WSRO Report of meeting at WHO 28 June 2004

Report of meeting at WHO 28 June 2004-07-02

Please treat the contents of this report with extreme discretion.

Those present were Mr Andr e Prost (WHO) and Dr Richar d Cottr el l ( WSRO). This infor mal meet ing wa s bet ween the WSRO Direct or ­General a nd Mr Andr e Prost , who is a WHO Director with special responsi bility for relat ions bet ween WHO and both gover nments and pri vat e industry. Mr Prost has hel d thi s post thr oughout t he period that Repor t 916 (“Diet , nutrit ion and the pr evention of chroni c di sea ses�) and t he “Gl obal Strat egy on Diet , physi cal activity and heal th� wer e bei ng prepar ed.

Obj ectives The purpose of the meeting wa s to ascertai n the mood wit hin WHO followi ng the pr esentati on of the Resolution to adopt the Global Strat egy to the Worl d Heal th Assembl y in Ma y thi s year and the obvi ous embarra ssment (to WHO staff) tha t it wa s onl y accepted wit h substantia l modi fica tion. Particularly, i t wa s int ended to seek advi ce as to the ext ent to whi ch WHO st aff blame the sugar indu stry for thi s embarra ssment and the attitu de WHO is likely to adopt to WSRO in the future.

Background Mr Prost is shortly to retir e fr om hi s curr ent positi on wi thin WHO but ha s been ask ed to stay on to assi st the Direct or ­General in, a s yet, unspeci fi ed wa ys. He wa s most fri endly and helpful (he was pr evi ou sly in regular contact with the su gar indu stry, especiall y Graha m Somer vill e of CEFS and Richar d Cottr el l, whi le WHO Amba ssador to the EU) .

Atmosphere within WHO The main WHO staff members responsible for initiating Report 916 and the Global Strategy have either left of their own volition or their contracts have been terminated. These include Yach, Puska, and Waxman. Only Nishida seems to have remained on WHO staff. Mme le Galles (the more recently appointed Assistant Director General responsible for Non communicable Disease Prevention) seems entirely isolated and out of favour with the Director ­General (Dr Lee). It is doubtful whether she will keep this post for much longer.

The events at the WHA in May were a considerable embarrassment to Dr Lee. It appears that le Galles (new in her post) prepared for this meeting by contact with academic advisors (chosen by her staff, who were hardly impartial), with Non­Governmental Organi zations (most of whi ch have ideological agendas) and with the Health Ministries of Developed Countries. She seems to have ignored the Foreign Ministries, who are, in fact, the lead Ministry for Member Governments of WHO.

When the proposal for a Resolution on a Gl obal Strat egy ca me up for deci si on at t he Wor ld Heal th Assembl y, the Member Gover nment s’ Health Mi ni stries wer e over ­rul ed by the For eign Mi ni st ri es in al most every case. Thi s seems to have been pri marily influenced by resi stance to wha t wa s seen as an at t empt to expa nd of t he influence of the Health Mi ni stri es int o territor y cosi der ed the pr operty of t he For ei gn Mi ni stries, rat her than any particular int er est in the issues themsel ves.

The result was that t he Resolution would ha ve failed entir el y but for some rapi d manoeuvri ng by Dr Lee to encourage redra fting of t he Resolution (by Member Government r epr esentat ives, not by WHO staff) int o a for m that was acceptabl e. I t wa s not ewor thy that le Gall es was excluded fr om this process. The resi stance to the wording pr oposed for the Resolution wa s ver y widespr ead and not confi ned to Developi ng Countries or t o sugar exporting countries.

Thus the role of the sugar industry, as such, is seen as secondary to these events, although sugar is seen as a key factor in the reasoning of many Member Governments. The WHO is a democratic organization and the voters rebelled against the staff. Not a comfortable position for a new Director ­General.

Future Prospects Thus the likelihood of WSRO developing a constructive relationship with WHO, possibly leading to NGO status, have not been irrevocably damaged by the events to date. Mr Prost strongly recommended that WSRO shoul d meet Dr Beagl ehole, who a senior member of le Galles’ NCD Division and a well known epidemiologist. He also recommended contact with his successor as Director for Government and Industry Relations, Ms Susan Holck. It i s cl ear that WSRO will need to offer some form of collaboration wi th WHO, i nvol vi ng substantial sponsor shi p, to be consi dered for NGO statu s. Our earlier work on fluori dat ed sugar is now too far in t he past to be seen as of much releva nce. What i s not cl ear is the ext ent of sponsor shi p expect ed and whet her it will be possi bl e to identify a pr oj ect that would be acceptabl e to WHO but of direct value to the su gar indu stry (ot her tha n mer el y a gesture of good will to WHO). It i s al so cl ear that cer tain indi vi dual s connect ed with Report 916 remai n i mplacabl y hostil e to the sugar industry, i ncluding Yach. Fortunat el y, ther e does not now seem to be a defi ned gr oup of anti­su gar staff withi n WHO. It remai ns to be seen to what extent pr essur es host ile to su gar coming fr om out side WHO will influence deci sions wit hi n WHO in the futur e. Dr Lee is appar ently not i nclined to allow WHO to become hea vily involved in implementing any diet and health activities. He i s hi msel f under pressure, however , a s a result of t he poor per for mance of several of hi s seni or appoi ntees. It is likely that there will be a number of changes in senior positions withi n the next few months. Richard Cottrell