From Flu Wiki 2

Forum: An Open Letter to the Flu Community

16 July 2006

anon_22 – at 08:52

I wrote this a while back in response to the most excellent series on WHO at Effect Measure: part 1 part 2 part 3 part 4 part 5 which IMO should be required reading for anyone who wants to understand, criticize, make useful comments or contributions about, the WHO. :-)

I thought this might be the time to raise the debate again, and this time not just about the WHO but about all those involved, WHO, governments, scientists, journals, media, us. Especially us.


Revere’s series have drawn our attention to the distinction between the WHO as an increasingly ineffective institution, and the staff of the WHO (and the CDC and other institutions) as including some talented and devoted good folks who believe as we do in transparency, honesty, co-operation, etc.

At the same time, there is a large group of regular contributors on various avian flu blogs who have shown the ability to deal with issues fairly, responsibly, giving criticism and/or praise where either is due, but also able to harness tremendous creativity and dynamism, responding to events and data 24/7 at speeds only limited by bandwidth. This phenomenon is as unprecedented as the avian flu virus itself. We call it ‘the hive mind’ at the fluwiki.

These two groups have fewer differences than some might think.

Each must now reach out to the other.

Scientists must learn to overcome their Pavlovian horror of talking on equal terms to ‘laymen’. The media and policymakers must learn to judge information, analyses, ideas, based on the credibility of the thought process, not just credentials, names, and official positions.

Because the constraints within the WHO are real, we must acknowledge the need to protect individuals who, by reason of their affiliations, are not always able to disclose ALL that they know. We must honor that by making it comfortable for them to disclose however much they can, anonymously or otherwise. When they say “I cannot tell you that.” instead of questioning their motives or harassing them for elitism or whatever, we must say thank you and move on.

The incessant badgering of ‘experts’ on some blogs, irrespective of merit, must stop. Each piece of information or analysis must be judged, criticized, on the strength of the case under consideration, not on personality or prior affiliation. We value information. We want good data in whatever form we can get it; it doesn’t have to come from WHO official statements. But we must learn to honor and not abuse both the data and the messenger(s).

At the same time, the WHO, if it doesn’t want to become increasingly irrelevant, must step up to the challenge. The tragic necessity to find a new Director General and the almost universal recognition of the inadequacy of the WHO alert phase system have created space for new thinking. They must grasp this opportunity and use it well.

The DG has a fair amount of discretion as to what constitutes information that should be routinely disseminated for the public good. In recognition of the increasingly important role of non-state actors, including internet sites that play an increasingly influential role in public education, and many minor NGO’s doing important work on the ground in underdeveloped countries, he/she should make it standard practice to publicly reveal all epidemiological information, however incomplete, at the same time as such information is provided to states for public health purposes. Exceptions to this should be made on a case by case basis and with explanation.

Individual scientist’s rights to first publication of data, including viral sequences, can be honoured by compulsory and provisional acknowledgements whenever such data is used, until such time as peer reviewed publication can happen. This obstacle is not insurmountable; editors of science journals must perform their public duty to ensure such a step is possible and is honoured.

Objections to publication on grounds of bioterrorism risk should (if not done already) be evaluated by a small panel of experts drafted from outside of the WHO, perhaps from the UN Institute for Disarmament Research. Such panel can provide a general risk assessment with regards to avian and pandemic flu, outlining principles governing disclosure policies, to be used as guideline by the WHO.

The most important over-riding principle should be disclosure unless there is a case to the contrary. That is, member states must voluntarily agree to full disclosure in principle unless otherwise stated. Once such permission is given, the onus should be on member states to raise items of exclusion and the rationale behind them on a case by case basis.

State sovereignty is not as solid as leaders would like to believe; the global movements of jobs and money are well-recognized examples of erosion of state power which paradoxically often bring the best hope of prosperity for countries. It is past time for nations to exercise sovereignty-lite. History will show that Westphalia-Lite is well under way; those who attempt to stop historical trends risk death by irrelevance, as the Soviet giant discovered in one short season in 1989.

Finally, political leaders within individual countries must recognize and admit their impotence in the face of this pandemic threat. There is no shame or dishonour in doing so; not if they do it NOW.

By standing up and admitting it, they will win the support of the core group of people on whom they will have to depend to deal with this threat: those scientists, public health officials, healthcare workers, community responders and volunteers, and the concerned mums and dads who have wandered the corridors of online chat-space in the wee hours to make sense of the situation.

We already know that government is powerless to solve the whole problem.

We only ask that you exhibit leadership by telling the truth.

THAT is the only place from which one can draft in the incredible and diverse energy needed to mitigate this biggest threat the world has ever known.

anon_22 – at 09:28

This is also intended as a split-off thread for continuation of the discussion from this thread, since some very important points were being made. Thanks.

anonymous – at 09:31

you wrote all this in that short time ? I can’t even read that fast. I don’t yet understand, what this is about. An open letter, OK. But about what ? A short summary would be useful for those who don’t want to read so much before they decide whether they are interested in the thread or not.

Monotreme – at 09:35

anon_22,

Very well-written letter. Nothing I disagree with, given your assumptions.

However…

You make certain assumptions that may not be true. First, you assume that everyone who works at the WHO, CDC and in national governments ia basically ethical and means well. I do not think this is true. I wish this were otherwise, but we ignore ugly truths at our peril. Although I suspect most of the scientists at the WHO are ethical and are doing the best they can, I think there are people there who are genuine sociopaths and have no interest in warning or preparing the world for a pandemic whatsoever. Their primary goal is to advance their careers and they will do this by whatever means necessary. One strategy may be to aid and abet a member nation in covering up inconvenient facts. Given the many bureaucratic rules that govern the WHO, this would not be hard to achieve or to disguise.

Many of the higher level managers are likely suggested for appointment by the countries from which they come. I have concluded this because some of the very high ranking people at the WHO have poor scientific backgrounds and disasterous and highly objectionable records in public health. It is hard to imagine that they were chosen on the basis of merit.

