World Health Organization appoints Robert Mugabe as ambassador, suggesting it values politics over health

Business partnership meeting. Picture businessmans handshake. Successful businessmen handshaking after

StatNews describes it as a blunder:

The global health community is struggling to make sense of a blunder that has shaken confidence in the new director-general of the World Health Organization and given rise to concerns — both outside and within the WHO — about the impact the episode will have on the credibility of the agency he leads.

… Tedros Adhanom Ghebreyesus appointed Zimbabwean President Robert Mugabe to a ceremonial position of honor, naming the longtime authoritarian as a WHO goodwill ambassador …

…[T]he stunning incident has created a sense of deep unease about why Tedros made the sure-to-be-challenged appointment …

Was it a blunder or just politics as usual?

Does the WHO play politics with its health recommendations?

Some have questioned whether the move was an attempt by Tedros to reward those who supported him in the race for director-general. Though balloting during the May election was secret and there’s no way to be certain who voted for whom, the 55-member African Union had unanimously endorsed his candidacy.

The road to that endorsement was paved by a vote by the union’s executive council in January 2016, which came just as Mugabe ended a year’s term as the African Union’s chair. Mugabe chaired the meeting.

Human Rights Watch and others denounced the appointment:

HRW’s Kenneth Roth said Mr Mugabe’s appointment was a cause for concern because the president and some of his officials travel abroad for treatment.

“When you go to Zimbabwean hospitals, they lack the most basic necessities,” he said.

Zimbabwe’s main MDC opposition party also denounced the WHO move.

“The Zimbabwe health delivery system is in a shambolic state, it is an insult,” spokesman Obert Gutu told AFP.

“Mugabe trashed our health delivery system… he allowed our public hospitals to collapse.”
Other groups who have criticised Mr Mugabe’s appointment include the Wellcome Trust, the NCD Alliance, UN Watch, the World Heart Federation and Action Against Smoking.

The appointment of Mugabe was a spectacularly bad decision, and has since been rescinded, but those of us who care about the health of women and infants have long suspected that the WHO plays politics with its recommendations as well as its appointment.

Consider the WHO’s longstanding endorsement of an optimal C-section rate of 10-15%. It was fabricated from whole cloth in 1985, apparently to suit the prejudices of the man behind it, Marsden Wagner, MD, a noted supporter of natural childbirth pseudoscience. There was never any evidence to support it.

In 2009, buried deep in its handbook Monitoring Emergency Obstetric Care, you can find this acknowledgment:

Although the WHO has recommended since 1985 that the rate not exceed 10-15 per cent, there is no empirical evidence for an optimum percentage … the optimum rate is unknown …

Yet the WHO has returned to promoting this nonsensical “optimal” C-section rate despite the fact that the existing scientific evidence shows that a C-section rate of 19% is the MINIMUM C-section rate compatible with low rates of perinatal and maternal mortality.

Think about that for a moment. The WHO is publicly advocating an optimal C-section rate that not merely has no basis in scientific evidence, but has actually been shown to be INCOMPATIBLE with safety. Why? I suspect it’s just politics as usual. It suits the needs and prejudices of executives at the WHO, science be damned.

The WHO is also playing politics with its breastfeeding recommendations. Most are unsupported, or even contradicted by the existing scientific evidence. For example, pacifiers are banned despite the fact that they don’t interfere with breastfeeding and actually prevent sudden infant death syndrome. The WHO grossly exaggerated the benefits of breastfeeding and utterly ignores the risks. They tout the “lifesaving” benefits of breastfeeding without being able to cite any population data showing that breastfeeding has an impact on infant mortality rates.

And most recently, despite a presentation to WHO executives by a panel of professionals concerned about high rates of breastfeeding complications and deaths, those executives actually declared that such injuries and deaths are “not a priority.”

That’s not healthcare, that’s politics. Decision makers at the WHO are promulgating recommendations that reflect their personal prejudices, rather than recommendations that follow scientific evidence.

