High-level officials of the United Nations are not known for their perspicacity, competence, or scientific acumen, but the head of the World Health Organization (WHO), Margaret Chan, is a particular embarrassment. With so much attention focused on the Ebola-virus outbreak in Africa, her exaggerations and petty scolding have made her a high-profile liability.
In a speech at a regional conference in Benin last month, she warned that the Ebola outbreak “is the most severe acute public-health emergency seen in modern times” and bashed pharmaceutical companies for not developing Ebola vaccines — products that could not possibly be profitable. “A profit-driven industry does not invest in products for markets that cannot pay,” she said — a truism if there ever was one. “WHO has been trying to make this issue visible for ages. Now people can see for themselves.”
Perhaps Dr. Chan is unaware of the U.N.’s own data on the infectious and other public-health scourges that afflict the developing world, Africa in particular.
Let’s consider first how Ebola stacks up against other public-health emergencies in developing countries. As the United Nations’ own data make clear, infectious diseases, many of them preventable and treatable, remain the scourge of poorer populations. In 2008, about 250 million cases of malaria caused almost a million deaths, mostly of children younger than five. In virtually all poor, malaria-endemic countries, there is inadequate access to antimalarial medicines (especially artemisinin-based combination therapy).
The incidence of malaria could be reduced dramatically by the judicious application of the mosquito-killing chemical DDT, but the U.N. and national regulators have curtailed its availability, owing to misguided notions about its toxicity (and no small measure of political correctness). Hundreds of millions suffer from other neglected tropical diseases, including lymphatic filariasis and cholera.
Although new HIV infections worldwide declined slightly during the past decade, 2.7 million people contracted the virus in 2008, and there were 2 million HIV/AIDS-related deaths. By the end of that year, more than 4 million people in low- and middle-income countries were receiving anti-retroviral therapy, but more than 5 million who were HIV-positive remained untreated. The number of new cases of tuberculosis worldwide is increasing, and the growing emergence of multi-drug-resistant strains of the bacteria is especially worrisome.
According to U.N. statistics, about 15 percent of the world’s population lacks access to safe drinking water, and “in 2008, 2.6 billion people had no access to a hygienic toilet or latrine,” while “1.1 billion were defecating in the open.” Primitive approaches to managing sewage continue to spread infections such as schistosomiasis, trachoma, viral hepatitis, and cholera.
Ebola? The current tally of cases is about 16,000, of which roughly 35 percent have been fatal. The outbreak has been limited largely to three African countries — Liberia, Guinea, and Sierra Leone — and according to WHO, the number of weekly probable and suspected cases is on the decline in Liberia and Guinea. There are even reports in Liberia of empty beds in previously overcrowded Ebola treatment centers.
Ebola deserves attention and resources, to be sure. But Dr. Chan has demonstrated that she has difficulty setting priorities logically and cost-effectively. For example, she and Yukiya Amano, director of the International Atomic Energy Agency (IAEA), championed the diversion of public-health resources to non-cost-effective pie-in-the-sky objectives, such as the creation of expensive, high-tech radiotherapy facilities to treat cancer in Africa.
Many cancers are caused by chronic viral infection, which means a wiser use of resources would surely be to attack infectious diseases by improving access to clean water, basic sanitation, antibiotics, and vaccines rather than building radiotherapy facilities. In some technology-poor but oil-rich Middle East countries, state-of-the-art radiotherapy (and cardiopulmonary bypass) equipment has been delivered but never used, or has been damaged by electrical surges or power outages. Moreover, many poor countries do not have a single medical school, and when their citizens study abroad, they often stay there or are ill-equipped for a low-tech milieu that is so different from where they trained.
Dr. Chan’s agency and its U.N. siblings have been spectacularly wrong — and their actions inimical to public health — in other ways, such as the obstruction of critical new technologies for agriculture.
