns are similar: improving childbirth outcomes in poor societies, vaccination campaigns to control cholera, Ebola and yellow fever, and developing an effective vaccine against malaria among them. But it has also extended its remit far beyond communicable diseases and health emergencies. A lot of resources are now devoted to promoting regulatory interventions to combat non-communicable ‘lifestyle’ diseases, involving campaigns against tobacco, alcohol, sugar, salt and other issues that are ultimately matters of personal choice.
Its approach to tobacco illustrates this; it embraces coercive measures such as advertising and promotion bans, non-smoking areas and high taxes while saying nothing about voluntary alternatives such as vaping and snus.
Indeed, it has become a massive advocate for the nanny state. Its default position is to deny people the right to manage their own health and lifestyle in favour of authoritarian measures such as mandatory health warnings, prohibition legislation, advertising bans and excise taxes. It also advocates socialised healthcare systems (to achieve what it calls universal health care), with the title of its 2018/2019 Results Report “Driving impact in every country”, and has even embraced the gender fluidity argument, claiming “As a social construct, gender varies from society to society and can change over time.”
In 2018/19 the WHO’s budget was US$4.4 billion, with $351 million allocated to “Non-communicable diseases” and $384 million for “Promoting health through the life course”, a program that includes “Equity, social determinants, gender equality and human rights”.
Member states each make a contribution based on their GDP, but that only covers about 20% of the budget. A further 5% comes from voluntary contributions by member states, leaving 75% from other sources. America is by far the biggest contributor and the UK second (Australia is 19th), but the third biggest is the Bill and Melinda Gates Foundation. In fact, just 20 donors contributed 80% of the organisation’s budget, of which only 13 are national governments including the European Commission.
Despite its reliance on non-government donors, the WHO’s intervention into non-communicable diseases is not obviously a result of pressure by them. None of the donations by the major philanthropic organisations contribute to funding this. About half of this nanny state allocation is taken from the assessed contributions of member states, while the other half comes from voluntary contributions by nine countries, including Britain, the Scandinavian countries and Australia.
It is more likely these countries are behind the program. It is not hard to imagine Australia’s delegates to the Health Assembly, which approves the work of the WHO, pushing the WHO in the nanny state direction; our domestic policies on alcohol, tobacco and other lifestyle issues are at least as intrusive and coercive as any other country. Moreover, on tobacco, our health bureaucrats constantly praise the merits of their own policies while ignoring the obvious fact that they are failing to reduce smoking and have caused a large and growing illicit tobacco market.
Australia’s enthusiasm for the WHO’s involvement in this area is obviously not widely shared. There is a clear gap between the WHO’s aspirations and the funding it receives from donors. This is leading to some scaling back of activities, although there is no indication it plans to change tack.
What this demonstrates is that by no longer sticking to communicable diseases and health emergencies, the WHO has become quite political. Whereas once its priorities were largely driven by need – people suffering and dying – it now assumes everyone aspires to live forever and requires its guidance to do so.
And when it is not doing that it is kowtowing to China and its lies, obstruction and obfuscation regarding the source of the Covid-19 virus.
A global organisation capable of helping the less fortunate people in the world is not an inherently bad idea. The question is whether that’s what we’ve got.
David Leyonhjelm is a former senator for the Liberal Democrats