The WHO should be a beacon of accurate health information for the world. Instead, it plays politics.

Any group that appoints an authoritarian despot as a health ambassador indicates that it values politics above health; it cannot necessarily be believed when it makes health recommendations. Those recommendations may represent political accommodations within the organization rather than the actual scientific evidence. Sadly, it appears that’s just what has happened with WHO recommendations on C-sections and breastfeeding.

  • CSN0116

    I went to a benefit gala Saturday night. It was for a foundation that drills wells in Sierra Leone. One well costs $6,900 to drill and provides safe water to hundreds of people every day. In eight years they have raised funds to drill 188 of them and they recruit donations only from one city, in one state, in the US. There are other devices that run on cow dung and can filter filthy water into something potable, producing hundreds of gallons per day. Some use solar energy. etc.

    Why do we lag so badly in providing this crucial resource to the world’s people? Why do we care about exclusive breastfeeding for 6 months? Wouldn’t safe water access simultaneously help a number of health issues WHO identifies as problematic? What is being done? What is actually being done?

    • Roadstergal

      Instead of confining their outrage, properly, to Nestlé’s activities around formula in the developing world, they have made formula into the F-word – to the point where I wonder if they’re less motivated around clean water because it would make formula more accessible…

      • CSN0116

        I think exactly this all the time. There’s also something creepily Malthusian about it all…

    • KeeperOfTheBooks

      Water is CRUCIAL, and has a number of consequences I hadn’t thought of until I read an article about some local guys at my church who decided to put their faith into action by drilling wells in Nigeria and Zimbabwe. One owned a drilling company, and others had done mission work in those countries and had identified a lack of clean water as being the biggest health issue there. Before the drill company owner died, sadly, of cancer, they’d managed to dig seven wells in very rural areas.
      They said that while they loved that the people they’d worked with now had access to clean water–in some of those places, the women had had to walk 2-3 miles each way to get polluted river water before the wells were dug–they also were thrilled about some unexpected benefits of those wells, like having better Muslim-Christian relations due to no more water shortages and the neighbors of various faiths bonding over this new source of clean water, and also that the local schools were able to hire much better teachers because they could offer clean water as a perk. (Talk about stuff we take for granted here…)
      Anyway, long story short, I think that doing things like that, and, more importantly, supplying the locals with both the resources and education to be able to drill their own wells eventually may be the best long-term solution to that problem.

      • Roadstergal

        Look at all of the money the US and France is spending on the military in Mali and Niger. What percentage of that spend would it take to get clean water in all of the small villages instead?

    • KeeperOfTheBooks

      If you don’t mind sharing such specific information, could you give us the name of that foundation? I wouldn’t mind chipping in some $$ towards it–sounds like they’re doing a fantastic job.

      • CSN0116

        Gladly! I was invited as a guest and knew nothing if it until I arrived. I was mightily impressed! It’s called Let Them LOL

        http://ltlol.com/

      • CSN0116

        1 in 5 children die by age 5. 1 in 17 mothers die in childbirth in Sierra Leone. They have built a school in addition to wells (yes, using water to attract teachers) and next up is a small birthing hospital.

        • KeeperOfTheBooks

          Oh, good for them!!! (Building wells, a school, and a hospital, that is, obviously, not the mortality stats.)

  • namaste

    O/T….l posted last week that my family and I evacuated from our homes in Sonoma County. All of our homes, pets, and possessions escaped completely unscathed. We are returning to in tact homes. The only question mark, since my family’s livelihood is wine, is how the fires affected our vinyards.

    • Who?

      Glad to hear you are all safe, and hope your business can pick up and carry on over the next few months.

    • Roadstergal

      Excellent news! Here’s hoping the vineyards are okay, too.

