The World Health Organization (WHO): A Problem of Trust

Over the past twenty years or so, what has been the record of the World Health Organization when it comes to major public health crises? Has the WHO itself invented at least some of those crises? Was there in fact a H1N1 “pandemic”? What counts as a “pandemic,” according to the WHO? What are the relationships between the WHO and scientists, large pharmaceutical transnational corporations, powerful member states, and private donors? Is the WHO a reliable “partner” in meeting the demands of serious public health crises? Has the WHO amplified the threats in some cases, while downplaying proven harm in others? What can we learn from this history that can shed light on the WHO’s role during the current COVID-19 “pandemic”? Who trusts the WHO? The WHO can be trusted to do what?

We have the aid of an important documentary to help us answer these questions. Directed by Lilian Franck, TrustWHO is a 2016 documentary about the Geneva-based World Health Organization, and the documentary has gained new attention in the past year. It runs for 85 minutes. Like a number of the other compelling documentaries reviewed on this site, this one was also made in collaboration with Arte.

To be succinct, the documentary aimed at uncovering some of the obscured influences at work in producing the WHO’s decisions on public health, particularly the growing role of private donors. Franck examines the roles of tobacco, pharmaceutical and nuclear industries on the organization. Ironically (or perhaps it was intended), Donald Trump’s announced withdrawal of the US from the WHO would only have helped to make the organization even more dependent on private donors, and could have made room for China to acquire a greater voice in the WHO. In fact, the withdrawal never took effect. If the US’ withdrawal had happened, the Bill and Melinda Gates Foundation would have become the top donor to the WHO.

The subject of the World Health Organization could not be more timely, especially after a bruising year which saw its international reputation badly damaged once more, particularly by first downplaying the risks of the novel coronavirus, and then praising China’s efforts at containment (which clearly failed). The WHO initially criticized the closure of international borders, and then countered itself; it also diminished the need for wearing masks, before again countering itself. For many nations in the “developing” world, the WHO stands as a de facto International Ministry of Health, on which they rely for information and advice. As the voice of a reporter states in the documentary, “recommendations of the WHO influence governments around the world,” and another explains, “it determines the medical norms which are applied around the world”.

As with other in-depth documentary review essays that appear on ZA, this one goes beyond a summary. Key details are related to the public who may not have a chance to access this documentary. There is also a dialogue with the contents of the film, and an application of certain ideas and observations to the current situation. As with previous reviews, this one will also end with a conclusion that offers a rating and advice on its appropriateness for classroom use in different university subjects.

Suspecting the WHO

TrustWHO begins by the third minute to drop increasingly striking hints that the WHO has displayed serious weaknesses in its crisis responses, and may also have been involved in a high-level official cover-up around the events involving contamination from Japan’s Fukushima nuclear plant. A barrage of criticisms then grows into a chorus, just before the title of the documentary appears on the screen—clearly suggesting that no one can trust the WHO, and in the US few did so.

Lilian Franck explains that she travelled to the WHO headquarters in Geneva, in the company of US journalist Robert Parsons who has written about the WHO for two decades. Parsons explains—and this is shown with accompanying footage—how large private companies, such as the transnational pharmaceutical giant, Merck, host private receptions within the folds of the WHO to exercise influence on WHO members, officials, and key political figures who formulate and implement public health policy.

The WHO and the Tobacco Industry: Conflicts of Interest

The standard history of the WHO is that it was founded in 1948 by 61 nation-states, who also financed the organization. Parsons, on the other hand, shows that from the very start the WHO was penetrated by private industry.

Even though from as early as 1950 published medical research showed some of the serious dangers of smoking, for decades the WHO did little to oppose the tobacco industry (this will be relevant later). Philip Morris International, in an effort to subvert anti-tobacco advocates that existed within the WHO, financed institutes and networks of scientific research such as the Catholic University of America’s Institute for International Health and Development, financed with an annual grant of $240,000. That institute was led by the US lawyer, Paul Dietrich—who, at the same time, was a consultant for the WHO Regional Office in the United States. This was the same story with six other consultants who played dual roles. Lilian Franck speaks to one of them, the British toxicologist Frank Sullivan. Sullivan explains that “it wasn’t a big issue” for the WHO, and he clearly indicated on forms that he played a dual role, i.e., consulting for the WHO while being financed by a tobacco company. Even after Sullivan’s collaboration with the tobacco industry became public in 2000, he continued to advise the WHO.

