WHO limping behind in more ways than one
ABASIC rule of good science is to keep politics out of it. One of the best rules of governance is to keep it as local as possible. The World Health Organiswation (WHO) violates both principles. WHO is strongly in the prohibitionist camp when it comes to tobacco in any form, including so-called e-cigarettes or vapour technology.
Shortly after WHO released a report damning the new technology, experts published a paper in the scientific journal Addiction that argued the WHO “review of evidence on e-cigarettes contains important errors, misinterpretations and misrepresentations putting policymakers and the public in danger of foregoing the potential health benefits of e-cigarettes”.
Negativity
Lead author, Professor Ann McNeill of King’s College, London’s National Addiction Centre, said: “We were surprised by the negativity of the commissioned review, and found it misleading and not an accurate reflection of available evidence.
“E-cigarettes are new and we certainly don’t yet have all the answers as to their long-term health impact, but what we do know is that they are much safer than cigarettes, which kill more than 6 million people a year worldwide.”
McNeill noted vapour technology is far safer to smokers and to nearby bystanders, yet WHO is pushing for more regulations, which “will make it harder to bring these products to market than tobacco products, inhibit innovation and put off smokers from using e-cigarettes, putting us in danger of foregoing the public health benefits these products could have”.
The journal report found that vaporised tobacco has toxin concentrations far lower than that found in regular tobacco smoke and that the risk to bystanders is minimal because the concentrations in the exhaled vapour is “too low to present a significant risk”. The medical journal British Journal of General Practice put forward the idea in favour of harm reduction though vapour technology. They reported that for every 1 million cigarette users who switch to vapour technology, 6 000 premature deaths would be prevented.
Dr Jacques le Houezec, from the Global Forum on Nicotine, says vapour technology “has been a consumer led revolution, the speed at which these products have developed and evolved shows just how much smokers are ready to adopt harm-reduction products. The use of e-cigarettes could save millions of lives during this century.”
Meanwhile, when doctors from Médecins Sans Frontières sounded the alarm about an Ebola outbreak in Guinea, WHO chose to downplay the risks.
Critics of WHO were furious that it could downplay something as deadly as Ebola. The Economist magazine described WHO’s response: “As Ebola spread, it dawdled, leaving overstretched aid groups to pick up the slack.”
In a reminder to readers, they stated: “This is symptomatic. Two decades ago, it did a poor job of coping with Aids, so the UN created its own agency to fight the disease. Too often the WHO’s policies are shaped by politics, rather than the best medical evidence.
“In recent years the Gates Foundation bankrolled an institute to gather health statistics and evaluate health policies, which is now regarded as more authoritative,” they said.
“Because the WHO is no longer seen as doing cutting-edge work, it does not attract or keep the best staff. And its record on pushing through international deals on health policy is patchy.
“An agreement was reached to work at reducing tobacco use, but member states tend to see negotiations (on such subjects as counterfeit drugs and anti-obesity guidelines) as a chance to lobby for their economic interests.”
WHO regional officials are not accountable to WHO but to local governments. The Economist says this “means some are stuffed with incompetent political placements”, particularly WHO’s Africa office.
According to The Economist, WHO should stop focusing on politics and instead “focus on the things they (local governments) cannot manage alone, such as helping poor countries set up health systems, disseminating the best medical research, and combating global epidemics. Politicians must be stopped from using regional offices as a parking-place for friends and relations of their allies.”
Time magazine concurred. “WHO has failed to lead the global fight – exactly the kind of crisis it has aimed to efficiently handle or prevent since its founding in 1948. In general, many say it’s ‘too politicised, too bureaucratic… too overstretched and too slow to adapt to change’, according to a report by the London think tank Chatham House, citing health experts and some former WHO staffers.”
Time interviewed WHO directorgeneral Margaret Chan. She made excuses for the organisation’s response and made vague promises of doing better.
Chan excused the response saying: “Now, looking back, all of us would say, yes, the scale of the response did not match the scale of the outbreak. And that is fair. And of course all of us underestimated the complexity.”
That simply was not true. Not everyone underestimated the problem. Long before WHO’s “hindsight” kicked in, they were warned Ebola was a major crisis.
The report found vaporised tobacco has toxin concentrations far lower than found in regular tobacco smoke and the risk to bystanders is minimal.