Thus, in an alternative scenario to yours, it may be that there is a determined group at the WHO who are quite deliberately using all the power they wield at the WHO to obscure vital information in a (successful) attempt to protect the economic interests of the country that sponsors them. It would be difficult to prove my scenario. But I think we should consider this one as well.

Reports of corruption, like this one, or incompetence at the WHO should be fully investigated. But by whom? An external reveiw panel is the only solution that I can think of. Such a review panel would be helpful for the honest, competent scientists at the WHO as it would provide a legitimate venue for them to express their opinions.

anon_22 – at 10:09

Monotreme,

“You make certain assumptions that may not be true. First, you assume that everyone who works at the WHO, CDC and in national governments ia basically ethical and means well.”

No, I do not assume that at all.

On the other hand, I do not like to label people as sociopaths unless I have evidence. And even then, I may not choose to do that on a public forum.

And no, I do not ignore ugly truths. I write about them all the time. Such as the fact that the UN system is constantly held hostage by representatives of governments of member states that hold the world hostage by their selfishness.


I have to go now. Will write more later.

anonymous – at 10:42

I think there is plenty of evidence that there are sociopaths working within WHO.

I suspect the type of incompetence, if not downright wickedness (use such a strong term to describe a system, originally designed for good, that can contribute to the destruction of so many), is widespread and common in many organizations and institutions. I worked for many years at hospital where the most incompetent people rose to the top. I was very active getting union representation for all employees who benefited greatly by having such advocacy.

However, I was endlessly harassed by management and ultimately quit my job (either that or I suspect get fired) for being a strong, vocal patient and employee advocate.

People at the top were not interested in fixing problems. They were interested in their cushy jobs which for the most part they were unpualified for not only in credentials but in character, or lack thereof.

No matter how many people were hurt by management tactics, no matter how many patients actually died because of shortsighted decisions made only by concerns for the bottom line, ultimately nothing ever changed. Singly, many of the scoundrels in the system left, but were only to be replaced by worse scoundrels, all looking out for their self-interests. If public was accidentally served in so doing, well fine, otherwise, public good was only something referred to in mission statement that, like most mission states, was total crap.

I have very little hope for the little hospital I worked for, and I have little hope for the WHO. Don’t know what the answer is.

Don’t think it’s playing nicey nice. Don’t insult the sociopaths. Just get along. Play by their rules. Will never work because, well, sociopaths being sociopaths, they don’t operate out of conscience. But how to get people to speak out, which would be to basically risk their jobs, their livelihoods, their families’ well-being, their professional futures?

I have seen and experienced personally the cost of sticking one’s neck out in an effort to do the right thing. It is ugly and personally it has cost me plenty.

It seems the system is rigged to pay only lip service to protecting whistle blowers, but when it comes right down to it, who wants to take such a gigantic risk when TPTB have deep pockets and much greater resources.

It is easy to say oh someone do the noble thing. But who will provide food for that person’s family when they do and then pay the price of losing their job and possibly being blackballed and not being able to work at a comparative job again?

I am not advocating silence or lack of courage. But when the sickness within a system is so endemic and goes right to (or comes right from) the top, it would behoove us to recognize the enormous resources that the Goliath of a system can throw at anyone who dares to be a David.

Melanie – at 12:17

anonymous – at 10:42,

You are making very serious accusations which you are not backing up with any evidence.

When I look at the WHO and CDC, I see large bureaucracies which make all of the bumbling moves that bureaucracies make.

Please be a little more judicious with the kinds of language you throw around.

Monotreme – at 12:35

Melanie,

I can’t speak for anonymous, but as far backing up the charge of possible corruption at the WHO, here it is:

[[http://www.peacehall.com/news/gb/english/2006/03/200603081328.shtml| WHO officer in China helps to hide bird flu?]]

This has not been substantiated. However, it has also not been investigated. I think it should be.

Calling someone a sociopath is a value judgement no different than saying that they are bumbling or incompetent. I think anonyomous was making a general statement about large organizations - which I happen to agree with. There really are sociopaths among us and they really do do bad things, IMO. They love large organizations with complex bureacratic rules because it is easier for them to escape detection there.

The only way to indentify them and remove them is through external review panels, which is what I advocate for both the WHO and the CDC. Large organizations that are not subject to external review almost always go bad. Just human nature.

DemFromCTat 13:01

I think there is plenty of evidence that there are sociopaths working within WHO.

Folks, this is not acceptable language, period. Not from anonymous posters. Not from anyone. Do not repeat it. Assume the next poster and the next reader is a WHO official, though not one in charge of policy. What arer you trying to accomplish?

Please stand down.

Commonground – at 13:32

Monotreme - if you throw out CDC and WHO - what do we have left? By the time you get an external review panel up and running and get the final conscensus - the pandemic will be over.

Anon_451 – at 13:38

Monotreme – at 12:35 Melanie – at 12:17 anonymous – at 10:42 anon_22 – at 10:09

First Let me say that I have nothing but the greatest respect for all of you. Your knowledge and insight has been a great help to many here myself included.

Monotreme: I read the initial letter and must say that dealing with the reality of H5N1 is long overdue. However; you must remember that all government agencies around the world pay HCW’s at the lowest rate possible (as they do most government workers) as such, the really brightest among them become discouraged due to the bureaucracies. They either go with the flow in hopes of getting high enough to make changes or they leave. Those that stay find when they can make the changes they really can not because the real power is in the hands of people that are appointed to their postions for political reasons. After they have spent their early years in government service trying to do a good job, they find they can no longer leave. TPTB in the private sector have pegged them as incompentent because they have work in government for so long. (Note these would be true around the world not just the US). So they are now in the position of; speak up and your family WILL suffer, don’t speak up and MAYBE the whole world will suffer.