Some background is necessary. Irrigation for agriculture accounts for roughly 70 percent of the world’s fresh-water consumption, and even more in areas of intensive farming and arid or semi-arid conditions, so the introduction of plants that grow with less water would allow water to be freed up for other uses. Especially during drought conditions — which currently plague much of Europe, Africa, Australia, South America, and the United States — even a small percentage reduction in the use of water for irrigation could result in huge benefits, both economic and humanitarian. Genetically engineered, or “genetically modified” (GM), crop varieties can accomplish this and are widely recognized by agricultural scientists and policymakers as critical to meeting future water shortages.
During the past decade, however, various U.N. agencies, including Dr. Chan’s WHO, the Food and Agriculture Organization (FAO), and the Convention on Biological Diversity (CBD), have created major regulatory obstacles to innovations in plant breeding.
Genetic engineering offers plant breeders the tools to make old crop plants do spectacular new things. In almost three dozen countries, farmers are already using genetically engineered crop varieties to produce higher yields with lower inputs and reduced impact on the environment, and greater food security in poor populations. Plant biologists have identified genes regulating water utilization that can be transferred into important crop plants. These new varieties are able to grow with smaller amounts or lower-quality water, such as water that has been recycled or that contains large amounts of natural mineral salts. Where water is unavailable for irrigation, the development of crop varieties able to grow under conditions of low moisture or temporary drought could both boost yields and lengthen the time that farmland is productive.
But research is being hampered by resistance from activists and discouraged by governmental overregulation — including by the Codex Alimentarius Commission, the FAO/WHO U.N. agency that sets international food standards — and by onerous, unscientific regulation of field trials under the Convention on Biological Diversity (the “Biodiversity Treaty”). In spite of the scientific consensus that the molecular techniques of genetic engineering are essentially an extension, or refinement, of conventional — but less precise and less predictable — techniques of genetic modification, both entities have established requirements for the products of genetic engineering that no conventionally modified product could meet.
Ironically, the U.N.’s obstructionism has taken a huge toll on a sector of genetic engineering known as “biopharming” — using genetic-engineering techniques to induce crops such as corn, tomatoes, and tobacco to produce high concentrations of high-value pharmaceuticals. Why is this ironic? Because one of the most promising drugs to treat Ebola infections, ZMapp, is obtained from genetically engineered tobacco plants that have been infected with genetically engineered plant viruses.
The U.N.’s lack of coherence and consistency is bizarre. The U.N.’s Food and Agriculture Organization calls on one hand for greater allocation of resources to agriculture and then makes those resources drastically less cost-effective by gratuitous, unscientific overregulation of the new biotechnology. The secretary-general of the U.N.’s World Meteorological Organization announces that “integrated water-resources management is the key to achieving the Millennium Development Goals of securing access to safe water, sanitation, and environmental protection,” while an alphabet soup of other U.N. agencies are making virtually impossible the development of genetically engineered plants that can grow with low-quality water or under drought conditions. The most ambitious of the U.N.’s Millennium Development Goals — “to eradicate extreme poverty and hunger” by 2015 — certainly will not be accomplished by then, or ever, without innovative technology. And that, in turn, cannot be developed in the face of U.N.-based bans and excessive regulatory barriers.
Instead of taking constructive action to redress these inconsistencies, Dr. Chan, the head of WHO, is out and about, crying “Wolf!” and bashing the pharmaceutical industry.
Yet again, the U.N. is part of the problem, instead of the solution. That is not at all surprising. The U.N. was designed to fail. It lacks any semblance of accountability and was (and is) populated by sleazy second-raters chosen for positions under a kind of nationality-based affirmative-action scheme, in which senior positions go not to the best-qualified person, but to someone from the nation or region that is next in line. Moreover, the pool of possible candidates is not a promising one, which is not unexpected. If you were a head of state or government minister, would you wish to lose your best people to the U.N., or would you prefer to keep them close, to make you look good and to benefit your country? It’s hardly surprising that the U.N. ends up with the least competent and most disaffected and dysfunctional. What is surprising is that the United States uncomplainingly contributes disproportionately to the U.N.’s budget.
— Henry I. Miller, a physician and molecular biologist, is the Robert Wesson Fellow in Scientific Philosophy and Public Policy at Stanford University’s Hoover Institution. He was the founding director of the FDA’s Office of Biotechnology.