Lilian Franck then went to the WHO, and spoke on camera with the two department leaders combating tobacco under the auspices of the WHO. They seem to become very uncomfortable when reminded of Sullivan’s continued role after 2000. Douglas Bettcher, the Director of the WHO’s Department for Noncommunicable Diseases, loudly proclaims that tobacco is “our number one enemy,” but he becomes rather tight-lipped when asked about Sullivan, and claims to have no knowledge of his continuing role in the WHO after 2000. Vera da Costa e Silva, head of the WHO Framework Convention of Tobacco Control, explains that the WHO performs no background checks for conflicts of interest, even now, “you cannot just start by already being suspicious about people and their capacity to do things”—in other words, a policy of wilful blindness. This interview was not conducted freely, however: Franck indicates that three WHO officials remained in the room, and conducted the responses with frequent gestures. In addition, Franck was never able to obtain archival documents from the WHO concerning Sullivan’s conflict of interest forms.

The WHO and H1N1: Fabricating a Pandemic

Franck observes how in 2009 the WHO pushed H1N1 (“swine flu”) as a major threat, and was wrong. It should be noted that H1N1 was accidentally released from a research laboratory. There have also been six escapes of SARS alone after the 2003 epidemic, and four of them escaped from the same lab in Beijing. This is added to a list of several other known cases of viruses escaping from labs.

The WHO declared a pandemic for H1N1. I was supposedly infected and can attest that, if it really was H1N1, it was a very strong flu, one that kept me away from class for four weeks (at no point requiring anything other than typical flu medication and lots of sleep). The media in the US repeated “estimates” that up to two billion people worldwide would be infected with H1N1. A rising chorus of increasingly alarmed voices spread the messages of threat and fear, even more rapidly than the virus itself spread. The documentary replays some of this quite well. The reality was that far fewer people died from H1N1 than from a normal flu outbreak—the kind of outbreak, incidentally, where most people treat flu shots as optional without being hysterically labelled as “anti-vaxxers” and browbeaten into conformity.

At the time, the WHO changed its definition of “pandemic,” just as critics were publicizing the many business deals between pharmaceutical companies and individual countries. Companies signed secret agreements with states on acquiring vaccines for H1N1, which the WHO then triggered by declaring a pandemic. An extract of one such contract involving Italy is shown in a still taken from the documentary (see below). Germany, Italy, France, and the UK, among other countries, signed these secret deals that obligated them to purchase swine flu medications in the event of an outbreak—but only if the WHO issued a Pandemic Level 6 alert.

Dr. Margaret Chan, Director General of the WHO in 2009, declared the pandemic. The WHO then spent over $18 billion on health measures worldwide for the pandemic, according to Wolfgang Wodarg, former delegate to the European Council, who is also featured in this documentary. On screen, Wodarg plainly accuses giant pharmaceutical transnationals—naming GlaxoSmithKline, Novartis, and Sanofi—of manufacturing a pandemic:

“They had all launched new production programs to produce the vaccine for this pandemic. They had all made agreements with nation-states. And since they had invested so much in this but couldn’t sell the vaccine because there was no pandemic and no sign of a flu outbreak—they fabricated a pandemic”.

Gregory Hartl, the WHO’s press spokesman was interviewed for the documentary by Franck, since the organization’s swine flu specialist was somehow not available. Hartl’s defense is that everyone would have been outraged if a very lethal pandemic happened, and there was no vaccine ready. Minus extreme lethality, that is exactly what happened with COVID-19, only this time the pharmaceutical giants seem to have learned an important public relations lesson: do not sign agreements and go to production in advance of a declared pandemic.

Also appearing on screen is German Velasquez, who at the time of H1N1 was the WHO General Secretary in the Department of Public Health, Intellectual Property and Medication. His admissions are stark:

“Nobody there [at the WHO] was afraid. I didn’t know anyone at the WHO who had himself vaccinated. Including the Director General [Dr. Margaret Chan], who told journalists in response to their questions that she hadn’t had time but would get herself vaccinated later”.