You have really hit the nail on the head when you said that “Finally, political leaders within individual countries must recognize and admit their impotence in the face of this pandemic threat. There is no shame or dishonour in doing so; not if they do it NOW”

WHO bashing will get NONE of US anywhere. We have to except that the WHO is an arm of the UN and that it is fully controlled by the political leaders of that body. The WHO, HHS and CDC will do what the sitting administration requires it to do. They may try to move the political leaders one way or the other but the bottom line is “ITS NOT THEIR CALL”

In England it is the Prime Ministers Call in the US it is the Presidents Call, In the UN it is the Secretary General’s call. In short DONT BASH the messanger. That the medical communty could do a better job in communicating the theat to the leadership, goes with out saying. But the leaders also like to bash the messanger. When the medical community fails to speak with one voice, Political (and private) Leaders chose the message they want to hear and fire those who do not go along with the program.

What I am saying is “DONT BASH THE FOLKS IN THE MEDICAL COMMUNITY” We, all of us, on this Wiki, need them all to come together and speak in one clear and loud voice. This is real and you must get ready for it. Any desenting view will be grabed upon by the political and private leaders to “SAVE MONEY” or make more money.

Please (remember I am the guy who wants to take a flame thrower to the place) Let us all come togetter and accept the WHO for all of its faults and understand that we NEED them as a complete group to STAND UP for the lives of the whole world.

No more WHO bashing, PLEASE

FrenchieGirlat 13:42

Back. I’ll try and comment on some points made on various threads. Bear with me, it’s doing to be long…

anonymous – at 13:49

“we NEED them as a complete group to STAND UP for the lives of the whole world.”

yes we do. and so we wait.

anon_22 – at 13:55

Monotreme,

Nobody is denying there are problems. Why else are we talking here?

I don’t deny that institutional reviews etc are necessary. But I am also very aware of the fact that the flaws are ingrained into the whole structure of the system, as revere so eloquently dissected in the posts at Effect Measure linked above. That such flaws take very long periods of time to change, far longer than is available on the timescale of a possible pandemic. That many others with just as valid reasons to change them have come up against brick walls, and injured themselves and thereby lost their effectiveness as a result.

The UN continues to stand, with all its flaws, because that is all we have, and also because those who have tried to change it for the better come up against so many obstacles that the effects have been minor and almost inconsequential.

I don’t doubt that there is corruption. I know enough about the ‘Oil for Food’ programme and what happened at Rwanda to get sick at heart for the people who die unnecessarily because of corruption, incompetence, irresponsibility, etc. But it is precisely because I know about them that I choose a softer path, that of going around it, because much as I champion the power of an individual to do good, those powers are extremely limited when compared to institutions, especially extra-territorial ones such as anything under the UN.

When we write on this forum, no one needs to listen to us. They have no obligation to do so. But I’d like to think there their are people of integrity and reason here and there who can be won over by the strength of our arguments. And to do that we need to be impeccable in our fairness, be reasonable in our demands, taking fully into consideration the obstacles that are present, such as maybe corruption or incompetence. Taking those into account is not the same as condoning them. It is just one way of saying, “Despite that, can we make something good out of it?”

anonymous – at 14:06

and even if saying there are sociopaths within the WHO is too strong a language to be useful (even if true), okay, let’s say even if there simply no sociopaths within the organization, they are not blameless. even if they operate at the direction of the membewr states of UN, they are not blameless.

Someone says don’t bash the messenger. Well if the messenger is not passing on a message only it is in the position to fully know, then the messenger deserves to be baashed.

ARe they responsible for releasing sequences? If so and they don’t, they deserve to be bashed, or put another way, to be held accountable, which usually starts with criticism. If they are not responsible in any way for the lack of transparency with sequences, they are certainly responsible for obscuring a lot of info re clusters, etc.

Also responsible for doing away with phase system. So it was imperfect? Well, what has it been replaced with? Anything better? Not that I can see. If it has then it would be helpful to state so on this thread. This is a charge that has been placed with them and it seems they have not lived up to their responsibility. If they can’t because of political considerations, then they should say so so that people of the world won’t naively go along thinking that they might get adequate warning of growing threat of pandemic from the WHO.

Commonground – at 14:14

anon - at 14:06 - I guess the same could apply to the MSM. I know a lot of my friends are waiting for THEM to say something before they take it seriously.

“If they can’t because of political considerations, then they should say so so that people of the world won’t naively go along thinking that they might get adequate warning of growing threat of pandemic”.

FrenchieGirlat 14:14

With regards to the previous threads questions by anonymous et al.:

1. Paparazzi chasing such employees as we are, and having to constantly watch our back. We have very very tight security systems and I will not comment further on this, lest I give some ideas to some badly inspired individual reading me.

2. Corruption questions: we are not allowed to accept gifts unless by special permission of the Head, with such gifts being then turned to worthy causes as deemed by the Head, so no personal profit. Terms of our contract are: “accept gifts/favours and be immediately dismissed”. The rule is enforced. Also, we are paid enough that we do not have to accept gifts/favours for feeding ourselves and our family.

3. Competence: 99.99% of the staff is competent for the duties which have been assigned them. The fact that they are tied not to speak out is not linked to their competence but to the rules of the organization. A number of high posts are filled with consensus from Member States, i.e political competence in addition to technical competence, simply because you cannot negotiate treaties between countries if the person fostering the negotiations does not have the trust of the Member States. I might add that from a certain level up, there is rotation to ensure that small/poor countries do get a voice in the international debate through the approval of their candidature from Member Countries. If this were not the case, poor countries would never have a voice in an international organization.

4. Bad apples: I firmly believe that there are much less bad apples in our international organizations systems than in some other large national bureaucracies. For the simple reason that most of the staff are good apples and would shun/cast aside any really rotten bad apple and ensure they have no public voice or internal influence - at all. There are many ways where a loyal/integer member of staff can undermine a bad apple if the management is not willing to chuck it out.

5. Also gross incompetence is sanctioned by dismissal. You are not an international civil servant for life as some public servants in some national administrations. Though many of our contracts are deemed “permanent”, they still have clauses allowing dismissal. It has been done before. Many other contracts are fixed-end, which means that you can find yourself without a job at a predetermined date without even notice. And since we are “extra-territorial”, we have no national unemployment scheme to call on if we lose our jobs. A Country Member who would be dissatisfied with an international organization may also decide not to pay its contribution to it; this happened a few decades ago when the U.S. of A. did not pay its ILO contribution, and 400 staff were laid off at the end of their fixed-term contract, with little or no compensation…

6. We take pride in having the privilege of working in an international organization to some common good for all countries. We owe no loyalty to an individual country (part of our contract), but only to the international organization which employs us. Such motivation is checked in the recruitment process and watched throughout employment.

