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World Health OrganizationExactly. Today we are going to take a critical look at the World Health Organization (WHO). We will do so because (generally speaking) very few people (if any) dare to touch "sacred cows". Health being one of the most basic human necessities and politics being one of the most powerful forces on earth, the WHO embodies both quite effectively. As such their aura as public benefactors and health promoters gives them carte blanche (so to speak) to do "whatever they need to do". The questions then becomes: What is it that they "need to do"? and How much are we paying for "it"? Because, you know, you are paying for it. That's right, most of WHO's funding comes from governments who obtain that money through the unholy trinity (tax, borrow and print); this means your pocket.

WHAT DO YOU DO?

Let's begin by trying to answer the first question. What are WHO's "core functions" (as they call them)? They are listed in their website (in italics below). Let's take a look.

Leadership and Partnerships

"providing leadership on matters critical to health and engaging in partnerships where joint action is needed"

Leadership eh? Considering that the WHO is a bureaucratic organization without real power (its "resources" are not actually "theirs" belonging to independent nations), how exactly are they "leading"? They can't issue actual orders, just suggestions. This conundrum becomes clear in the second part of the sentence where they state that they do so by "engaging in partnerships". OK. So the operational process is more-or-less like this: Let's all take courage and you pay and you go and solve the problem. We will stay here and…err… cooperate! Yeah. That's it. Brilliant!

This is epitomized by the WHOCC (WHO Collaborating Centres) which according to their Director-General "In everything we do, WHO relies on the expertise of hundreds of formal WHO Collaborating Centres, in your countries, and thousands of the best brains in science, medicine, and public health, in your countries. They give us their time freely…"

Well, considering that their time is not actually "free" (you are paying for it) we should add this expenditure to the already overbloated WHO budget.

And what do WHOCC's get in return? "institutions designated as WHO CC gain increased visibility and recognition by national authorities, and greater attention from the public for the health issues on which they work." In other words, nothing practical. Sure, fame, glory and notoriety may be fanciful and desirable but at what cost? Why should a bunch of researchers become famous at your expense? Remember, they are not becoming famous because of what they do but because of WHO (pun intended) they associate with.

Furthermore, if you bother reading the "WHO Terms and Conditions" [for WHOCC organizations] you will notice that not only WHOCC's must sign contracts with the WHO, but in so doing and in "WHO sponsored" projects they are barred from seeking any other kind of funding support that may be remotely related to any kind of commercial activities. In other words, for those scientists to become famous, the government (i.e. you) must fund them. Furthermore, they are prohibited from diminishing this burden through commercial applications of their research… commercial applications that would (in a free market) generate profits allowing for further research which will constantly improve your standards of living! Yeah… this really makes sense…not!

Research

"shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge"

So, they change research agendas? Really? Where? As far as we can tell there are very few (if any) national research organizations throughout the world that actually changed their research agenda substantially to accommodate WHO-suggested research. Let's be clear here. Yes, in order to obtain the coveted WHOCC title a research organization must sign a contract with WHO to implement the "agreed plan of work". And therefore in the strictest sense of the meaning, yes, WHO is "shaping" agendas. However, this is not how most people would interpret the statement. Any normal person reading that statement would believe that WHO is actually dictating the direction of research. But is this true? Well, if you take an organization that is researching issue "X" and then this organization agrees with WHO to research issue "X" would you say that said organization's research agenda has been "shaped"? Does it really matter if this research follows WHO guidelines as opposed to in-house or ISO, or ASTM or IEEE or some other standardization organization guidelines? We believe not because those guidelines are not affecting the direction of the research, only its methodology and that very little at best. If you look at the list of WHOCC's you will notice something suspicious. Most (if not all) of them are researching "X" while under contract with WHO to research "X". Is the WHO actually "shaping" the research agenda or is it "shaping" public perception? Hummmm… what a conundrum to ponder about...

And what about grants? Sure, WHO has research grants, but they are mostly soft-skills (i.e. training) and very, very few actual lab-type research projects. So yes, strictly speaking they may be "shaping" research agendas, but then again, what is the real impact of those agendas in the real world? We believe very little but if we are mistaken, please feel free to contradict us.

And what *exactly* is the meaning of "stimulating the generation… of valuable knowledge"? The term "valuable knowledge" itself is fuzzy. Any knowledge is "valuable" to somebody. We would have to assume that they refer to valuable (i.e. practical) medical knowledge but as we have mentioned before, WHO's impact on research at a world-wide level is negligible. So… what are they "stimulating"? We most certainly don't know.

And how about "translation" of knowledge? As far as we can tell, there are no WHO sponsored, suggested, recommended or WHO-anything projects to translate scientific information into other languages at any meaningful scale. And if they are not doing so, what are they translating this knowledge into? Martian language? Mathematics? Ballet?

Dissemination on the other hand they do, beginning with their own so-called "reports"… of which they produce a lot… with content of highly dubious use because they are mostly pieces of socialistic political opinion as to what "should" be done (the exception being reports of scientific nature).

They also organized the HINARI (which is a consortium of private biomedical publishers) offering their online publications for free to under-developed and "deserving" countries. But then again, this "effort" costs WHO close to nothing, because they are only the administrators of the program which is to say that they are simply the Help Desk that provides User ID's and Passwords. Not to mention that many semi-deserving countries do have to pay a modest fee to WHO. We would not be surprised at all if this program is self-funded.

Lastly, the WHO created the Global Health Observatory (GHO), which is a collection of WHO-developed/reworked statistical data. As the WHO does not usually do data collection at large scale what is the real "effort" invested into the GHO? Just a little bit. A very little bit. Data is acquired from other sources and then re-worked by WHO statisticians and published on a (very) slow website. That's about it. Not exactly an extraordinary effort.

Note: please see the Glossary if you are unfamiliar with certain words.

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