Yet at the same time Lilian Franck, who was pregnant during H1N1, admits to being very afraid of large crowds, airports, and travel. Why? Public media exaggerated the level of danger—see the clip below and note how it appears to be from this year rather than 2009:

German Velasquez notes also that it was commonly publicized at the time that the WHO changed its guidelines for declaring a pandemic, and the old guidelines vanished from their website. The key point is that the WHO could not have declared a pandemic using the old definition: the severity, the number of deaths, would have been a key factor under the previous definition. It was now easier to declare a pandemic.

Franck confronts Gregory Hartl on screen, showing him a copy of the previous guidelines and the key phrase that is highlighted reads, “severity of illness”. That criterion is absent in the new guidelines. Next we hear Hartl defending the need for the WHO to work with pharmaceutical companies to produce vaccines—only “working with” goes much further than dialogue and advice: the WHO’s own director of vaccines, Marie-Paul Kieny, came straight from a large French pharmaceutical company, TransGene.

Franck is denied an interview with her by Hartl (the WHO press spokesman), so she confronted her at a public event. Kieny appears in the documentary in her capacity as the WHO Assistant Director-General. When asked why the criterion of “severity of illness” had been dropped by the WHO, she responds rather reasonably that it was a difficult concept to ever pin down since it relies on many factors, including the conditions of an individual’s health. Instead, the WHO began to emphasize whether community transmission was taking place, and in how many countries it was happening. Confusingly, Kieny appears to say that such definitions will change again.

Following the Science…of the Pharmaceutical Industry

From where does the WHO’s scientific knowledge, and its own scientists, come? As Wodarg explains, the WHO’s scientists are delegated to it by the countries and organizations that finance the WHO. Many of these persons have a track record of giving advice that profited the pharmaceutical industry.

In this regard, Franck reports the following:

“The WHO working group on Swine flu consists of 13 external consultants. Two of them report conflicts of interest. Neil Ferguson declares consultancy fees from GlaxoSmithKline, Baxter and Roche, the manufacturers of the swine flu vaccines and medications. Not a problem for the WHO”.

This is the same Neil Ferguson who famously exaggerated the threat of COVID-19 in 2020, with a model that predicted millions of deaths in the US and UK. Ferguson also advised the UK government, pushing its harsh lockdown strategy for COVID-19. Ferguson has a proven track record of making wild predictions that grossly exaggerated the number of expected deaths from a series of outbreaks preceding COVID-19. For example, in 2005 Ferguson predicted that the bird flu outbreak would match the Spanish Flu of 1918, and result in 200 million deaths—instead only 457 individuals worldwide died from the bird flu. In 2002, Ferguson predicted that as many as 50,000 deaths would occur from Creutzfeldt-Jakob disease (vCJD)—instead only 178 deaths were recorded, and no one has died from it since 2016.

When speaking of Ferguson, the WHO made an effort to use subjective words such as “small” and “limited” when describing the funding he received from pharmaceutical companies—but no objective figures were provided.

Franck continues:

“In 2007, Albert Osterhaus loses his voting right on the Dutch heath commission due to his conflicts of interest. He declares to the WHO that he has shares in the pharma company Viroclinics, which is suspected of profiting from Swine flu. He also declares that he is the chairman of ESWI, describing it as a group of independent scientists. In fact it is partly financed by vaccine manufacturers [including AstraZeneca]”.

Osterhaus appears in the film saying: “I can tell you there’s no scientific meeting today organized that is not being sponsored by industry”—and he defends this. He continues to consult with the WHO despite his declared conflict of interest, which he redefines not as a conflict, but as an interest. Eventually Osterhaus stands up and walks away from the interview, not wanting to share any hard facts about how much money his “independent” group received from pharmaceutical companies.

Neoliberal Health Politics

What is also interesting, as shown in the film, is that the WHO Director-General (Dr. Margaret Chan at the time) set up a private meeting with vaccine manufacturers that excluded staff from the WHO itself, including top-level department heads with a direct interest in vaccine development, such as German Velasquez. The European Council issued a reprimand to the WHO for its lack of transparency and for the heightened role played by experts who were paid for by the pharmaceutical industry. The WHO essentially ignored the Council of Europe. The WHO thus effectively began to operate as a clandestine organization.