7. “Plants to defend the party line”. I, for one, am not a “plant defending the party line”, albeit a nice-looking rose :-). I have been aghast at reading some WHO statements. However, I am still willing to give the benefit of the doubt to WHO, because I happen to know from the inside some of the constraints, the good and the bad, which I will debate further later on. My loyalty will remain so until someone definitely proves 2+2=4 that WHO is such the monster as described by some. However my limit is that my loyalty will not stretch to give my life and my family’s life to my employer.

More later…

anon_22 – at 14:21

anonymous,

“ARe they responsible for releasing sequences? If so and they don’t, they deserve to be bashed, or put another way, to be held accountable, which usually starts with criticism.”

Is this a forum for public flogging, or is this a forum for exploration of ideas to generate change?

Yes, start with criticism. But what is the good of criticizing a system that has no obligation to respond to public opinion? Except maybe to satisfy and reinforce some perceived moral high ground?

How many lives can we save by being ‘right’ and righteous?

I’d like to suggest that maybe it is far more important to suspend (not give up) our righteousness to find solutions.

Or to use a more pragmatic view, the first step of all, and I mean ALL, negotiation is to find common ground. Continuing to put our self-perceived moral superiority front and center ain’t gonna get you there.

Commonground – at 14:23

anon_22 - at 14:21 - I couldn’t have said it better myself!!

LMWatBullRunat 14:26

The key to unravelling the present state of affairs is understanding the organizational imperatives of all the participants. Value judgements as to the acceptability or otherwise of the actions of the various participants will be largely irrelevant unless they directly impact those organizational imperatives.

Western concepts of right and wrong are not going to have much effect in cultures whose imperatives don’t recognize that principle. The WHO is one organization whose members include such states and cultures.

What must be done is to present the needed actions and consequences of failing to act appropriately in terms those cultures understand.

Anon_451 – at 14:28

FrenchieGirl – at 14:14 You have made much of my point> Many if not most of the people that are being bashed are very good at what they do, however; they are painted with same brush as the Politicians who use their office for personnel gain. As such they may be the best thing since sliced bread but the private sector sees them as incompentent. It is the “worker bees” that keep everything running in spite of the politicans at the top.

anon_22 – at 14:31

LMWatBullRun – at 14:26

Well said!

anon_22 – at 14:51

Monotreme,

“Many of the higher level managers are likely suggested for appointment by the countries from which they come. I have concluded this because some of the very high ranking people at the WHO have poor scientific backgrounds and disasterous and highly objectionable records in public health. It is hard to imagine that they were chosen on the basis of merit.”

This is another post that I wrote recently on the subject that resonates with what you are saying. Maybe this could help put my thinking in context for you.


Does anybody know anything about what is happening with the appointment of the next Director-General?

I distinctly remember that when the current acting DG Anders Nordstrom started on the job, there was a brief period when official statements became a shade nearer to reality. Now that trend seems to have disappeared.

I don’t know exactly how these things work, but generally every appointment of significance to an UN agency is fought over by various countries quite vigorously, often with very little relevance to what that agency actually does. I’m sure policies in relation to a pandemic or even continuing avian outbreaks would have such serious implications to countries, businesses, politicians, in fact, anyone with any stakes in power on a global or international level, that this appointment will be one of the most bitterly fought over behind closed doors.

I have a suspicion that we won’t see any changes nor responses until this battle is settled. And I’m not optimistic that things will change for the better after that, for the simple reason that as a pandemic becomes more likely, the stakes become higher, and the obstacles to openness therefore will grow and not lessen.

I think we should continue to advocate and put pressure on the WHO, but we should also invest substantially in all the other ways of pandemic mitigation that does NOT depend on such openness.


And I might add make a distinction in our perception between the political appointees and the lower-rung staff.

Monotreme – at 15:00

I will repeat my constructive suggestion:

Create an external review panel and send them Geneva and give them carte blanche to look at all the data. Let them interview all the managers and scientists at the WHO, individually and privately.

Let them publish the results of findings.

This could be done very quickly. No more than 1 or 2 months is necessary to accomplish this.

Failing this, I will have no confidence in the WHO, period.

Same goes for the CDC.

Monotreme – at 15:05

anon_22, I agree that the appointment of the next DG is very important. I fear that the same political calculus that led to the appointment of the last DG will be in play again. This is why I think it’s important to criticise the WHO, now. Perhaps a sufficient level of criticism will lead to a good choice.

After Katrina, FEMA and DHS receceived a great deal of criticism from various political blogs and the mainstream media. Whether this has resulted in any improvements at these agencies is open to debate. However, decision-makers at least had the sense that they were being watched.

How is watching the WHO? Who else is providing any oversight whatsoever. If not us, who?

lugon – at 15:19

(My previous posting was lost - maybe not worthy. Grin.)

Maybe we need to focus on What needs to be done and Who can do it or help it happen. Some examples:

There are many things begging to be done. It’s apparent the WHO and others were not designed to do all of them, or even if theoretically designed to do them they can’t do them in present practice. Humankind has a set of tasks.

lugon – at 15:23

My comment about masks is meant as an example: we can explore unfinished ideas openly, better than official bodies can. There was a WHO document on “strategies” somewhere. We could provide serious answers to those needs. Then we would be (even more) “someone” than we are now.

LMWatBullRunat 15:23

to the point, here are some examples of the imperatives of various governments I see-

China- 1) Maintain political control of the population; 2) expand the ability to affect regional neighbors and influence the actions of their neighbors; 3)expand their economic base.

