WHO takes its lumps at Hudson Institute conclave
Academics, public health experts and association leaders met yesterday at the National Press Club to discuss "The World Health Organization: How can the United Nations agency fight disease inthe 21st century. " The event was sponsored by the Hudson Institute.
Promising "diagnosis and prognosis," the experts delivered some valuable insights and advice for WHO, culminating in a powerful address by Dr. Gail Wilensky, a member of the WHO Commission on Social Determinants of Health and head of Pres. George H.W. Bush's Medicare and Medicaid program and one of America's "Top 25 Women in Health."
The group intended to catalogue ideas, not produce concensus and, indeed, opinions were disparate. Some highlights:
Amir Attaran, PhD of the University of Ottawa, decried WHO's focus on visible problems at the expense of public health realities, urging the agency to show more respect for science and confine its activities to its areas of competence (avoiding "mission creep").
Nicole Bates of the Global Health Council outlined the importance of partnerships, particularly with the private sector, a point reinforced by Jean-Luc Poncelet, M.D. from the Pan American Health Organization (PAHO) who also reminded the group that the real work gets done at the country level, not in Geneva. I added that involvement of private sector partners enhances the likelihood that program initiatives will be real-world and sustainable, using the example of the salt industry's active partnership to combat Iodine Deficiency Disorders. Several responses credited the salt industry with enlightened and effective leadership.
Mary Pendergast, FDA deputy director under Dr. David Kessler under Presidents Bush and Clinton, suggested WHO focus on eradicating infectious diseases where it has enjoyed success rather than tackle chronic diseases where its record is spotty (or worse). I added that perhaps the true dichotomy was not infectious versus chronic, but rather interventions for which well-accepted interventions were being applied (as is the case in infectious diseases and some chronic conditions such as smoking) versus interventions recommended for chronic diseases which remain controversial due to lack of health outcomes trials of the specific interventions such as restricting dietary salt.
My take-away message for reforming WHO for the 21st century:
1. Make a concerted effort to identify the best science and confine intervention initiatives to those well-supported by the evidence.
2. Conduct honest consultations and actively engage with private sector partners to fashion sustainable program responses to health challenges.
3. Become more involved in providing assistance to the 192 member health ministries to create and maintain FDA-type regulatory bodies in their countries.
Thank you Hudson Institute and program chairman Dr. Carol Adelman, director, (Hudson Institute) Center for Science in Public Policy .
