There are two newspaper articles doing the rounds at the moment about the World Health Organisation’s travel budget: Maria Cheng’s AP Exclusive: Strapped UN health agency spends big on travel, and Mara Pillinger’s The World Health Organisation spends more on travel than on key diseases. That’s actually okay. The controversy, if you can call it that, centres on the claim made by Cheng that the WHO “routinely spends about $200 million a year on travel — far more than what it doles out to fight some of the biggest problems in public health including AIDS, tuberculosis or malaria”. Bow tie enthusiast and global health academic Jeremy Youde says that the global health community is ‘freaking out’ about WHO’s travel budget – is he right?
No, he’s not.
Ed.: Errr, you might want to elaborate.
Andrew: Do I have to?
Andrew: But they’ll think I’m freaking out.
Andrew: My readers
Ed.: LMAO – just fucking elaborate will you.
To say that someone is ‘freaking out’ is like saying that they’re getting their ‘knickers in a twist’, that they’re over-reacting in an emotional kind of way (which of course in itself is frowned upon by those more in command of their feelings). It’s patronising, right? Well guess what? It’s okay to freak-out, especially about something like this. But I should clarify what I think ‘this’ is as both articles raise some troubling issues that go way beyond travel budgets.
Transparency: Why can’t we access the ‘internal documents’ obtained by Associated Press, the data from which Cheng’s article relies? The WHO should make travel budgets publicly available.
Picking up the tab: As I freaked out to Paul Wemos in a tweet: “So just to be clear, WHO member states pay the organisation peanuts but then expect IT to pay THEM to attend its meetings? Clever”. A WHO news release explains in more measured terms: “Less than half of these costs are for staff travel – nearly 60% is spent on travel of external experts to support countries, and for representatives of Member States to travel to technical meetings and sessions of WHO governing bodies”. Pillinger gives two reasons why the WHO pays, with one explanation more convincing than the other (I’ll leave you to decide which): because its member states tell it to, and because some member states can’t afford it. I’ve been to the World Health Assembly. Took my tent, stayed on a campsite across the lake, had a lovely time. You can bus it from London to Geneva and back for less than £100; fly if you must for £126 return with Easy Jet. But maybe that’s just a little too rich for some pockets.
The need to know: WHO has 6 regional offices and 150 country offices dotted around the world. As IOs go, it’s pretty well networked. You would think that with its extensive in-country presence, its staff wouldn’t need to travel quite so much. But no. The justification turns all of that on its head: it is precisely because WHO has such a complex network that it has to do so much to-ing and fro-ing! “Without travel” argues Pillinger “WHO would have a hard time knowing what is happening on the ground”. What we’re really talking about here is, of course, a dysfunctional network.
Ok, so the network doesn’t work too well, but at least the ROs and COs can get on the phone/web and electronically communicate all that vital data? Not so. Health ministries, ROs and COs just can’t be trusted: “Vital data are routinely delayed, incomplete, or inaccurate…Sending headquarters staff (or experts who report back to headquarters) into the field provides an alternative to official channels and helps improve information quality”. Ouch! So what are we talking about here? It’s not really travel, is it. It’s under-performing health systems; ineffective implementation of the legal instruments of global governance; and a general failure to understand why those health systems are weak to begin with, and why those instruments don’t work.
Embracing new technology: Can somebody please tell me why, with the advent of the internet, we are still being peddled the line that “there is no substitute for face-to-face interaction when it comes to building relationships”? There is a substitute – it’s called Skype. IOs absolutely have to start integrating, and normalising, virtual communication as a substitute for the pre-Anthropocene hand-salving that, incredibly, continues to define 21st century diplomacy. And here we come to the real rub of the articles by Cheng and Pillinger: global warming.
If you’re going to freak out, choose your freak out wisely: Cheng and Pillinger give us plenty to freak out about, but personally I think the comparison between travel budgets and budgets from disease eradication is not really the most freaky. Ok, so the travel budget of $200m is pretty high, but not untypical for an IO. You might want to get a bit freaked by the relatively small amount of money the WHO devotes to AIDS, TB and malaria – less than its travel budget. But what you should really be freaking out about is the contribution that all that flying around is making to global warming. This is why the $200m travel budget is egregious. Framing the problem as a ‘that-money-would-be-better-spent-on-x,y-or-z’ is the wrong frame, and a distraction to the bigger issue. The WHO needs to take a stand, lead the way, blaze a fracking (ahem) trail in terms of its response to climate change. And that means changing how it operates. Which means cutting back on its travel.
Here’s Pillinger’s closing statement” “WHO’s travel spending is a basic feature of its mandate as an international organisation, not a symptom of bureaucracy run amok”. I’m sorry Mara, but you’re wrong. WHO’s mandate also includes to “foster the ability to live harmoniously in a changing total environment”. We are facing a radically changing total environment and the WHO, in order to ensure “the attainment by all peoples of the highest possible level of health” MUST change its ways. And be visible in doing so in the hope that other IOs will take note and emulate. It was estimated that the Paris Climate Talks resulted in an additional 300,000 tonnes of CO2 emitted into the atmosphere. The total emissions from the World Health Assembly may be comparable, and that happens every year. It’s just not sustainable.