Indonesia- 1) expand and translate their economic base; 2) maintain political control and avoid exacerbating internal cultural frictions;

I could go on, but the point is, that repeated statements that China is “wrong” are not going to affect those three imperatives. If we can get the Chinese government to appreciate that their present course of action will affect their ability to control their population, we might have a better chance to change their behaviour.

FrenchieGirlat 15:26

Anon_22

I understand and appreciate that. But I also know that journalists for example get confidential briefings from contacts ‘for background only’ or ‘off the record’ or under ‘Chatham house rule’, and that the journalist then uses that to go and find third party sources that they can quote. So suppose someone emails someone they feel they can trust on confidentiality on this forum, would we be able to at least get some understanding?

1. With respect to scientific matters, my first reaction was, well then, what about this journalist who would have the information we, FluWikians, need “for background only” or “off the record” - how come you would not bash him for keeping his mouth shut? In this case why give the journalist the benefit of the doubt, and not WHO employees/scientific employees. Then my second reaction was, well, if the journalist is sufficiently versed into science, then he should know which third parties he can quote and can go straight to them bypassing the WHO “off the record” quotes. Then my third reaction was, well, if the journalist is not sufficiently versed into science, how does one know he might be able to give an accurate opinion/article on the subject, how does one know he might misquote or make wrong assertions?

My fourth reaction was, no disrespect intended, how does he know anyone is trustworthy on FluWikie? That the FluWikian the journalist (or scientist) would not denature what is to be said to suit one’s own purpose, or simply inadvertantly?

My fifth reaction was, whatever a knowledgeable person may impart to FluWikians, whether journalist, independant scientist, WHO staff, how does one know how interpreted it will be by those reading us? I mean, many people only hear what they want to hear, or are able to hear? How do you cope with this?

With respect to the trust in the confidentiality of a FluWikian, no disrespect meant, no offense meant, we are all anonymous, mostly, despite our handles and a couple of “fear not” individuals. How do we FluWikians know whom to trust on FluWike? And as raised by another, IP addresses are NEVER a secret. You can’t hide behind a proxy. Any computer whizzkid can unravel our trails. Even if a FluWikian was to have a conversation in a closed room between 4 eyes, that might even be broken. Also, it would be left to the FluWikian who was the recipient of confidentiality to use his/her own judgment as to what he/she would then say to fellow FluWikians, therefore automatically introducing a measure of biais in what is repeated to the other FluWikians. How to deal with this?

more later…

anonymous – at 15:27

the problem is : can we trust WHO that they will inform us appropriately or not ? They have no priority in informing the public. If covering up the start of a pandemic is suspected to avoid panicing then this could well have priority within WHO-standards. And their members are not allowed of free speech. They have a history of misinforming the public with H5N1.

If we want fighting against desease - then WHO might well be rather competent. If we want information - then we’d better have an independent second source.

I don’t trust WHO to tell us, when they have signs that panflu has started. I don’t trust WHO to tell us how dangerous they really think the situation is. They might give directives to their employees to downplay the situation. They are just not interested to give us good information. Also see their latest statement, that their task is not to support H5N1-research (by releasing the sequences). I conclude, that we need another organisation for this ?!?!!

anon_22 – at 15:28

Monotreme – at 15:00

Create an external review panel and send them Geneva and give them carte blanche to look at all the data. Let them interview all the managers and scientists at the WHO, individually and privately. Let them publish the results of findings. This could be done very quickly. No more than 1 or 2 months is necessary to accomplish this. Failing this, I will have no confidence in the WHO, period.

Well, I would imagine the only people who have the mandate to order such a review would be the World Health Assembly or more likely the UN Security Council (as the final arbitrator of any disagreements within the WHO or WHA).

Even if we ignore the fact that the Security Council has its hands full with Iran, Mid East, N Korea, Darfur, etc etc, reviews do not happen unless there are very serious allegations of illegal activity, an example being the ‘Oil for Food’ programme. And the Security Council is under the same constraints of each country voting either for its own interest or in blocs formed by horse-trading on issues that have nothing to do with health.

Suffice it to say that the inquiries started in 2004 about the Oil for Food programme (set up in 1995 and terminated in 2003) are still ongoing.

No, I know about ugly truths. I find it very distasteful that Kofi Anan was Under Secretary General of the UN for Peacekeeping during both Rwanda and Srebrenica, and that when the previous Secretary General Bhoutros-Galli was removed because of Rwanda, Anan stepped effortlessly into his place.

It is very hard to have any confidence in any of these institutions. But to do business with them it may be necessary occasionally to ‘Shake hands with the devil’ which was the name of the book written by Canadian commander Dallaire about Rwanda but could also apply to our current discussion.

That’s why any small glimmer of integrity or conscience in anybody inside the system is a sign of hope to be encouraged. Despite all the ugliness.

lugon – at 15:29

“What would China win by releasing sequences?” “How do we help China win?” This might be one kind of questions worth asking. Of course, it’s better to know China to be able to answer, and I don’t have a clue. That’s what “hive minds” are for!

anon_22 – at 15:29

Frenchie,

I understand your points. All those issues will need a lot of trust. And I gave that as an example of how very occasionally the ingredients for that trust might be in place. But I agree that it is not an easy thing.

anon_22 – at 15:35

Monotreme,

“Same goes for the CDC.”

Actually, the CDC is a completely different consideration. CDC, FEMA, etc are national institutions, funded by taxpayers. They have to respond to their political masters who in turn have to respond to the electorate, which is YOU.

That is, there is a system of accountability which links the CDC to you, in not very many steps, all of which are within your power to influence.

Knowing this difference gives you the power to effect change. If you can get enough of the American public, the media, etc on board with the critical necessity for openness, there is a good chance of making substantial changes within the timescale that may make a difference before a pandemic can happen.

Tom DVM – at 15:36

There is only one thing worse than no health authorities at all…

…and that is an incompetent agency that over-inflates its ability to manage a health catastrophe while providing a false sense of security: providing an excuse for sovereign health regulatory agencies and a ‘fall-guy’ if the WHO’s clear prediction of no pandemic turns out to be wrong.

As a professional, I will ‘hold my nose’ and put up with their bull-**** and worse.