In footage of a public briefing featuring Dr. Chan, shown in the documentary, she explains that she is against conflicts of interest (because she has to say this in public)—but she makes one other important point: “we must recognise that in this 21^st century, no government can provide everything to their people”. And why is that? It is largely the result of neoliberal ideological programs put into policy, either through structural adjustment imposed by multilateral financial institutions, or by choice through public-private partnerships. It has nothing to do with the date, as if this is the weather for the day. It is a fact produced by austerity regimes, of deregulation that has rolled back the state, and the consequent privatization of work that was previously done by the state.

Lobbying thus becomes a critical feature of public administration, and of course health policy too. In the documentary we see a range of public political critiques of the influence of lobbyists, from the German parliament where Angela Merkel has been lambasted as the “chancellor of lobbyists,” to the UK parliament where Prime Minister David Cameron was described as being in Pfizer’s pocket by the opposition, to Bernie Sanders denouncing Hillary Clinton’s ties to Wall Street, and then Donald Trump loudly declaring the following:

“My whole life I’ve been a business man. I’ve contributed to most of them [politicians]. I’ve given to Democrats, I’ve given to Hillary, I’ve given to everybody! Because that was my job. I gotta give to them because when I want something I get it. When I call…they kiss my ass. Ok, it’s true, they kiss my ass”.

The Political Economy of the WHO

In the wake of the 2008-2009 financial crisis, most WHO member states froze their contributions. One result has been that now UN organizations, foundations, NGOs and industry contribute almost 40% of the WHO’s annual budget. The second largest source of financial support, right after the US, is the Bill and Melinda Gates foundation. No wonder then that, until a recent scandal and the divorce of Bill and Melinda Gates, Bill Gates was regularly featured in the top corporate media as if he were an expert on COVID-19, its mitigation, and vaccination—even as he planned to dim the sun in a dangerously deranged effort to counter the “climate emergency”.

The documentary shows Bill Gates addressing the WHO where he declares, in a possible slip: “Our priorities are your priorities,” not the other way around. The WHO, contrary to what one might have expected, is a relatively underfunded organization, with an annual budget of $2 billion, which Franck tells us is just half of what Coca-Cola spends on advertising alone, and one third of what nearby hospitals in Geneva have as a budget. In addition, the WHO cannot dedicate its money as it sees fit; instead, particular sums are tied to particular projects and specific countries. Money for malaria cannot be used to meet a sudden Ebola outbreak. This means that, in the words of a German Minister of Health (Hermann Gröhe) appearing in the film, the WHO “does not have the operational capacity or culture to deliver a full emergency public health response”.

Margaret Chan’s office put off Lilian Franck for almost a full year when asked for an interview. Eventually, Franck gave up. Franck instead met with one of her close advisers, Gaudenz Silberschmidt, the WHO Director for Partnerships. Speaking of the independence of its scientists (the lack thereof), he argues that there can never be any such thing as an “independent external review” of the WHO, because ultimately nobody is independent, by definition. In the meantime, Silberschmidt maintained that all companies were welcome into the WHO, thus precluding even an attempt at any sort of independence, as a matter of policy.

Private companies use WHO meetings as a means of approaching health officials from developing countries, in the hope of expanding markets for the companies’ products. Those companies that have purchased influence in the governments of developed countries, have double the leverage in the WHO: they represent themselves, and their interests are represented by member governments as well.

The WHO and Fukushima

While disturbing enough already, the documentary takes an even darker turn when it comes to the Fukushima nuclear catastrophe. We learn that in the area of the accident, over a year after more than 42% of children had nodules or cysts in their thyroid glands—whereas the corresponding data for Chernobyl was between 0.5% and 1%. We are then introduced to Professor Shunichi Yamashita, who works with the WHO on nuclear catastrophes, and we hear him trivializing the data, stating: “If you laugh, the radiation doesn’t have any effect. If you don’t laugh, it has an effect. This theory has been proven in animal experiments”. One has to ask: how many irradiated laughing mice and chickens has this man studied?

