Tuesday, 1 November 2016

Roger Scruton on the WHO

As the WHO's secretive COP7 shindig draws closer, there's a good article in the Wall Street Journal about the organisation's dogmatic opposition to tobacco harm reduction.

For those who don't know, the FCTC COP meetings are biennial conferences held by an unelected international organisation where policies which affect hundreds of millions of nicotine-users are discussed in near-total secrecy (journalists and the public are banned). The UK's delegation is usually made up of the unelected bureaucrat Andrew Black and the unelected boss of a fanatical anti-smoking sock-puppet pressure group, Deborah Arnott.

It seems likely that this year's conference will spend most of its time promoting a policy that has conspicuously failed to reduce tobacco sales where it has been tried (plain packaging) while denigrating the only significant innovation in smoking cessation to have emerged in decades (e-cigarettes).

Roger Scruton's little book on the WHO is worth reading to get the background on this. It was published by the IEA in 2000, long before e-cigarettes emerged, and I only recently got round to reading it, but it is very prescient. For example, he noted that...

There is a crucial lack of transparency in the arguments and proposals emanating from the WHO on the subject of tobacco, and a clear intention to impose its legislation come what may. Whatever the arguments, it may reasonably be doubted that a committee of unelected bureaucrats has the right to nanny us in such a way, and to impose regulations that ought to be the business of national governments

In a more philosophical vein, he remarks on the WHO's growing obsession with 'NCDs' (non-communicable diseases) over infectious diseases as follows:

• People must die, and it is not necessarily in their interests, or in the interests of the rest of us, for them to ‘strive officiously to stay alive’. It is more important, in general, that people should enjoy full, productive and happy lives, than that they should eke out their years to the point when nobody regrets their dying. Any measure of the health of a society which paid attention only to the average age at death would have left out most of what matters. Equally important are the strength, well-being and physical condition of the population during its active life.

• There is a vast difference in life-expectancy between people in developed and under-developed countries. Life expectancy for men in Japan is well over 80; in central Africa it is around 50, in the Indian sub-continent around 60, in Europe and North America between 75 and 80. In almost all parts of the world the life expectancy of women is significantly greater than that of men.

• There is also a threat in the under-developed countries from diseases that have proved to be curable elsewhere.

• There is a distinction to be made between communicable and non-communicable diseases, which must be taken into account in any allocation of resources. A communicable disease (such as TB or smallpox) threatens whole populations, and is therefore an immediate public problem. Non-communicable diseases (such as cancer or heart disease) become matters of public concern only when life-threatening communicable diseases have been held at bay.

• There is a further distinction to be made between diseases of old age, and diseases which threaten at every age, and which strike the old and the young indiscriminately. Diseases of old age tend to be non-communicable, like cancer and heart disease.

• Diseases which threaten the young tend to be communicable, like malaria, river-blindness or Aids.

• Finally, there is a distinction to be made between voluntary and involuntary risks to health. Some people are risk-averse, and place health at the top of their agenda, being unwilling to risk their health for any other good. They are not necessarily the happiest of people, and indeed hypochondria is a form of human misery, which not only fills the sufferer with fears but also cuts him off from human sympathy. Normal people are prepared to risk health for happiness. One of the largest causes of hospital treatment in the UK today is sporting accidents – rugby, football, cycling and horse-riding. Those who engage in these sports regard them as so fundamental to their well-being as to take the risk in their stride. It cannot be the function of a health bureaucracy to cure us of such self-imposed risks.

The WHO's juvenile anti-capitalism, which has since reached new heights under Margaret Chan, is also discussed:

Tobacco has been on the WHO’s agenda for some time, and this is hardly surprising, given the many health-scares with which it has been associated. Little by little, however, it has moved up the scale of priorities. Now, under the new regime of Dr Brundtland, it has taken on the role of Public Enemy No. 1. It is not difficult to see why. People are making money out of tobacco. The tobacco giants are multinational corporations in fierce competition with each other, who engage in all the practices – from stereotyping adverts, to the sponsorship of pursuits like Formula 1 racing – which make big business contemptible in the eyes of those who depend for their living only on hand-outs from the public purse. Tobacco fits perfectly into the costume of the unscrupulous capitalist, as this was tailored by Marx and Engels. Unlike malaria, therefore, tobacco is the kind of thing against which you can declare war.

Dr Brundtland has publicly intimated that cigarettes should be available if at all only on prescription, and she has seen in the anti-tobacco cause a way of imprinting on the WHO her own distinctive style of politics. And she shows us exactly what is dangerous in the structure of transnational institutions in the modern world: they have been given legislative or quasi-legislative powers without full accountability for their exercise. And they have been irresponsibly placed in the hands of career politicians: in other words, people who desire nothing so much as an opportunity to legislate, without the tedious business of consulting those who will bear the burden.

Legislation without consultation sums up the WHO's approach very well. And things have only got worse at the WHO in the 16 years since those words were written.

Scruton's book is well worth reading. You can download it here.

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