I find their actions personally disgusting.

Tom DVM – at 15:38

Sorry, should have read…providing an excuse for inaction by sovereign health regulatory agencies…

anon_22 – at 15:45

Monotreme,

“How (who) is watching the WHO? Who else is providing any oversight whatsoever. If not us, who?”

Of course we watch. But how does one influence it, officially? Well, it goes like this:

You - your elected representative - your government - your govt’s department in charge of diplomacy (the State Department for the US) - your country’s ambassador to the UN (John Bolton) - UN Security Council/UN General Assembly - World Health Assembly - WHO

Yeah, there are too many steps where public health considerations do not come up as priority, sadly.

That’s not saying you shouldn’t try. Mike Leavitt appears to be able to get much of the US Government to at least understand and acknowledge the pandemic problem, as compared to most other countries.

Strong public pressure towards your government (ie not the WHO directly) to convince them of the critical and strategic importance of getting better compliance out of WHO or other countries is a worthwhile goal although it is a long-ish shot.

FrenchieGirlat 15:46

Monotreme — at 15:05

I immensely respect your opinions.

With regard to:\\\

After Katrina, FEMA and DHS receceived a great deal of criticism from various political blogs and the mainstream media. Whether this has resulted in any improvements at these agencies is open to debate. However, decision-makers at least had the sense that they were being watched.

You omit to say in the instance of Katrina, this was an internal matter to the US. The criticism came direct from the people who voted/paid taxes for FEMA and DHS to function.

In the case of an international organization, the only pressure you can apply is to your own government for it to pressure the other Members States in the court of the international organization. You are not, as an individual, directly paying fees/tax/dues to WHO, your government is. If you have to raise hell, then you should raise it to your government.

And as long as your government does not understand/realise which threat we are facing, your government will do nothing if a minority of citizens shout.

I’ll agree that we are all in a Kafkaian situation, because if your government uses the excuse that WHO has not called loudly enough an international threat by bird flu against American citizens, it then falls to these American citizens to show the US government that the threat is real. And in order to do that, you need to back it up with science, the very same science that is being witheld…

Now perhaps someone can give an idea to get out of the catch-22 situation just described. I can’t.

With regard to:

‘’Create an external review panel and send them Geneva and give them carte blanche to look at all the data. Let them interview all the managers and scientists at the WHO, individually and privately.

Let them publish the results of findings.’‘

1. WHO is part of UN. So what you are advocating would need to be an External Review Panel to, indirectly, survey the UN work. Whatever findings an external review panel were to make on WHO, it would still not be binding on WHO, or onto the UN.

How would you appoint your experts to make sure they would be unbiaised by credo or money, and have higher authority than the UN? How would this panel impart the information for the good of the planet? Who says what is good and what is bad?

more later…

LMWatBullRunat 15:48

Tom DVM, while I share your opinion on this subject, that is not a solution to the problem. Your outrage and disgust do not help move things forward.

The reason that the WHO is doing what it’s doing is because their actions fulfill their governing imperatives. We need to place the actions we want to see them take in a manner which makes them believe that the best way to promote their imperative is to take our proposed solution.

The only other thing we can do is alter their imperatives, and that takes a very long time, typically.

lugon – at 15:53

I don’t know. How many governments are needed to change WHO’s behaviour? What’s the smallest government that could possibly be influenced? How could it be influenced?

Another line of thinking: What other things, different from national governments, affect WHO’s behaviour?

FrenchieGirlat 15:54

Just another fleeting thought in passing… WHO would be a very convenient scapegoat for Member Countries not wanting to acknowledge their own incompetence/greed/dishonesty… By witholding information, Member States do not give the WHO the tools it needs to do its job and these Member States are protected by the very confidentiality WHO affords them. And then they can blame the WHO escaping their own responsibility in the process, and WHO is also tied by confidentiality in not pointing the finger at these irresponsible countries… Am I dreaming ?

Tom DVM – at 15:55

annon 22. There is no oversight, there is going to be no oversight, there is going to be no effective and constructive criticism…you are dealing with an agency that is untouchable…

…every person in that agency knows they are untouchable…and they are obviously well enough payed to keep their mouths shut and also not interested in leaking any information as well.

They hear no evil…they see no evil…and most importantly they speak no evil.

You are obviously dealing on flu wiki with a group of professionals, many of whom have stood up against the system and payed a high price for it…

…don’t ask us to lay down and just take it…

…If you let them away with this type of thing for long enough, a situation will come along eventually where each of us stand to lose our love ones because of them…we should have dealt with them a long time ago before the stakes were so high…

…our silence, even if it is too late now,is not an option.

FrenchieGirlat 15:59

lugon – at 15:53 — Another line of thinking: What other things, different from national governments, affect WHO’s behaviour?

Its staff and that of sister organizations… including the lowly ones.

With respect to WHO, staff had very much to do in this respect with the SARS crisis…

With respect to WHO and another international organization, staff had very much to do with the measures taken to protect the blood supply at the time of the investigation and subsequent discovery of the HIV virus, never mind what the media and courts said. If staff had not acted, many more would have died with unprotected blood transfusions…

lugon – at 16:01

How can we help WHO’s staff, FrenchieGirl? What kind of pressure, ideas, etc - and where?

anon_22 – at 16:02

Tom,

Since when have I advocated silence?

While I acknowledge the obvious sincerity of your posts, I have to agree with LMWatBullRun – at 15:48 “Your outrage and disgust do not help move things forward.”

My only other response is to suggest revisiting the points what I made at 14:21.

lugon – at 16:03

What are those “sister organisations” and which are “the lowly ones”?

FrenchieGirlat 16:07

Tom DVM – at 15:55

I respect much of your opinions too.

I take exception with what you say ‘’…every person in that agency knows they are untouchable…and they are obviously well enough payed to keep their mouths shut and also not interested in leaking any information as well.

They hear no evil…they see no evil…and most importantly they speak no evil.

