Member states of the World Health Organization - the UN agency charged with promoting international cooperation in the fight against disease - have just approved its priorities and $3.2bn budget for the coming year.
In a world in which life-expectancy is increasing as a result of rising personal prosperity, one would expect the WHO to devote its limited budget to the trans-boundary diseases which pose the greatest threat to global health.
While this should include threats such as avian flu, it must also include diseases like AIDS and malaria, which disproportionately affect the poor.
Instead, the WHO is throwing money at the modish obsessions of western health bureaucracies, ranging from road safety to blood pressure . Its self-appointed remit is so broad that it is surprising they don't yet have a global initiative to stop children from running with scissors.
This is the conclusion of a study the Campaign for Fighting Diseases recently commissioned from economist Professor Richard Wagner . His analysis of the WHO's budget for 2006-7 reveals that the agency focuses far too much on non-communicable diseases - such as high blood-pressure and psychiatric health - and not enough on AIDS, malaria and other communicable diseases of the poor.
Unsurprisingly, most of this money is swallowed up by bureaucracy, bloated salaries and public relations.
So why does the WHO prioritise the diseases of the rich above those of the poor? A handful of western countries provide the lion's share of its budget. The WHO is therefore answerable to Western politicians not African people, leading it to focus on political rather than medical priorities.
Furthermore, these Western politicians and health bureaucracies are in thrall to lobbyists who push politically-correct demands for regulating infant formula, cutting down salt in food and banning tobacco advertising in sport.
This is why WHO-sponsored initiatives on 'healthy eating' can exist while millions of African children struggle to eat at all. Don't get us wrong: we are in favour of eating healthily and share the WHO's concern that too many people die unnecessarily from smoking tobacco. But with so many children dying from preventable and easily curable diseases, the WHO should be more focused on these problems.
Worse, many influential activists also preach that state planning is the only way to ensure good health - and this is also gospel at the WHO. In Canada and the UK , state-run health systems fail to provide decent, equitable healthcare even though their people can afford them. In India or sub-Saharan Africa, such schemes would be madness.
Even when the WHO does intervene against communicable disease it often fails. After seven years, its 'Roll Back Malaria' programme has overseen a rise in malaria cases , largely because it has yielded to environmentalists' calls to limit the use of DDT - even though the insecticide is extremely effective against malaria. Until last year, it was also recommending cheap but ineffective chloroquine instead of more expensive but effective artemisinin combination therapy.
With AIDS, the WHO's '3 by 5' campaign is struggling because it has bowed to Western activists' demands to prioritise treatment over prevention. Consequently, new cases are piling up quicker than they can be treated.
So what can be done to make the WHO more responsive to global health priorities?
One option would be the outright abolition of the WHO. Far from making things worse, many other bodies exist that can coordinate global action: witness, for example, Rotary's success in eradicating polio.
Another option would be to move the WHO from Geneva to Africa. This would sharpen the organisation's focus onto real issues in poor countries and would ensure that scarce resources are not frittered away on dubious projects.
Above all, the WHO needs a new constitution that limits it to communicable diseases - the real threats to the world's health.
The Campaign for Fighting Diseases is a project of International Policy Network
Published with the permition of the Campaign for Fighting Diseases which is a project of International Policy Network
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