- The Washington Times - Thursday, August 3, 2000

Some 17 million people die of infectious and parasitic diseases around the world each year, most of them in developing countries where the four horsemen of the apocalypse come not as visitors but as neighbors. The tally is ghastly: lower respiratory diseases, 3.7 million deaths; tuberculosis, 2.9 million; diarrhea, 2.5 million; HIV/AIDS, 2.3 million; malaria, 1.52 million.

Any letup in the fight against these diseases, any pause to recover one's breath, may make matters far worse. Said the World Health Organization (WHO) in a 1998 report, "Experience shows that reduced spending on controlling infectious diseases can cause them to return with a vengeance, while globalization particularly expanding international travel and trade, including the transportation of foodstuffs increase the risks of their global spread."

Given the panic in this country over the relative handful of victims of the mosquito-borne West Nile virus, one would want to take that warning seriously. But that's not the subject on which the WHO is trying to focus the attention of elite U.S. media. No sir. The WHO is obsessed with allegations that the tobacco industry sought to counter the agency's anti-smoking agenda.

In a front-page article Wednesday, The Washington Post cited a "sophisticated, top-secret" campaign by tobacco companies to discredit the agency and cut its budget for anti-smoking work. Further, the article continued, the companies tried to place their own consultants at the agency to keep an eye on anti-smoking activities. The source of The Post story was a 240-page report that the WHO commissioned last fall and released this week. That report also generated an ominous New York Times story entitled, "WHO Says Files Show Tobacco Companies Fought Antismoking Efforts."

As an example of the industry's maneuvering, both stories cited the work of a man named Paul Dietrich, who heads the Institute for International Health and Development, a research group in Alexandria. It seems that Mr. Dietrich had written newspaper op-eds critical of WHO spending priorities without disclosing that his firm has received money from a tobacco company. His firm receives funds from many Fortune 500 firms, he said in an interview, and he said he had received money from an industry related foundation too.

So what exactly did Mr. Dietrich say in his op-eds to promote the industry? In a May 1997 article in the Wall Street Journal Europe, Mr. Dietrich didn't mention the industry at all. He was, however, sharply critical of the way the WHO was spending its money.

Almost all of the money the agency appropriated in 1997-98 for control of communicable diseases, he warned, was allocated for conferences, meetings, personnel and overhead costs. Only about 3 percent of the agency's total budget was allocated to specific countries to fight infectious as well as noncommunicable diseases. Since 1994, the WHO had cut back on country-level expenditures for communicable-disease control by more than 65 percent. The agency's own executive board criticized the agency for failing to focus its budget on major health concerns.

Mr. Dietrich recommended, among other things, that the WHO focus on research, "especially in diseases that most affect developing countries like respiratory diseases, tuberculosis, malaria and cholera." If that's pro-tobacco propaganda, probably lots of people would plead guilty to spreading it too.

It's true that research dollars are limited. Almost by definition, spending more money to protect Third World children from killer diarrhea means less to protect graying Westerners from the consequences of a decision to do something dumb, such as smoking too many cigarettes or eating too much fatty food.

But there are at least two arguments for devoting one's attention to dealing with infectious diseases first. One, there isn't much evidence to suggest that anti-smoking campaigns work. Second, the risks of smoking have been well known for decades. Like it or not, smokers assumed those risks when they took up the habit. Children in developing nations assume the risk of disease and premature death just by being born.

WHO officials have the luxury of worrying about "bad habits"; they aren't likely to end up as anonymous casualties whose "graves" are the statistical rolls for annual cholera or tuberculosis deaths. Journalists too have an incentive to focus on tobacco industry controversies because those stories are far more likely to get good play than just another story of premature death in Africa. But notwithstanding WHO charges, one need not be a tobacco industry advocate to think there is something wrong with those priorities.

E-mail: smithk@twtmail.com



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