UN: Technical Agencies

Lord Rea Excerpts

Thursday 20th March 2014 Grand Committee

[Lord Rea (Lab)]

My Lords, this short debate covers a very wide-ranging subject but it is regrettable that there are only three speakers. Perhaps this is something to do with it being on Thursday afternoon, but it is surprising. There are many people who are far more expert on the United Nations and the World Health Organisation—about which I shall speak—than I am. However, the noble Baroness, Lady Warsi, may be relieved that she has to answer only three speakers when the United Nations covers such a huge range of subjects.

In my short contribution, I will concentrate on the World Health Organisation, which is just one of some 20 United Nations agencies. Its membership covers every single country in the United Nations—194 at my last count—and it has representatives in 140 of them, collaborating with national health ministries. In some developing countries, a WHO team helps with developing the governance and administration of health services in various ways. Although the WHO has been criticised as cumbersome—even sclerotic—it has had some very able directors-general who have pulled it into better shape. The WHO has some significant successes to its credit, the best known being the elimination of smallpox and the near-elimination of poliomyelitis. It has had many more quiet successes, many of which are still going on, concerned largely with monitoring disease levels, particularly epidemic outbreaks. Until recently WHO has concentrated on infectious, rather than non-communicable, diseases but there has been increasing interest in looking at the origins and handling of the latter since Gro Brundtland’s reign as director-general. This is appropriate, since they now make up half the diseases affecting the developing world as well as nearly all the serious diseases affecting the developed world.

In the area of infectious diseases, the WHO collaborates with a number of other agencies. Some of these are its own offspring but receive separate funding and have devolved or different administration. I am thinking of UNAIDS or the Global Fund to Fight AIDS, Tuberculosis and Malaria. So in its governance it retains a considerable degree of democracy and accountability through its committee structure at different levels, with representation from member states meeting regularly. My noble friend mentioned the regular attendance of at least two of our Ministers.

Some of the most useful work of the World Health Organisation is done by its many expert committees, some of which are standing committees meeting regularly with permanent staff on subjects such as essential medicines and biological standards. There is one group that regularly reviews the guidelines the WHO issues fairly regularly on a variety of topics. My noble friend mentioned perhaps the most recent, which was on sugar intake and has ruffled some feathers in the food industry. Other expert committees are ad hoc on topical subjects and may meet only a few times, but the members of these committees are all internationally recognised authorities in their chosen field. They are selected from panels of experts held by the WHO. A sizeable proportion of these experts is from the United Kingdom. Will the Minister describe the process by which they are selected? When they are selected, do they make a declaration of interest before they are appointed?

Reports from these committees are widely respected, although not always welcomed by Governments, which is as it should be. Progress in public health often involves controversial measures not welcomed by vested interests making profits from the activity or product concerned which is deleterious to health.

I shall make a very few remarks on drugs. The UN Commission on Narcotic Drugs has rather laid down the approach internationally to the control of drugs. The emphasis has largely been on curbing supply with a prohibitionist stance. The director of the UN Office on Drugs and Crime has said that it is time for the UN’s stance on drugs to change from having a largely prohibitionist role to one more focused on the health impact of drugs and on reducing the harm they cause. Will the Minister say whether the Government have moved even a little in that direction?