WSRO Report of meeting at WHO 28 June 2004

This is a text version of the leaked WSRO minute by Richard Cottrell. A pdf version is here.

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

Please treat the contents of this report with extreme discretion.

Those present were Mr Andre Prost (WHO) and Dr Richard Cottrell (WSRO). This informal meeting was between the WSRO Director-­General and Mr Andre Prost, who is a WHO Director with special responsibility for relations between WHO and both governments and private industry. Mr Prost has held this post throughout the period that Report 916 ('Diet , nutrition and the prevention of chronic diseases') and the 'Global Strategy on Diet, physical activity and health' were being prepared.

Objectives

The purpose of the meeting was to ascertain the mood within WHO following the presentation of the Resolution to adopt the Global Strategy to the World Health Assembly in May this year and the obvious embarrassment (to WHO staff) that it was only accepted with substantial modification.

Particularly, it was intended to seek advice as to the extent to which WHO staff blame the sugar industry for this embarrassment and the attitude WHO is likely to adopt to WSRO in the future.

Background

Mr Prost is shortly to retire from his current position within WHO but has been asked to stay on to assist the Director-General in, as yet, unspecified ways. He was most friendly and helpful (he was previously in regular contact with the sugar industry, especially Graham Somerville of CEFS and Richard Cottrell, while WHO Ambassador 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 Non-­Governmental Organi zations (most of which 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 Global Strategy came up for decision at the World Health Assembly, the Member Governments' Health Ministries were over-rruled by the Foreign Ministries in almost every case. This seems to have been primarily influenced by resistance to what was seen as an attempt to expand of the influence of the Health Ministries into territory cosidered the property of the Foreign Ministries, rather than any particular interest in the issues themselves.

The result was that the Resolution would have failed entirely but for some rapid manoeuvring by Dr Lee to encourage redrafting of the Resolution (by Member Government representatives, not by WHO staff) into a form that was acceptable. It was noteworthy that le Galles was excluded from this process. The resistance to the wording proposed for the Resolution was very widespread and not confined to Developing Countries or to 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 Beaglehole, 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 is clear that WSRO will need to offer some form of collaboration with WHO, involving substantial sponsorship, to be considered for NGO status.

Our earlier work on fluoridated sugar is now too far in the past to be seen as of much relevance. What is not clear is the extent of sponsorship expected and whether it will be possible to identify a project that would be acceptable to WHO but of direct value to the sugar industry (other than merely a gesture of good will to WHO).

It is also clear that certain individuals connected with Report 916 remain implacably hostile to the sugar industry, including Yach. Fortunately, there does not now seem to be a defined group of anti-sugar staff within WHO. It remains to be seen to what extent pressures hostile to sugar coming from out side WHO will influence decisions within WHO in the future.

Dr Lee is apparently not inclined to allow WHO to become heavily involved in implementing any diet and health activities. He is himself under pressure, however , as a result of the poor performance of several of his senior appointees. It is likely that there will be a number of changes in senior positions within the next few months.

Richard Cottrell