The WHO was founded in 1948 within the United Nations system created by the United States in order to give continuity to its hegemony over the winning allied bloc. It was made up of 55 countries. Its main topic on the agenda: antibiotics, which in the immediate post-war period, as told by the third man, inaugurated health diplomacy and fed a tremendous black market. But there wasn’t even time for debate. The first imperialist tensions between blocks blew the structure away. In 1949, less than a year after the start of work, Stalinist Russia and its allies abandoned the organization in a pre-war context.
Stalin’s death accelerates a change of imperialist strategy in the Eastern Bloc. The Russian bureaucracy, pressured by a series of wildcat strikes on its own soil, but also by movements in the countries of its bloc, and especially by the German workers’ insurrection of ’53, is afraid of rushing into war without sufficient military force or control over the workers. Khrushchev affirms the doctrine of peaceful coexistence. And what better place to show the Russian will to participate in the multilateral order hand in hand with its main imperialist rivals than the WHO?
The false golden age of the WHO
Russia’s return to the WHO in 1955 sets the beginning of what is today – falsely – remembered as the organization’s golden age. In the new spirit of technical cooperation, the smallpox eradication campaign was launched: a global and massive process of vaccination against a disease with a long and dreadful history that still caused hundreds of thousands of deaths every year in the late sixties.
Although victory was not fficially declared until 1979, in the 1970s it was taught in schools all over the world that the ongoing eradication, together with the space race, was a proof of progress and the greatest conquests of Humanity to date. Both were actually by-products of a horrible and monstrous reality: the most dangerous militaristic escalation in History so far. That the first eradication of a disease by human action was done on account of the propagandistic coverage of the cold war was in fact the definitive proof that human progress was no longer a direct consequence of capitalism on either side .
But what is characteristic of imperialist propaganda is to present again and again one thing as its opposite, war as peace, reaction as progress. And at that time the main dish of what was peddled as progress was the independence of a series of semi-colonial countries in Asia and Africa that the two blocs came to dispute over. Most of these new states joined the WHO during the 1970s, among other things to participate in mass vaccinations. The organization grew to 150 member states. Russia, which had direct influence over most of them, rushed to take control of the organization by displacing the US. The goal was to use it for its own ideological positioning by presenting itself as the leader of what Mao, who by then had switched blocs, called the ‘Third World’.
The result of the Russian health diplomacy materialized in 1978. That year it organized the Almaty conference of the WHO. The assembly proclaimed the right to health as a universal human right, the WHO as its guarantor, and improving socio-economic conditions as a central part of its work.
What did this mean? That the semi-colonial countries, helped by Stalinist Russia and its satellite countries, were appropriating for the first time a structure of the multilateral order created by the USA and turning it into a battering ram against the American power and its European allies.
The WHO began to promote a model of state health which guaranteed the control of national pharmaceutical and medical markets by the young states… giving an opportunity to exports from the Eastern Bloc. In addition, the organization began to demand increased budgets as a way of carrying out viable campaigns in the semi-colonial countries, it became a loudspeaker for the demand for trade exemptions and development aid proclaimed by its suffocated bourgeoisies, and it applied itself – as later UNCTAD and UNESCO would do – to placing sticks in the wheel of the imperialist policy of the United States, its main donor. All under the slogan of achieving Health for All in the year 2000. For Russia it was a midfield goal, and for countries like India an expression of their ability to play their own game.
The privatization of the WHO
In 1981 the causative agent of AIDS was identified as a virus, HIV, and Ronald Reagan became president of the United States. The combination of both facts will bring to a close the supposedly golden age of the WHO and the Almaty strategy. On the one hand, the WHO was unable to respond to the pandemic in the midst of a peak social alarm in the US and Europe. Complaining about a distant and vindictive WHO that did not respond to the interests of the paying countries when they asked for help, the USA and its main allies led to the creation of a specific pandemic agency: UNAIDS. In it, WHO was reduced to a member among 11 other UN agencies, most of them controlled by the United States. The political coup was formidable, demonstrating that in the face of a global health crisis, the WHO was neither sufficient nor functional.
But it still had a sequel. Instead of increasing its quotas as requested by the WHO, the US unilaterally reduced its contribution by 20%. The organization saw its budget freeze. From then on, each emergency meant launching a donation campaign. In the 1990s, the WHO made these donations the basis of its funding. Today, only 20% of the budget comes from country contributions. 80% are donations. The two main donors? China and the Gates Foundation. The WHO became a de facto service agency connecting great powers willing to pay and great funds – like the Gates’ – with national governments by giving them coverage. For what in theory remained its core function, expanding primary health care, there were never any private sponsors. That’s what China is for.
China and the WHO
But the weight of Chinese aid has its own history. In 2002 the SARS epidemic erupted in China. The Beijing government, fearful of the impact on investments, tries to cover up the situation and denies the alarm. But the epidemic goes first to Hong Kong and then out of China. The then director of the WHO, Gro Harlem Brundtland, the Norwegian Thatcher, condemned the withholding of information by the Beijing authorities, proclaimed a global health alert and caused a scandal that led to an unprecedented event: the resignation of the Chinese health minister. After the success, in 2005, she promoted the approval of the International Health Regulation, which gives the power to the WHO to warn about epidemics and condemn the recklessness and concealment of the states.
China is immediately aware of the political danger this poses. It sends medical missions, multiplies health aid and non-repayable loans to African and Asian countries to create infrastructure and hospitals. The WHO becomes its next target. In 2006, the organization’s assembly elected as director the Chinese candidate, Margaret Chan, who had been responsible for health in Hong Kong during the SARS-CoV-1 epidemic.
The consequences of this political change will be seen in 2014, when the organization joined the African states suffering from the Ebola epidemic in an attempt to deny the alarm. Only six months after the outbreak and when the first cases occurred outside the region, was the international health alarm proclaimed by Chan.
The Covid pandemic outbreak came at a time when the USA was in a process of scrapping multilateral agencies. The first WHO statements, when there were already serious doubts about the information provided by China, were dithering, full of exaggerated and servile flattery to Beijing’s exemplary management which immediately turned them into part of its propaganda. The US government accused the organization of having an “alarming lack of independence” with respect to China and turned the organization’s world assembly into a dramatization of the imperialist conflict. What’s more, it set a precedent. Bolsonaro was more honest, however, instead of attacking the WHO for resisting to blame China, his attack accused the organization of proposing nothing more than lockdown against the pandemic and thus hindering the economic goals of the government. The EU, on the other hand, interested, in Macron’s words, in avoiding any alliance between the two powers, immediately took sides with Tedros and his team and joined in a special fundraiser in the purest telethon style.
European leaders were publicly outraged to see the WHO turned into a battleground between the two great current imperialisms. But was it ever anything other than a battleground between the various imperialist interests in conflict at every moment?