Tony C said:
UNAIDS is just another of the bloated agencies of the UN who's main reason for existence is to perpetuate itself. They will come out with all these reports about the need for more money but they have no real interst in Controlling AIDS. If they did they would be out of a job.
Likewise the WHO. Look at the bang up job they are doing with SARS. Ask people in Toronto about the WHO. The people at the WHO have jumped on SARS because they know they can use it as a way to get more money for their agency. Yet there are many more diseases out there that are much more deadly and widespread that they are ignoring.(The Flu is one of them)
Tony,
I hesitate to get into a "sparring match" with you about UN agencies because we've always gotten along and I would rather keep it that way. But in all honesty, your comments about UNAIDS and WHO suggest that you really don't know either agency well.
By now you must know I don't usually post BS, and certainly not on a subject like this. I do alot of work on public health issues, both globally and in Latin America, so I'm very familiar with both agencies. This is particularly true of WHO, which I have dealt with since 1981.
I may not agree with everything WHO does, but I would never characterize them as "bloated" by any means. In actuality, given their mandate, they operate on a virtual shoestring. Most of their money comes not from their regular budget, but from so-called "extra-budgetary funds" -- funding provided apart from the regular budgetary contribution, almost always with strings attached -- in other words, DANIDA, SIDA or AID will provide funds only for certain programs and certain target countries, often using only resources (personnel, equipment, drugs, etc) obtained from the donor country, but under the WHO name & coordinated by WHO. In other words, more than half of the money WHO is asked to manage WHO has absolutely no say in how or where it's spent. If you have a problem with that, take it up with the US Government, who does this all the time.
WHO got involved with SARS because they were asked to by many governments, including the US (CDC). Did they make some missteps on the issue? Yeah, probably. In my estimation, they went too far with the warning about travel to Canada. But all institutions, including the US and the vaunted CDC and NIH, make missteps, especially during epidemics. (I can point you to several good books with detailed examples from recent history.) I would prefer, though, that public health agencies make errors on the side of caution rather than hesitate to react overlong.
WHO
is doing valuable work on major killers and debilitating diseases far worse than "the flu" (which, by the way, can mean any of several things caused by viruses, which so far are untreatable by medicines or vaccines). In fact, it was WHO, under Director-General Brundtland, who brought back the world's attention to the fact that malaria and TB together kill or disable as many people globally as does AIDS, and created new initiatives to tackle it. And it was WHO that pointed out, like it or not, cardiovascular disease (CVD) is the leading cause of death in all regions except sub-Saharan Africa (where infectious & parasitic disease account for half of all deaths). In the Americas, for example, CVD accounts for about 1/3 of all deaths, whereas infectious & parasitic disease (including AIDS)
is only cause of death category number 4, accounting for only 6% (the #2 cause in the Americas behind CVD are "malignant neoplasms" -- i.e., cancer, lymphoma, leukemia -- at 18%, and the #3 cause is injuries --
yes, injuries -- at 9.5%). WHO has tried to tackle the CVD issue head-on, but has met stiff resistance from the tobacco, alcohol & food lobbies and the governments that back them. And many governments prefer earmarking scarce budgetary resources to combatting infectious diseases, since these tend to hit hardest the poorest nations and certain segments (such as children) among their populations.
Among infectious diseases, acute respiratory infections (ARIs) -- pneumonia, influenza -- caused more deaths worldwide than AIDS in the year 2000 (the last year for which I have data). Among children, ARIs & diarrhoreal disease (imminently treatable, often with just simple oral rehydration salts) are the leading causes of death. But WHO (with UNICEF on the childhood killers) has been harping on these issues and trying to marshall attention & R&D on these issues for decades, Tony. WHO has not been ignoring the issue, Tony -- the donor governments often have, though, I'm sorry to say.
And I won't bore you with a discussion of the little-known & little-heralded but very valuable work WHO does on issues like medicine, food and chemical safety. For many developing countries, WHO is the only help they get on these issues.
I have less experience with UNAIDS, but from what I've seen over the last four years, they are not bloated and not simply out to perpetuate themselves, as you allege. They don't manage the "big money" (meager as it is, given the dimensions of the threat) being devoted to the AIDS worldwide. UNAIDS mainly seeks to provide the best available data (gotten through sources like CDC), coordinate R&D efforts & disseminate information on the latest info & best practice.
UNAIDS was created at the
behest of governments like the U.S. so that there would be a single point in the UN system, and a global coordinator of sorts, to tackle the AIDS issue.
Anyway, I hope you're just "shooting from the hip" and will check it out more carefully before attacking WHO further. I have references for the studies and data if you want them -- just PM or e-mail me. And yes, some of the data cited comes from sources other than WHO -- including CDC, AID, the CIA, and AFMIC.
Repectfully,
Keith