  • Amazed

    OK, guys, what comes next? Erecting a monument to the Nazi doctors for their contributions to medicine? At least these guys had some, their methods notwithstanding. What does Mugabe have to show that could explain this appointment even a little?

    On the other hand, said appointment is very fitting with their current stance on preventable mortality. Babies dying from NOT being breastfed successfully is not their first priority. Mugabe fits right in.

  • DaisyGrrl

    So I googled “Zimbabwe life expectancy” and, oh boy, it was depressing. There’s a chart that shows life expectancy since 1960 (source World Bank). You can play around with the chart to compare with other sub-Saharan countries. Mugabe came into power in 1980 and life expectancy in Zimbabwe peaked in 1986 then declined dramatically. Life expectancy has almost recovered to the level it was at in 1980.

    That he was appointed at all is disgusting. I can’t see how the WHO expects to maintain any credibility after a move like this.

  • Empress of the Iguana People

    The ideals WHO is part of are pretty good, imo, but by god they need to work on its realization.

  • Russell Jones

    I’ve been guilty of seeing the WHO for what it could be and should be rather than for what it is, but this lunacy might just be enough to cure that. It’d be easy to blow off this decision as the act of a clueless dumbass who’s in way over his head as WHO president, but no one this side of Donald Trump is that stupid. It’s not as though Tedros thought, “We need a serial mass murderer as our goodwill ambassador. Pol Pot, Stalin and Milosevic are dead, Charles Taylor is in prison, and everyone else is small potatoes, so Mugabe it is!”

    Nah, there’s something deeply and systemically haywire at the WHO. The Tedros presidency is likely just a symptom, sad to say.

  • namaste

    Errrr, I thought I read yesterday that the WHO revoked the Mugabe appointment. Personally, I have no idea what they were thinking even considering it in the first place. Whatever it was they’re smoking over there, I want some.

    • Russell Jones

      The revocation is mentioned in Dr. Tuteur’s post, but yeah, the fact that the WHO made the appointment at all is a WTF moment of biblical proportions.

    • Empress of the Iguana People

      I do NOT want some. Its clearly some bad sh!!

  • CSN0116

    WHO breast feeding data is the most obnoxiously misplaced and misunderstood data, exploited by white women in mommy groups in the US who employ it to support extended and exclusive breast feeding as necessary and lifesaving (important when there’s no access to clean water …but developed world, duh).

    Aside of that, I don’t really understand what they do. It seems as if they collect loads of data from places all over the developed and developing world – data that cannot and should not be compared between places (perhaps within) – and present it all in generalized-like platforms. Their “recommendations” also seem sweeping and do not much differ based on place, GNP, population, or culture. So, what is the point? I mean, I guess it’s a good thing to look at what’s wrong with health care worldwide and track progress to improve it, but they don’t seem well-suited as an organization to do this.

    I read once, somewhere, a long time ago that the WHO cannot be trusted and that they are dismissed by many physicians. Antics like this just further that reputation, I suppose.

  • Mel

    I’m barely conversant in African political issues – but Robert Freaking Mugabe?!?!?

    Jesus Christ. WHO is on crack.

    • guest

      That was my reaction, too. “Mugabe? Like, the crazy dictator Robert Mugabe? That guy who caused the whole infrastructure of Zimbabwe to collapse?”

      I’m ashamed to say, I only know of him or his policies because my town has a population of Zimbabwean refugees and expats. I’m not very well-versed in African politics, either, but I’ve heard my neighbors talk about Mugabe a bit, especially during the 2016 US election. Let’s just say they saw some similarities between him and certain orange billionaire.

    • Emilie Bishop

      I have close friends who have been missionaries in Zimbabwe. “Mugabe” is used in their house the way “Hitler” is used in most of the US. I seriously thought that appointment was a joke when I first read it a few days ago. I would bet anything money and/or favors changed hands in that decision. Did they seriously think it would go unnoticed?

    • Gæst

      No, Who’s on first.

      (Sorry.) (Not sorry.)