How WHO went from health to sickness

The vast, multi-headed organisation known as the United Nations is pushing 50 and many of its agencies are bogged down by a multinational bureaucracy seemingly impervious to reform and riddled with practices that threaten the very future of the world body.

The World Health Organisation is a study in how corruption and sleaze can eat the heart out of an international organisation. It was once known for scientific excellence and for stamping out killer diseases such as smallpox. Today it is caught in the worst financial and political crisis of its 47-year history. Millions of pounds are unaccounted for in a main regional office and there is a breakdown of communication between the organisation's deeply unpopular director general, Dr Hiroshi Nakajima, and donors.

Meanwhile, as diplomats and doctors squabble over the organisation's future leadership, in the US Congress, where the right-wing majority now holds sway and is on the lookout for excuses to hack the UN down to size, the knives are out for the WHO and other UN bodies.

The rot at the heart of large international organisations is not petty thieving or large rackets aimed at skimming UN aid. The overriding problem is that most of the organisations have ossified and are virtually incapable of reform from within. So many of the UN's 17 agencies are stuffed with mediocre staff (appointed through political patronage rather than on merit) that even those with good leaders are in trouble.

Ironically, the WHO has always been a relatively low spending but effective organisation with a budget of a mere $1.8bn a year compared with the NHS's $60bn. For most of its life it has provided the leadership needed to tackle infectious diseases, drug misuse and the health consequences of wars and natural disasters, none of which respect national boundaries.

All that changed, however, under the leadership of the controversial Mr Nakajima, who became director general in 1988, amid allegations of bribery and vote-rigging by his sponsor, Japan. But Mr Nakajima did not cause the WHO's problems. He is the product of a system that rewards patronage and provides little room for accountability.After his election an audit carried out by Britain's auditor general, Sir John Bourn, found that the executive board of WHO, which nominated Dr Nakajima for the job, was riddled with potential conflicts of interest. Many members had benefited from a bonanza of personal contracts funded by the Japanese government.

Under Mr Nakajima's weak leadership, the WHO has fallen into a policy vacuum and lost the initiative on major health issues. It is almost silent in the debate on population control and its alcohol and tobacco campaigns have been condemned as insipid and ineffective. Unchallenged, the drinks and tobacco industries are busy targeting new markets in Eastern Europe and the developing world. From being one of the UN family stars, the WHO has lost all momentum.

Last week Sir John resigned as external auditor after Mr Nakajima's office refused to co-operate following a new report alleging fraud, mismanagement and a shocking lack of controls at the organisation's Congo regional headquarters. There followed a slanging match at the World Health Assembly, the annual meeting of 190 member states. Things unravelled rapidly for Mr Nakajima when several African nations accused him of uttering racist slurs against African staff and demanded his resignation.

Regional organisations such as the EU have started to take over some of WHO functions, speeding up the process of decline. All UN organisations face the same quandary - change quickly or die slowly.

Leonard Doyle

News
people
Arts and Entertainment
Joel Edgerton, John Turturro and Christian Bale in Exodus: Gods and Kings
film Ridley Scott reveals truth behind casting decisions of Exodus
News
people
Sport
footballArsenal 2 Borussia Dortmund 0: And they can still top the group
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksNow available in paperback
Arts and Entertainment
An unseen image of Kurt Cobain at home featured in the film 'Kurt Cobain: Montage of Heck'
filmThe singers widow and former bandmates have approved project
News
Andy Murray with his girlfriend of nine years, Kim Sears who he has got engaged to
peopleWimbledon champion announces engagement to girlfriend Kim Sears
Arts and Entertainment
Jake Quickenden and Edwina Currie are joining the I'm A Celebrity...Get Me Out Of Here! camp
tv
Arts and Entertainment
George Mpanga has been shortlisted for the Critics’ Choice prize
music
News
Albert Camus (left) and Jean-Paul Sartre fell out in 1952 and did not speak again before Camus’s death
people
Arts and Entertainment
Roisin, James and Sanjay in the boardroom
tvReview: This week's failing project manager had to go
News
Ed Miliband visiting the Holocaust museum in Jerusalem. The Labour leader has spoken more openly of his heritage recently
newsAttacks on the Labour leader have coalesced around a sense that he is different, weird, a man apart. But are the barbs more sinister?
Arts and Entertainment
'Felfie' (2014) by Alison Jackson
photographyNew exhibition shows how female creatives are changing the way women are portrayed in advertising
News
i100
Life and Style
Fright night: the board game dates back to at least 1890
life
Environment
The vaquita is being killed by fishermen trying to catch the totoaba fish, which is prized in China
environmentJust 97 of the 'world's cutest' sea mammals remain
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Ashdown Group: Data Warehouse & Business Intelligence Co-ordinator