Lilian Franck asks if the WHO is downplaying cases of nuclear radiation in Fukushima, and the rise of thyroid cancer. She still cannot get to speak with Dr. Margaret Chan, and is told by WHO officials that she prefers to have others speak.

Franck meets with Dr. Keith Baverstock, a member of staff at the WHO. He is important in this story because of work that he did on the aftermath of Chernobyl, and his studies of the rise of thyroid cancer among children. Along with several other colleagues, he published two papers in Nature that reported their findings. He was then ordered by a WHO official to withdraw those papers from Nature, with the explicit threat that otherwise his career would be “shortened”. He refused to bend.

It thus seems that the WHO was interested in minimizing the impact of the Fukushima disaster, and in this it was not alone. Japanese public health authorities did not respond adequately. Experts commissioned by the government faulted the government itself for underestimating the dangers, for failing in its crisis management efforts after the reactor accident, and that the nuclear power company (TEPCO) attempted to conceal the real extent of the accident. Japan’s then prime minister, Naoto Kan, bore considerable responsibility for the situation that unfolded—he personally believed that no radioactivity would emerge from the reactor accident, even though raised levels of radioactivity were officially documented as far as 200km from the Fukushima nuclear plant.

Gregory Hartl of the WHO appears on screen, and in WHO video footage, defending the practice of not administering iodine tablets immediately to those in the proximity of the nuclear plant after the disaster. He even appears to warn that taking iodine could be harmful, if it doesn’t match exposure to nuclear radiation, as if such exposure was debatable in the case of Fukushima. Hartl seems to get emotional and even impatient with Franck’s questions, telling her that she is wasting her time with this topic and that they should move on to other topics. For more on this, see the clip below:

We are then introduced to Independent WHO, which consists in part of former WHO staff members who are dedicated to expose the complicity of the WHO in major cover-ups such as Fukushima. This organization appears to have halted its activities in 2017. During its time it also highlighted how the WHO downplayed Chernobyl, claiming only 52 people died from the meltdown of the nuclear reactor and its aftermath, when the New York Academy of Sciences found about 985,000 deaths resulted between 1986 and 2004. The WHO considered only cancer to be a health effect of radiation, ignoring other severe effects. The documentary then presents us with absolutely painful footage of very young children who speak of heart defects, multiple heart attacks, and other heart problems—and we hear from a tearful 14 year-old girl who appears to be no older than a child half her age.

The WHO’s Gregory Hartl appears downright hostile to the very idea that radiation could cause health problems beyond cancer, and dedicates special effort to rejecting the report of the New York Academy of Sciences. Lilian Franck then telephones Douglas Braaten, the editor-in-chief at the New York Academy of Sciences. He tells Franck that they never repudiated the book, completely contradicting the WHO’s Hartl (we do not hear him say this). But here it seems that Franck lands in some hot water, as the book she references has been strongly disputed and even the NYAS itself, on its own website, explains why it does not endorse the book even though it published it. From this point, Hartl refuses any more interviews with Franck, even refusing to take her calls.

For my part, I found that the time spent on the Independent WHO and the NYAS book, was not time well spent for this documentary. It does not solve any of the major issues raised by the documentary, and it seems to create more problems. As a filmmaker, I probably would have dropped this material altogether, but I do commend Franck for her honesty in putting her process on clear display.

What remains an important question, raised by Franck, is the extent of the influence of the nuclear industry, which if anything has been rejuvenated by “climate emergency” calls for rapid “decarbonization”.

Franck’s presentation shifts the spotlight to the International Atomic Energy Agency (IAEA), and its support for the peaceful use of nuclear technologies. The IAEA collaborated, in a dominant role, with the WHO. The IAEA had a number of high-level meetings with the WHO, and according to a critic interviewed in the film (Dr. Ian Fairlie, a radiation biologist), the IAEA dictated the line that the WHO would take. While Fairlie does not repeat the claims of the NYAS book, he does estimate tens of thousands of deaths worldwide from Chernobyl, because the radioactive plume from Chernobyl spread around the world and particularly impacted Europe and its 700+ million people.

While increased radioactivity was indeed found across Europe—and Franck presents news footage from the time—the WHO continued to downplay the impact, limiting it to the Soviet Union. When it came to Fukushima, the WHO simply reprised its role from Chernobyl and claimed the impact would be minimal. The documentary presents a stack of media articles, quoting the WHO, that stressed that there would be little in the way of increases in the incidence of cancer after Fukushima, and that most such fears were unfounded.

