Understanding global security - Peter Hough

HEALTH THREATS TO SECURITY
prior to the use of DDT, compared with only nine in 1951, after several years of
treatment with the insecticide (McEwen and Stephenson 1979: 23). Replacement
insecticides have not matched the success of DDT in its early years, and malaria has
resurged in Africa, South East Asia and South America. In Ceylon (now Sri Lanka),
where DDT had reduced the annual number of malaria outbreaks to 17 by 1963,
its withdrawal prompted a resurgence of the disease to greater levels than ever,
reaching an estimated two million cases in 1970 (Hicks 1992). By the 1990s malaria
was claiming around 1.5 million lives a year worldwide, with the disease gaining
resistance to drugs such as chloroquine and mefloquine, in addition to the anopholes
mosquito’s resistance to DDT and other insecticides. In 1998 the WHO, abandoning
all aspirations to eradicate the disease, instead launched the far more conservative
‘Roll Back Malaria’ campaign, which declared as its aim the halving of malaria cases
by 2010. This was to be achieved by improving access to treatment in Africa
and increasing the of use insecticide-laden nets to deter rather than eliminate the
mosquitoes (WHO 2002a).
In spite of its achievements the WHO, along with other specialized agencies
under the UN umbrella, became the target of criticism in the 1980s and 1990s for
being over-bureaucratic and inefficient. The ‘New Right’ philosophy of Reagan and
Thatcher sought to challenge what it considered to be complacency in global public
bodies in the same way as it had done for state bureaucracies in the USA and UK. The
clearest manifestation of this challenge came with the withdrawal of those two
countries from the United Nations Educational Scientific and Cultural Organization
(UNESCO) in 1984 and the withholding of a proportion of the US regular budgetary
contributions to UN agencies from 1985. Criticisms of the WHO from the 1980s,
however, went beyond the confines of cutting ‘global red tape’ and freeing up international
trade. The Japanese WHO Secretary-General from 1988 to 1998, Nakajima,
was widely vilified for running the organization like a personal fiefdom in which
nepotism, discrimination and vote-buying were alleged to have occurred. Things
came to a head during the campaign for his re-election in 1993 when a bizarre protest
saw his prized pet carp and ornamental goldfish expertly filleted and left as sushi by
the side of the fishpond at the Geneva headquarters.
The election of the highly respected Dr Gro Harlem Brundtland (see Box 7.1)
in 1998 heralded a reform of the structure of the WHO still widely considered
necessary in spite of the ebbing of New Right ideology and the existence of more
internationalist governments in London and Washington. In an exercise reminiscent
of the overhauling of welfare systems in most developed states, Brundtand’s measures
were taken to streamline bureaucratic procedures and incorporate greater
financial accountability, aided by the utilization of private managerial expertise and
greater levels of transparency. The 52 old WHO programmes have been transformed
into 35 departments, with ‘sunset’ programmes abandoned to free up resources
(Brundtland 1999a). The new departments, in turn, have been consolidated into nine
‘clusters’ each headed by an Executive Director, who together form a cabinet which
meets weekly to discuss policy with the Director General.
The WHO has also been subject to criticism from an opposing coalition to the
New Right, made up of some medical professionals, humanitarian NGOs and functionalists
(proponents of greater internationalization led by specialist organizations),
concerned that the organization has lost its political influence and is being relegated
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