£35000 per annum: Ashdown Group: Required skills include SQL querying, SSRS, u...

Ashdown Group: C#.Net Developer - C#, ASP.Net, PHP, HTML, JavaScript, CSS

£30000 - £35000 per annum: Ashdown Group: C#.Net Developer - C#, ASP.Net, HTML...

Argyll Scott International: Senior Business Analyst- Insurance

Negotiable: Argyll Scott International: Senior Business Analyst - Insurance ...

Recruitment Genius: Property Manager

£25000 - £29000 per annum: Recruitment Genius: This independent, growing Sales...

Day In a Page

Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

It's in all our interests to look after servicemen and women who fall on hard times, say party leaders
Millionaire Sol Campbell wades into wealthy backlash against Labour's mansion tax

Sol Campbell cries foul at Labour's mansion tax

The former England defender joins Myleene Klass, Griff Rhys Jones and Melvyn Bragg in criticising proposals
Nicolas Sarkozy returns: The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?

Sarkozy returns

The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?
Is the criticism of Ed Miliband a coded form of anti-Semitism?

Is the criticism of Miliband anti-Semitic?

Attacks on the Labour leader have coalesced around a sense that he is different, weird, a man apart. But is the criticism more sinister?
Ouija boards are the must-have gift this Christmas, fuelled by a schlock horror film

Ouija boards are the must-have festive gift

Simon Usborne explores the appeal - and mysteries - of a century-old parlour game
There's a Good Girl exhibition: How female creatives are changing the way women are portrayed in advertising

In pictures: There's a Good Girl exhibition

The new exhibition reveals how female creatives are changing the way women are portrayed in advertising
UK firm Biscuiteers is giving cookies a makeover - from advent calendars to doll's houses

UK firm Biscuiteers is giving cookies a makeover

It worked with cupcakes, doughnuts and macarons so no wonder someone decided to revamp the humble biscuit
Can SkySaga capture the Minecraft magic?

Can SkySaga capture the Minecraft magic?

It's no surprise that the building game born in Sweden in 2009 and now played by millions, has imitators keen to construct their own mega money-spinner
The King's School is way ahead of the pack when it comes to using the latest classroom technology

Staying connected: The King's School

The school in Cambridgeshire is ahead of the pack when it comes to using the latest classroom technology. Richard Garner discovers how teachers and pupils stay connected
Christmas 2014: 23 best women's perfumes

Festively fragrant: the best women's perfumes

Give a loved one a luxe fragrance this year or treat yourself to a sensual pick-me-up
Arsenal vs Borussia Dortmund: Alex Oxlade-Chamberlain celebrates century with trademark display of speed and intuition

Arsenal vs Borussia Dortmund

The Ox celebrates century with trademark display of speed and intuition
Billy Joe Saunders vs Chris Eubank Jnr: When two worlds collide

When two worlds collide

Traveller Billy Joe Saunders did not have a pampered public-school upbringing - unlike Saturday’s opponent Chris Eubank Jnr
Homeless Veterans Christmas Appeal: Drifting and forgotten - turning lives around for ex-soldiers

Homeless Veterans Christmas Appeal: Turning lives around for ex-soldiers

Our partner charities help veterans on the brink – and get them back on their feet
Putin’s far-right ambition: Think-tank reveals how Russian President is wooing – and funding – populist parties across Europe to gain influence in the EU

Putin’s far-right ambition

Think-tank reveals how Russian President is wooing – and funding – populist parties across Europe to gain influence in the EU
Tove Jansson's Moominland: What was the inspiration for Finland's most famous family?

Escape to Moominland

What was the inspiration for Finland's most famous family?