It has to be noted that the documentary does not actually demonstrate or prove that the nuclear industry influences decision-making at the WHO in any direct, cause-and-effect chain. There is no mention of any nuclear power companies that are major donors to the WHO. Instead, what we have is a series of pro-nuclear statements from a range of European leaders (and a succession of French presidents), which suggests at least indirect influence by the nuclear industry via states who are key members of the WHO. In other words, the material is suggestive rather than conclusive.

“Vaping Alert!”: How the WHO Fabricates Fear

Here I want to take a detour from the documentary, into a topic that is related and current. Not having much if any need to ever consult the website of the WHO (the accidental wisdom of indifference), my first real encounter came with a report of the WHO’s position on vaping. I was astounded by the degree of outright fear-mongering and misinformation, the shoddy logic, and the unsubstantiated assertions. It was thanks to vaping that I personally quit smoking outright, and I have been vaping since 2014 without any problem. Already poor at delivering nicotine when compared to cigarettes, I nonetheless reduced the vaping nicotine content even further, down to negligible levels—and nicotine is not what causes cancer. Some even dispute whether nicotine is harmful. In fact it was a cardiologist who recommended to me that I switch to vaping, calling it a “no brainer”. As he explained: an unlit cigarette contains at least 400 dangerous chemicals, many of them carcinogenic; when lit, that number increases to over 6,000 chemicals. Vapes contain at most two questionable chemicals, and one of them is sprayed in the air throughout most hospitals.

It was thus difficult to understand on exactly what grounds the WHO was condemning vaping before it had even ascertained the facts. But what we do know is that at the end of 2019, just before the COVID-19 pandemic overtook, the WHO and national and provincial governments in countries such as Canada and the US, were firing up a mass panic that vaping was unsafe and was resulting in a mass of deaths—which then mysteriously stopped and the issue just went away. Some users were vaping a cannabis derivative and using a Vitamin-E oil, for which vaporizers are not designed, and thus clogging their lungs—the harm was not vaping as such, but the misuse of vaping. Nevertheless, some provincial “health officials” in Canada declared all vaping to be harmful. Universities, eager to latch onto the latest fear campaign or moral panic, quickly promoted whatever little research they were doing about the alleged/imagined “harms of vaping”. The WHO seemed to be echoing this fanciful, foolish, and potentially dangerous trend.

To underscore the absurdity of the WHO’s position, an analogous argument would have gone like this: vaping devices contain batteries, and some people find that by disassembling those devices and ingesting the batteries, they can end up in hospital. Vaping is therefore dangerous and a threat to public health.

Others also took note of the WHO’s strident arguments and its loose grip on facts. One writer noted the poor timing of the WHO’s statements: “At the same time the World Health Organization (WHO) was dithering about the dangers of the coronavirus, it was perpetuating another public health threat of greater magnitude”. The former head of UK Action on Smoking and Health, Clive Bates, went into great detail and produced a scathing step-by-step critique of the WHO’s (changing) positions on vaping, that really denuded the organization of even a shred of credibility. Peter Hajek, who directs the Tobacco Dependence Research Unit at Queen Mary University of London, also denounced the WHO’s statements: “The WHO has a history of anti-vaping activism that is damaging their reputation. This document is particularly malign”. Hajek added: “There is no evidence that vaping is ‘highly addictive’….Less than 1% of non-smokers become regular vapers. Vaping does not lead young people to smoking—smoking among young people is at [an] all-time low….There is clear evidence that e-cigarettes help smokers quit”. John Britton, director of the UK Centre for Tobacco & Alcohol Studies and a consultant in respiratory medicine at the University of Nottingham, plainly stated: “[the] WHO misrepresents the available scientific evidence”. Public Health England maintains that vaping is substantially less harmful than smoking, and also reminds us that nicotine is relatively harmless.

