Generally, I strongly support the World Health Organization (WHO) and its unambiguously important work to save lives through its public health efforts. The backlash against it in the U.S. is simultaneously misguided and politically motivated. I know why. It detracts from our failures in the U.S. to save lives, but there is more to the story. Republicans generally have a greater hostility to international organizations because they view them as tying our hands and/or taking our money to help people in poorer countries. The argument is that U.S. foreign policy must be about U.S. national interests not some idealistic notion of global cooperation.
But here’s the thing. The WHO plays critical roles in polio eradication, vaccines for preventable diseases, providing essential healthcare services, public health surveillance, emergency operations, and, yes, preventing and controlling outbreaks. Here’s a great fact-check document about WHO, specifically its efforts to bring the world together to combat Covid-19. Those efforts do protect and promote our national interests by bringing greater global political stability.
And when it comes to the WHO, Americans overwhelmingly agree – 77% of us – that the WHO is a force for good.
On the other hand, like any national government agency, let’s say the FDA or the CDC, international governmental organizations are anything but perfect! And the WHO is no exception. For example, the WHO has not done as much as it could do in assessing medicine sales over the Internet in terms of drug safety. That was clear in its last major effort to tackle the global problem of substandard and falsified medical products — the latter of which is more commonly referred to as “counterfeit drugs” in the United States. It for the most part focused on the dangers, not on the new digital regulatory frameworks providing models of online access to medicines that have helped millions of people in the U.S. and across the world.
I specifically addressed this issue to the WHO in my public comments to the organization in July of 2019:
“While the World Health Organization has recognized the potential benefits of online pharmacies, it has mostly focused on the risks posed by rogue actors that sell falsified and substandard medicines.[vii] The WHO’s reports on this topic have yet to highlight the medicine affordability and access benefits of properly credentialed online pharmacies that sell across borders. The safety of properly credentialed international online pharmacies is clear in the relevant peer-reviewed literature.”
In that particular comment, I was referring to the WHO’s “A study on the public health and socioeconomic impact of substandard and falsified medical products.” In that report, the WHO surveyed existing research that included field tests of drug authenticity and quality across various countries and settings. It estimated the sales value of substandard and falsified medical products globally at about $30 billion. While that is certainly a large figure, it’s far lower than the $200 billion estimate perpetuated by organizations funded by drug companies seeking to scare people about ordering medicines over the Internet. For that, I applaud them. However, WHO’s report conspicuously did not look at research from internet purchases of medicines. The report states that in addition to excluding the “cost and socioeconomic impact of falsified and substandard medicines…The scope was further limited to exclude consideration of intellectual property issues and Internet pharmacies, and include data only from the public domain.”
Without consulting research about testing medicines ordered over the Internet, the WHO’s study and its companion report, “WHO Global Surveillance and Monitoring System for substandard and falsified medical products,” were overwhelmingly critical of online pharmacies, only assessing the problems. Why?
One of the reasons to criticize the WHO is that its funding for certain programs and initiatives comes from countries with an agenda, which is clear on its reporting on surveillance and monitoring system:
“Building on an initiative developed in the WHO Western Pacific Region, the GSMS was born. Principally funded by the United States Food and Drug Administration (US FDA), with support from the Bill and Melinda Gates Foundation and with training events supported by the European Commission, Asian Development Bank and United States Pharmacopeia Convention, it was piloted in 10 countries in 2012 and 2013, and launched in Africa in July 2013.”
That’s right. Its work on the surveillance of bad drugs has been principally funded by the FDA, which we all know shares the pharmaceutical industry’s misguided narratives on online pharmacies and medicine importation. The WHO is a public health body that does a lot of good, but it’s unfortunately too easily swayed by larger governments whether its China or the United States. That’s not a reason to hinder its efforts by leaving or defunding the organization; it’s a reason to consistently and adequately fund WHO to do more independent work to protect the global public health.