We are paid well enough so that we do our jobs well and are not liable to corruption. We are paide well enough so we can make our own social welfare arrangements. We are not untouchable. If your country refuses to pay its contribution to any international organization, we are out of a job, without recourse to unemployment money, because we are not allowed to contribute to a national unemployment scheme. We are not allowed to contribute to a national pension scheme or invalidity or sickness insurance scheme. We have to use our well paid salaries to provide for this also, at the same time as doing good jobs.

We see the evil, we hear the evil, and though we speak no evil, we ACT and FIGHT this evil in every which way we can.

This is an unprecedented world problem, we need novel solutions. No amount of bashing WHO is going to get you nearer your goal which, if I am not mistaken, is to save human lives on this planet.

anonymous – at 16:10

Frenchie, and why these silly WHO statements about the clusters in Turkey, about the 7 million deaths upper limit, about the mutations in Karo, discontinuing the pandemic levels, being late with outbreak comments, being late with examinations on outbreaks, upgrading the threat when funding decisions are imminent and downplaying it later, failing to comment on the secret sequences - just to mention a few examples. You seem to ignore all this. Who did a bad job to build trust. Why can’t they post here or elsewhere or answer questions occasionally ? Why do they have no forum, where we can ask questions ?

lugon – at 16:10

I’ll go for a walk and ask my dog what he thinks.

FrenchieGirlat 16:15

Lugon — at 16:01 and 16:03

Sister organizations are all international organizations, whether governmental or non-governmental. There are several dozens big ones, and plenty of small ones.

Lowly ones are like me, I’m a documentalist. I retrieve and give information relevant to my employer’s tasks. They are middle rank officers, statisticians, legal counsellors, medical officers, mid-rank administrators, economics officers, welfare officers, even typists, secretaries, small bosses/chiefs…

anon_22 – at 16:17

anonymous, Tom, etc,

Perhaps still the important thing is to make the distinction between the WHO as an institution, their political masters, the political appointees, and other staff who may have the full range of integrity and honesty.

At the expense of making discussions cumbersome, such distinctions are vitally important. Criticizm or encouragement should go where each is due, IMHO.

FrenchieGirlat 16:24

Anonymous — at 16:10

WHO answers to the World Health Assembly (WHA) which is composed of governments, not individuals like you and I. A forum for discussion with citizens of the world is therefore probably not viewed as a necessity, since such citizens may make their voices heard through their own governments. Though I’ll admit a forum is a pretty good idea nevertheless.

Though I have some (fairly foggy) ideas about the way WHO tackled the bird flu releases, I cannot comment on it. Sorry. I understand they did what many view as a botched job, but having known of some imperatives in my previous jobs in other international organizations, I would still give them - at least for another while - the benefit of the doubt. See my fleeting idea above at 15:54.

I am also reminded that in case the strictures are too strong for an international organization to speak officially, it has been known for it to engineer voluntary leaks… Let’s just hope this happens.

FrenchieGirlat 16:36

Lugon — at 16:01

How can we help WHO’s staff, FrenchieGirl? What kind of pressure, ideas, etc - and where

1. Let us get the info from FluWikie and let us talk among ourselves. Stop bashing us, or FluWikians will be taken for a bunch of nuts not to be mentioned even in low voices.

2. I got cooperation from middle-ranking staff when I was looking for a statistician to have a look at the sequences… Unfortunately, our type of statistics is just too different to these scientific matters. For SARS, I got cooperation - sorry cannot say whom - but it was pretty high up the ladder and it went right to WHO.

3. At some later point, I shall be able to get some cooperation across the street. I need to wait till the time is right. Please don’t burn it now.

4. Anyone with contacts with the media, get articles published in the newspapers that count for the staff here, at both high and low levels: the International Herald Tribune, The Financial Times, Le Monde, Le Temps, La Tribune de Genève, El Whaf (whatever is the Egyptian newspaper called), national newspapers as staff come from a diversity of countries. Have it put in “Your health” columns, not front/middle pages. Majority of lowly staff are women, B-C1-C2 categories. Try television programmes magazines. Send press releases to Public Relations Officers/Welfare Officers/Medical Officers in international organizations with items of health interest to their staff, say, for example, “health on an official mission - what you risk when you are sent to… Indonesia, China, Viet Nam, Niger, etc.”

lugon – at 16:52

The press: we can ask them what they think. This was done in one of the articles mentioned in a presentation (see big files project).

We can ask them what they think and either publish that or get them into a conversation. Locally and from many places at the same time.

We can follow what the press writes and reflect that. Not the data they publish, but how they write about things. Would that be worthwhile?

This is different from what you (FrenchieGirl) are saying, I know. You’re suggesting we get them to publish things. But I guess we need to talk them into doing that, no?

(I’m gonna change my username to “blindman”. Hmm!)


My dog says, somewhat enigmatically, “barking competitions are not won by the largest dog”. :-?

DemFromCTat 17:08

FrenchieGirl – at 16:36

lugon – at 16:52

Tom, LMWatBull Run anon_22 thank you.

these are contentious issues, and no one knows exactly what do. Thanks for acting like grownups about it all.

FrenchieGirlat 17:31

Last post for today, after that I have work to do (for which I do NOT get paid overtime) and it’s already 23h10 here, and I get into the office at 8.30 tomorrow…

A number of international organizations will reply to individual letters which are constructively written. Replies may be made either by the Secretary (Director) General or the Public Relations Officer. And they are not sent to the bin.

If some good writer were to give us a model (models) that we could copy and send individually, that would probably help. In our private capacity, handwritten, with stamp, or in our official capacity, typed up. Even if we get a vague answer, after a long while because it’s not their primary mission to respond to the public, it might do some good. I would suggest we do not do it all at once, let a steady trickle of letters remind them time and time again that citizens of the world care. And address these letters to the top head of the organization.

International governmental and non-governmental organizations concerned with health: WHO, UN, International Federation of Red Cross and Red Crescent Societies, PAHO (Pan-American Health Organization), all disaster reliefs organizations such as Médecins sans frontières, USAID, Caritas International, etc. Anyone’s got the International Organizations Directory on hand (I haven’t and it’s too late tonight for me to compile hundreds of them).