The WHO bases most of its arguments on the dangers of nicotine addiction—nicotine is a dangerous threat, in their view. Nicotine is found in nature, including in many common vegetables, teas, and potatoes. The WHO also claims—despite a lack of any evidence presented—that vape liquids containing nicotine can so addict teenagers that they transition to smoking. Why would they? Why would they transition to something that can be ten times more expensive, that stinks, that stains teeth, fingers, and clothing, and that is known to cause many deaths every year? Exactly which studies show this transition to be a fact? There are one or two such studies, that at best are suggestive of such a trend, even if tobacco use among teenagers in North America and Europe has shown a consistent decline.

To be clear, not all scientists agree that nicotine is dangerous: some, discussed in Scientific American, even insist that it’s time to stop demonizing nicotine, and they urge us to understand its benign effects. Some published health research also indicates that “nicotine significantly improves short-term memory”. Other studies have examined the neuroprotective potential of nicotine, noting that nicotine use can lessen the incidence of Parkinson’s Disease. Dr. Lynn Kozlowski, a professor of community health at SUNY-Buffalo, also maintains that, “nicotine may be a useful drug for some people and help them function better,” since it can reduce anxiety and stress (and stress can itself be quite deadly).

Such nuance is entirely missing from the WHO’s proclamations. Like most other fear-based opinions, the WHO conflates nicotine use and smoking. The logic of their argument follows a common pattern of displacement, found typically today in the demonizing narratives of politicians and the media, applied to a wide range of topics. It goes like this:

• Assert that X is a potential problem, therefore make X sound suspicious;
• Introduce horrendum obiectum Y, and then link X to Y through at least one shared trait;
• Focus heavily on all the known and proven dangers of Y, indeed, let Y become the main content of the narrative;
• Relink X to Y, thus making it seem that the dangers of X stem from, or are identical to the dangers of Y.

The result is a basic non sequitur: because smoking is dangerous for your health, it follows that so-called “e-cigarettes” (the name is arbitrary, but usefully suggestive) are also dangerous to your health. The fact remains, however, that vaping ended my experience as a smoker, period. No more coughing, no excessive phlegm, no wheezing, no more shortness of breath, no damage to teeth and gums. I have had two chest x-rays, and doctors found no damage.

What explains the lack of nuance, the lack of scientific substantiation, the paltry evidence, and the harsh tone of the WHO on vaping? Part of the reason, some of the sources linked to above explain, is the disproportional influence on the WHO of one of its top private donors, US billionaire Michael Bloomberg, who is wholeheartedly in favour of banning vaping. It is not a surprise for some that with the issue of vaping, the WHO has reached another milestone in a growing track record of bungled responses, misinformation, and outright fear-mongering. Though Trump ostensibly opposed the WHO, he shared the organization’s exact same position on vaping, and he added to the fear-mongering.

The Documentary’s Conclusions

The documentary begins to close with some potential conflict-creating conclusions. We hear from a top official of the WHO arguing for a powerful and heavy role for a global public health agency. Franck might appear to support this, as she then features a medley of voices lamenting how underfunded is the WHO, how it is pressured and constrained, and frankly weak. But then at least one voice points to the fact that the WHO prioritizes economic interests, rather than health interests.

However, here Franck misses the chance to offer us a key lesson that can answer a number of our opening questions.

If the WHO downplays the health effects in one crisis area, and greatly amplifies them in another, it is not a paradox. The WHO follows where money leads: in one case (a virus), maximizing the dangers benefits pharmaceutical companies; in another case (radiation), minimizing the dangers benefits powerful industrialized countries and the nuclear industry.

Franck makes one more effort to speak with the Director-General of the WHO, Dr. Margaret Chan. It fails. At every point, the WHO denies Franck access to the Director-General. Unsurprisingly, the WHO also shuts down any criticisms of the WHO, or key member states, that might appear in papers submitted for publication in the Bulletin of the World Health Organization, even if by staff like Keith Baverstock. Baverstock was invited to write an editorial on the psychological impact of Fukushima on evacuees—and it was rejected. He was told that his article was rejected because “the Bulletin will not be a platform for such criticism, no matter how valid”. US journalist, Robert Parsons, had his press accreditation cancelled for all WHO sponsored events, because he asked too many pointed questions. Staff who protest corruption and especially nepotism in the WHO, such as Alison Katz, were fired and their positions were abolished. Transparency? Not so much.

