administration's drug and sexual health policy is a key
issue as the World Health Organization chooses its
next leader, a post that wields great power in
allocating billions of dollars in funds to alleviate
misery around the world.
After two days of
closed-door deliberations, WHO is set to announce its
new chief Wednesday.
WHO's top job include Dr. Margaret Chan, a bird flu expert
and former Hong Kong director of health; Dr. Shigeru Omi of
Japan, who heads WHO's Asia office; Mexican health
minister Dr. Julio Frenk; Spanish health minister
Elena Salgado Mendez; and Dr. Kazem Behbehani, a veteran
WHO official in Kuwait.
The United States
has not declared a preference for any candidate.
Critics say the
United States, WHO's largest donor, plays too large a
role behind the scenes. They argue that the Bush
administration is promoting the interests of its
pharmaceutical industry -- at the expense of
AIDS patients who
could be saved by cheap generic medicines -- and has
adopted an ideological line on issues like abortion.
has made more money available for AIDS research than any
previous American leader, but that largesse has not extended
to programs in reproductive and sexual health. His
administration has also challenged ideologically
charged WHO programs such as needle exchanges and condom
deny they are seeking to force the administration's health
policies upon the world.
"We are not
giving WHO money because we want to have influence,"
said Bill Hall, a spokesman for the U.S. Health and Human
Services Department. "We're doing this because we want
to improve the human condition around the world."
health experts and senior WHO officials told The
Associated Press that Washington consistently interfered
with policy under the U.N. agency's last
director-general, Dr. Lee Jong-Wook, who died in May.
government has a direct role in every significant decision
made in Geneva, and even close to a veto role," said Dr.
Richard Horton, editor of the influential medical
journal, The Lancet.
In one prominent
case of alleged interference, the United States
requested the suppression of a book commissioned by WHO that
criticized U.S. free trade agreements for jeopardizing
poor countries' access to cheap medicines.
In a letter to
WHO's acting director-general, a senior official from the
U.S. Department of Health and Human Services said the report
"spuriously" characterized U.S. trade policy. WHO has yet to
make a decision on the U.S. demand.
"Standing up to
the U.S. is not the easiest thing to do at the WHO,"
said Sisule Musungu, a Kenyan intellectual property
specialist, who coauthored the report with a former
sparked concern from two Democratic lawmakers, Sen. Edward
Kennedy of Massachusetts and Rep. Henry Waxman of
California, who have called for an investigation into
how American trade agreements threaten the health of
people in developing countries.
suppress a report because it is critical of U.S. trade
policy is unacceptable," Kennedy wrote in a letter to Mike
Leavitt, Secretary of Health and Human Services.
In a widely
reported episode in January, WHO's top official in Thailand
was stripped of his post after he said in an editorial that
a U.S.-Thai free trade agreement would jeopardize Thai
access to cheap drugs, leading to the deaths of
hundreds of thousands of AIDS patients.
"This was an
example of an instance where there was probably pressure
from a certain member state, in this case the U.S.," said
Dr. Tido von Schoen-Angerer, of Doctors Without
Borders, which works closely with WHO.
The United States
denies it had anything to do with the transfer of the
official, Dr. William Aldis, to the WHO's regional office in
New Delhi, India.
"We had no role
in that," said Hall of the Department of the Health
and Human Services. Though Hall says Washington formally
complained to the WHO about the editorial, he said no
suggestions were made about disciplining Aldis.
companies argue that allowing developing countries to
produce generic medicines may compromise their quality,
endangering the lives of the patients they are meant
to treat and leading to resistant strains of diseases.
position has been that generic drugs are generally safe, and
that the advantages of using them in cases like Thailand
outweigh the relatively small risks.
often been praised as a success story in its approach to
tackling AIDS -- producing cheap, generic versions of
antiretrovirals. More than 80,000 people depend on
these life-prolonging treatments and AIDS deaths have
dropped by nearly 80% in the last decade.
publication of Aldis's editorial, the Thailand-U.S. free
trade agreement has been stalled -- largely
because of the attention drawn to what the pact would
do to Thailand's strategy on fighting AIDS.