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WHAT DO YOU DO? - CONT'D

Change

"catalysing change"

To be honest, we don't have a clue how to respond to this one. It is so puzzling because we don't even understand what it means. So let's make our own interpretation. We say that this means that the WHO managed to get critically important projects underway through its presence; projects that would otherwise never happened. This is the very definition of "change". Fair enough. Let's take a look at the document "What's Worked? Accounting for Success in Global Health". This document was sponsored by the Center for Global Development which is a somewhat independent but US-government linked organization which makes them pro-government and pro-government organizations (i.e. socialist). In this document they point out 17 "Test Cases" (their wording, not ours). They are:

1. Eradicating smallpox. Yes, the WHO was of critical importance in this one.
2. Preventing HIV and sexually transmitted infections in Thailand. No critical WHO involvement.
3. Controlling tuberculosis sin China. No critical WHO involvement.
4. Eliminating polio in the Americas. No critical WHO involvement.
5. Saving mothers’ lives in Sri Lanka. No critical WHO involvement.
6. Controlling onchocerciasis in sub-Saharan Africa. No critical WHO involvement.
7. Preventing diarrheal deaths in Egypt. No critical WHO involvement.
8. Improving health in Mexico. (Mexico’s PROGRESA/Oportunidades). No critical WHO involvement.
9. Controlling trachoma in Morocco. No critical WHO involvement.
10. Reducing guinea worm in sub-Saharan Africa. No critical WHO involvement.
11. Controlling Chagas disease in the southern cone of South America. No critical WHO involvement.
12. Reducing fertility in Bangladesh. No critical WHO involvement.
13. Curbing tobacco use in Poland and South Africa. No critical WHO involvement.
14. Eliminating measles in southern Africa. No critical WHO involvement.
15. Preventing iodine deficiency disease in China. No critical WHO involvement.
16. Preventing dental caries in Jamaica. No critical WHO involvement.
17. Preventing Hib disease in Chileand The Gambia. No critical WHO involvement.

Humm… do you begin to see a pattern? Out of 17 "Test Cases" the WHO was instrumental and critical in only one of them; this is 6%. WOW! that certainly is an overwhelming success rate for change. This makes the whole WHO organization worthwhile…not!

Capacity

"building sustainable institutional capacity"

Seriously? Apparently yes, they are serious. OK. Let's begin.

The "building" thingy. Well, the WHO short of building their own buildings containing bureaucrats are not actually building anything else. This is, the WHO is not building laboratories or hospitals or any other facility that could remotely be used to treat patients or do research. So we are seriously at a loss as to what do they mean by "building". Perhaps they are referring to hiring more WHO bureaucrats but then again, if this is the case, this would be an obvious negative issue. Why would they want to publicize it? Or perhaps they are referring to the hiring of more health-related workers by different countries, but then again, the countries are doing the hiring, not the WHO. Or are they referring to training people? Well, considering that the WHO does very little actual training, we can't see it either.

The "sustainable" thingy. This one is really, really funny. Considering that WHO's budget originates almost entirely from governments, how can the WHO ever be "sustainable"? The WHO does not operate for-profit and therefore it cannot make any economic calculation whatsoever (for an explanation see Communists Can Not Count). By definition it they don't have any market-driven income they cannot be sustainable! It's like saying that somebody can be a sustainable bank robber! How much more ridiculous can this get?

And what the heck is "institutional capacity"? Which institution? The WHO? if this is the case then "capacity" simply means more bureaucrats "coordinating" and "leading". Well… no thank you. We already have too many of those. On the other hand if they mean WHOCC's, well, this is entirely out of their hands because they are not funding anything! So what exactly is the meaning of this? We have no clue. If you know the answer, please let us know.

Monitoring health

"monitoring the health situation and assessing health trends"

To a degree the WHO does this. They have fairly substantial databases and they do perform data analysis and trending. To a degree. But then the question is: to do what? What is the point of monitoring and assessing health trends if the WHO can't actually do anything about it. Point in case: Ebola. The WHO has been "monitoring and assessing" Ebola's progress to death… or to be more precise… to thousands of peoples' deaths. And for what? What has the WHO accomplished? Not much… according to their own press releases.

HOW MUCH?

OK. Up to this point we have elucidated what the WHO does (not much) and what it does not do (a lot). It is now time to take a look a closer look at how much is the WHO costing you, us and everybody else (never forget, the WHO is mostly funded by governments). For that let's take a look at WHO's "Financial Report and Audited Financial Statements" for 2012. The following picture provides an overview of where the money is coming from.

As you can see, there are "assessed" and "voluntary" contributions. Assessed means that this is what countries "must" pay while "voluntary" is what they pay without being forced to do so. According to the statement, assessed contributions were in the order of 475 million while voluntary about 1825 (meaning that only 21% of the budget comes from governments). If this would be the whole truth, that would not be so bad. However, let's take a look at what "voluntary" really means. WHO's financial report is an illuminating document where all the "donors" are listed. It is also a highly deceiving document. Donors can be categorized in two groups:

• Government agencies
• Private agencies

For the WHO to categorize government agencies as "voluntary donations" is disingenuous. Does it really matter if the money comes straight from countries or it goes through yet another layer of bureaucracy? Of course not. Government money is your money no matter which route it takes.

And then we have "private" funding. Although it is true that there are a few organizations in the list that are truly private, most of them are themselves funded by governments to a large degree! So a boondoggle by any other name is still a boondoggle. Take a look at the following graph.

If we add the money coming from "Member States" (governments) plus "United Nations and intergovernmental organizations" (government) plus Foundations (whose budgets are typically "supplemented" by governments to the tune of 75% or higher) we reach a grand total of: 89% (skipping "private" donations). What this means is that 89% of this "voluntary" fraction (or 1625 million USD) comes from governments, this is you, us and everybody else. If we add this figure to the other 475 million USD we reach 2100 million USD or about 92% of total WHO's budget. What this means is that in reality and in the best case scenario only about 8% of WHO's budget is truly "voluntary" in the manner in which a normal person would understand it!

But there is more. The WHO costs "only" about 2 billion USD per year. But this is not factoring in all the "free" work that WHOCC's and many other people do for the WHO. Work that it is not really free because it is, again, funded by governments and this means you. True, the financial report has entries for contributions in kind and in services, but those are direct contributions, not indirect ones.

The bottom line is that the WHO is mostly funded by…you!

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