Franck had to find a way into joining the press at a World Health Summit in 2015 in order to finally ask Dr. Chan a single question, one that could even be read as supportive of the WHO:

“Lilian Franck, OVALmedia. It’s a question to Dr. Chan. We just learned that refugee health and climate change are huge global health challenges. But I’m asking myself how can we meet them if WHO is constantly losing power. Important donor nations, they want a weak WHO, one could even compare WHO to the Titanic I would say. So isn’t it your responsibility, Dr. Chan, to step down before the end of your second term in order to signal to the world that your organization, your ship, is sinking?”

The film ends with Chan’s message that the WHO needs more autonomy in its spending decisions—and it is a disappointing end. Sand has been kicked into our eyes.

Conclusion: Criticisms and Recommendations

The ending of Franck’s documentary reminds one of much of the content of “progressivist” critiques of existing state institutions: they are failing us, even betraying us, so it’s time to save them by funding them more and making them even stronger. (Of course, in some cases the opposite is true: there has been a call for outright “defunding” of specific institutions, but this echoes “conservative” calls for abolishing the US Federal Reserve or taking down the CIA and FBI.)

Franck does not waiver from the position that, ultimately, it is the self-seeking, profit-oriented influence of powerful corporations that is to be blamed for the mismanagement (or worse) of public health emergencies. The question that lingers though, is whether international governmental organizations could ever be free of such influence in an international system that is still capitalist. In addition, she does not consider the issue of centralized power in a so-called public institution, and the abuses that can ensue from that degree of amassed power. The assumption might be that if it’s public, it’s good, it’s democratic—but how many existing public institutions live up to such expectations? How many publicly-funded institutions actually serve the public interest, or even answer to the public? How do you prevent a large bureaucratic machine from functioning to serve its own goals? Financial autonomy certainly is a problem for the WHO, but so is a lack of democracy, accountability, or even a reflection of a broad range of scientific inputs.

Indeed, as we have seen, even the assumption that a “public health crisis” is one to be addressed by the natural sciences (particularly biology, medicine, etc.), is a flawed one. Anything involving human behaviours must call upon a broader range of sciences, including the social sciences and even the humanities. When locking down, in the name of “following the science,” it was usually an overly restrictive and thus profoundly flawed notion of “science” that politicians adopted. A doctor of medicine is not someone you let lead where issues of social relationships, political legitimacy, business, finance, and production are concerned.

At no point does the documentary explain why a “world health organization” is even necessary. One might just as well conclude that something like the WHO exists as a neo-imperial means of exercising tutelage over the newly decolonized states that joined the UN from the 1950s to the 1980s, and lacked sufficient means to erect a public health infrastructure of their own—thus some of the very tools of independent statehood were, ironically, imported.

Franck seems to know what her truth is, and she tenaciously clings to it in her presentation of footage. Where her grasp seems shaky, or is shaken, is when she tries to articulate her ideas in dialogue with people who do not support her version of the truth—and sometimes we can hear a rising level of frustration, exasperation, disbelief, or even resignation in her voice during interviews. One wishes that she had been more assertive and less polite, but perhaps she refuses to let a situation take anything away from her desire to be a pleasant and decent person. Nevertheless, it is inexplicable why she remains so devoted to an organization that coldly stonewalled her at every turn.

Lilian Franck makes the story personal: she connects her story as a mother, and the life of her daughter, to outcomes conditioned or created by the WHO’s intervention in global public health. She is thus frequently present in front of the camera, as is her daughter. I do not mind this at all, and some might especially value this method, but other reviewers have complained about the film’s “maternalist” tone.

Clearly this documentary could be useful for not just sparking and even furthering debate, but also for the amount of information that it presents. This is one of the very few documentaries I have ever seen that actually has a “References” section in its ending credits—where nearly every second of the film is accounted for by noting the sources of footage or other information. This documentary could clearly be relevant to almost any course that deals with the subject of the political economy of public health policy, in International Relations, Sociology, and Anthropology. My rating for this documentary is 7.5 out of 10.

(This documentary was viewed four times over the past year, in preparation for this review. This review forms part of the new Biology and Culture, Health and Lifestyle series of Documentary Reviews on Zero Anthropology. Look out for more titles to come in this series.)