Friday, May 19, 2006

WHO, do you Trust?


WHO, the World Health Organization, is running point on the Avian Flu crisis, and much of what we know, or don’t know, comes from that international body. The messages we get are mixed and confusing, and much of the data they have, they keep under wraps.


Most of us probably think of WHO as some lofty scientific entity, devoid of politics and greed, dedicated to promoting the health and well being of humanity. And on the surface, that would seem to be the case. There are many dedicated scientists and doctors working there, and I’m sure their hearts and minds are in the right place.


Sadly, the WHO answers to all 190-member states of the United Nations, and has no autonomy and virtually no power unless granted by these countries. When WHO investigates an outbreak of any disease, they must be invited in by the host country, and must have permission to release any information. They walk a fine diplomatic line, and are at the mercy of 190 tangled and often corrupt bureaucracies worldwide.


Despite the cynicism and distrust levied by the people of our country against our government, when compared to many third world nations, we are a shining example of openness and honesty. Proves how grading on the curve can skew the results.


Few third world countries are willing to cooperate with the WHO, unless there is free money in it for them. They leverage access to disease outbreaks for political and monetary gain. The hold information hostage, by refusing to allow WHO to speak freely, when they feel it would be detrimental to their balance of trade, national treasury, or the control of their people. Public health does not play second fiddle; it isn’t even in the band.


Yesterday, a WHO team was on the ground in Indonesia to investigate the outbreak where a large cluster of family members has died in the last week. They were scheduled to visit the village where it occurred, but had to change their plans when the village leaders refused to allow them access. They are routinely barred from doing autopsy’s or taking blood samples due to religious and traditional beliefs. Their hands are often tied, and yet we depend on them to save us from a potential pandemic.


Add to this the political pressures from 190 different governments, and it’s a miracle we hear anything.


None of this is to suggest that WHO is without blame. They are a bureaucracy themselves, and have their own agendas, internal wars, and failings. They, like the CDC, and every other medical watchdog group, have varying levels of competence. It is a mixed bag, and we can do little but sit and watch and hope they get it right.


We’ve now sent the CDC to Indonesia, to `help’ the WHO in their investigation. We also have NAMRU labs (navy medical research units) doing confirmation testing. Perhaps, out of all of these entities, we shall learn the truth of what is going on in Indonesia, and Africa, and other hot spots of Avian Influenza activity. I hope so.


But for now, we have to take all press releases with a huge boulder of salt. There are forces at work here, agendas in play, that don’t want us to know the truth. We cannot afford to let down our guard, and trust that these organizations can, or will, tell us what is happening.


Sad, but true.