WHO's in charge of world health?

The World Health Organisation is the chief body of the United Nations responsible for global health problems. It is charged with monitoring the state of the health of the six billion citizens of Earth, and with stepping in with cures, remedies and preventatives when warranted.

The health of the world is far from excellent, and the same may be said of the WHO. Today is the start of the UN body's annual meeting.

It is discouraging to see that instead of coming to grips with the agency's problems and shortcomings, its bureaucrats are set to discuss a series of relatively unimportant matters which, at best, will make a relatively few healthy people more healthy.

In the year of the tsunami recovery, with its anti-malaria programme faltering and the most important Aids initiative on the brink of failure, the WHO will focus this week on quite different matters.

There is a Global Initiative to kick off, for example - on diet, physical activity and health. This is a project for middle-class people with wide choices, and will provide recommendations on meals and exercise.

Then there are the projects on road safety, destroying smallpox samples, finance and relations with non-governmental organisations.

There will be an entire conference session on the health conditions in Israel-occupied territories, but there will not even be one for all of Africa, the centre of the two most important and failing WHO policies.

The WHO has spent untold funds - perhaps to be accounted this week - on a much-needed Aids programme called 3 by 5. The aim, when this project began several years ago, was to have three million diagnosed HIV/Aids victims in developing countries taking effective, anti-retroviral drugs by the end of 2005.

It sounded like a realistic goal, given that five million new patients are diagnosed each year with the virus or syndrome. But it hasn't worked out that way.

A devastating article in the current edition of the British medical journal Lancet lists a few of the shortcomings. Just 30 of the targeted 50 nations have been covered at all.

The needed 400 WHO staff currently stands at 112. Dr. Jim Yong Kim, WHO director of the Department of HIV/Aids, predicts recalcitrant governments in India, Nigeria and - of course - South Africa make it almost impossible even to achieve the modest goal of three million patients.

But here is the worse news. Of four million HIV/Aids victims in Africa, just 325,000 or 8% will be under effective medical treatment in the unlikely case that the 3 by 5 programme suddenly accelerates to success by New Year's Eve.

Without South Africa on board, tens of thousands of Africans will be doomed to death by Aids because of the failure of the WHO project. And now officials have determined the knock-off anti-retroviral drugs from Indian firms are not at all "bio-equivalent" to the expensive, patented drugs they copied. This will not be a subject for discussion at the WHO gathering this week.

Nor is the deeply troubled anti-malarial programme called RMB, for "roll back malaria." Experts including, again, the Lancet have harshly criticised RMB, centred in Africa as are most of the million deaths to malaria each year.

They say RMB has been such a failure it may even have increased the number of victims. WHO teams were found pushing outdated, ineffective drugs such as chloroquine and sulphadoxine-pyrimethamine. Malaria does not appear on the WHO meeting's agenda.

After the Dec 26 tsunami, the WHO began its work only on Jan 18, and then in conjunction with a US government field team. There are profound health problems throughout the African continent, where two of the most prominent and important basic health-care plans are floundering and facing failure.

Yet the annual WHO assembly beginning today is to focus on issues such as "social health insurance," breastfeeding and an examination of the plight of the Palestinians.

These and dozens of other issues are important in certain ways, and deserve national or regional attention. But the WHO is, literally, the world's health organisation.

Its Geneva meeting gives the impression the WHO is either, willy-nilly, flitting from issue to issue, or ignoring its most important mandates.

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