Analyzing World Health Organization's Pandemic Response Proposals
Scrutinizing the World Health Organization's Pandemic Response Proposals
Introduction
There has been a considerable amount of discussion about the current proposals that place the World Health Organization (WHO) at the forefront of future pandemic responses. With billions of dollars in careers, salaries, and research funding involved, maintaining objectivity can be challenging. However, there are fundamental principles that those with public health training should agree on. Most others, if they take time to reflect, would likely concur. This includes most politicians, once they step away from party politics and soundbites. Here, we will examine some of the issues with the pandemic proposals set to be voted on at the World Health Assembly later this month, from a traditional public health perspective.
Misleading Urgency Claims
The Pandemic Agreement and IHR amendments are being pushed based on assertions of an escalating risk of pandemics. However, recent analysis from the UK's University of Leeds disputes these claims, revealing a decrease in natural outbreaks and resulting mortality over the past decade. Despite this, the WHO continues to promote the narrative of increasing risk. The question arises: do we want an organization influenced by geopolitical rivals to handle a future bioweapons emergency?
Low Relative Burden
The impact of acute outbreaks is a fraction of the overall disease burden, far lower than many endemic infectious diseases such as malaria, HIV, and tuberculosis, and a rising burden of non-communicable disease. With the advent of modern antibiotics, major outbreaks from past diseases like Plague and typhus have ceased. So, where should our focus lie?
Insufficient Evidence Base
Investment in public health requires evidence that the investment will improve outcomes and will not cause significant harm. The WHO's proposed interventions have not demonstrated either. The lockdown and mass vaccination strategy for Covid-19 resulted in 15 million excess deaths, even increasing mortality in young adults. This raises the question: are the WHO and other public-private partnerships following orthodox public health, or something different?
Centralization vs. Heterogeneity
Twenty-five years ago, decentralization in public health was deemed sensible. However, the WHO has taken a one-size-fits-all approach to the Covid-19 response, which has been met with agreement by its private sponsors and the two largest donor countries. This approach contradicts the principles of history, common sense, and public health ethics.
Ignoring Host Resilience
The WHO's IHR amendments and Pandemic Agreement focus on detection, lockdowns, and mass vaccination, ignoring the potential of community and individual resilience. Investing in nutrition and sanitation could not only reduce mortality from occasional outbreaks but also from more common infectious diseases and metabolic diseases. However, this approach would not be profitable for pharmaceutical companies.
Conflicts of Interest
The WHO, which was originally funded by countries to address high-burden diseases, now has 80% of its funds specified directly by the funder, altering its approach. This raises the question of whether the WHO is working in the best interest of public health or its private and corporate sponsors.
Conclusion
While it is prudent to prepare for outbreaks and pandemics, it is even more crucial to improve health. This involves directing resources to where the problems are and using them in a way that does more good than harm. However, the new pandemic proposals seem to be more of a business strategy than a public health strategy. The real question is whether the Member States of the World Health Assembly will choose to promote a profitable but morally questionable business strategy or the interests of their people when they vote later this month.
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