Those concerned with trade: International Chamber of Commerce (ICC — very active in developing countries), World Trade Organization (WTO), ECOWAS Economic Community of West African States,

Others who deal with areas that will be impacted greatly in a pandemic: UNHCR United Nations High Commission for the Refugees, UNCTAD, United Nations Conference on Trade and Development, UNIDO, United Nations International Development Organization, ILO, International Labour Office, OMI, International Migrations Office, ITU, International Telecommunications Union, EBU, International Broadcasting Union, WCC, World Council of Churches, UPU Universal Posal Union (have them make a stamp…), OPEC Organization of the Petroleum Exporting Countries, ASEAN Association of Southeast Asian Nations, various EEC bodies, etc.

FrenchieGirlat 17:37

And last, but not least, let’s use our Churches (Temples, Mosques, Synagogues, etc.). Whenever we go the places of cult, let’s speak to the priest and ask him to speak to his hierarchy. Let’s write to the heads also. Heads of Churches (Temples, Mosques, Synagogues, etc.) are listened to in governments, also in international organizations (the Holy See is an observer/member in many international organizations for example).

Good night now.

Monotreme – at 18:16

FrenchieGirl and anon_22, as regards the issue of accountability of international organizations like the WHO, I understand that we have no direct way to influence their behaviour. Indeed, I have given up trying after the Karo debacle. That made it very clear to me that they will be useless in the event of a pandemic if there are not radical changes made in personnel. Sometimes the only solution when an organization is badly run is to fire people. Not very popular to say in these PC days, but what can I say, I’m a throwback.

You are both right in that the only way to influence the organization is through elected officials, for those of us that have them. The reason I am so harsh and intemperate in my language is that I want to make a big stink about the disasterously dysfunctional organisation that is the WHO. I want as many people as possible to notice, and then I want them to complain to their elected officials. I want them to demand an external review panel be put in place. If this requires a security council resolution, so be it. How many lives are we talking about in the event of a severe pandemic - 10 million, 100 million or 1 billion? Pick a number. Any one of them should be enough. And the economic consequences? World-wide depression. The end of globalisation. Infrastructure collapse in many countries. There are very few events potentially more serious.

Politicians need to be educated as to the importance of public health issues. Right now, they don’t get it. I spoke to a high-ranking politician who had no idea that the WHO determined the alert level that his state’s pandemic plan is yoked to. I’m sure he has no idea about internal WHO politics or the poor regard that the scientific community holds their work in. This Forum is one of the very few opportunities we have to educate politicians and their staffers. This is the audience we need to reach.

The WHO will not improve on the own, IMO. Either an external review panel cleans house or their credibility will remain abysmally low, where it is right now. And that would be a shame because we will desperately need an international health agency during a pandemic.

Monotreme – at 18:30

As regards justification for an external review of the WHO, why don’t we start with this:

WHO officer in China helps to hide bird flu?

(Mar. 08, 2006) Boxun published a message sent by anonymous person(full text in Chinese), it says that WHO officer in China received bribery and help China government to hide the seriousness of bird flu in China.

Boxun claims that it cannot confirm the information at the beginning of the publishment, then publishes its full contents as it received.

It mentioned that WHO received dead birds (sample) in 2005, and WHO officer released the person’s name to government. It said that two persons were executed in February 27 2006.


This may turn out not to be true - but why isn’t being investigated? This is a very serious charge with profound implications. There should be an independent ombudsman to investigate charges against the WHO. Perhaps this should extend to other areas of the UN, as well, I’ve read some shocking stories about the behaviour of some UN troops, but this is beyond our area of focus.

The UN has an Ombudsman office, but I’m not sure how independent it is. Here’s a test for someone willing to send them an email: Send them a link to the Boxun story, ask them to investigate and report back the results of the investigation.

http://www.un.org/ombudsman/?

Monotreme – at 18:31

Correct link for the UN Ombudsman

Dennis in Colorado – at 18:36

Monotreme, the link you provided at the end of your post is to a password-protected site on the fluwiki.

Monotreme – at 18:37

Dennis in Colorado,

I screwed up the formatting of the link. Corrected at 18:31.

Tom DVM – at 18:38

Monotreme. I for one hope that we get what you want…but humans basically do things only because he pain of inaction is greater than the pain of action…

…They are untouchable…completely untouchable…they are above the pain of retribution because they are insulated from retribution…

… if the UN forced the WHO to be accountable then the UN itself would have to be accountable.

In other words, the UN and its agencies is at the top of the food chain with no predators whatsoever.

The bottom line as many on flu wiki already know from previous experience with a wide variety of authorities and agencies…

an unaccountable agency = an apathetic agency and what we are observing and have been observing for two years is an agency that doesn’t give a **** because it doesn’t have to…period.

We have a saying where I come from for attempting to do now what I have been attempting to do for nine years…it’s called ‘pissing into the wind’!!

Monotreme – at 18:49

Tom DVM, I don’t expect to be successful, but I feel I have to try. What I think many at the WHO and elsewhere don’t get is that facing an external review panel now is much to be preferred to facing one after a severe pandemic. That review panel will not listen to excuses or spin with much patience, I suspect.

Tom DVM – at 18:53

Agreed. You are being very generous in typifying it as a review panel after a pandemic.

Where do I sign up? /:0)

Monotreme – at 18:57

Tom DVM,

Well, the first order of business is to survive the pandemic. Any progress in expanding your preps? ;-)

We’re going to need people like you, after.

Tom DVM – at 19:00

Don’t worry. I’m too mean to die. I plan to do just what they did in 1918.

They’ll be no running and hiding and revisionist history this time!!

and by the way, you got me with the preps comment.)

CAMikeat 19:13

Tom DVM – at 19:00,

Don’t worry. I’m too mean to die. I plan to do just what they did in 1918. They’ll be no running and hiding and revisionist history this time!!

Good. I agree with Monotreme. We will need you Tom. Actually the same goes for you Monotreme. We are going to need people that understand that “NO” is not an acceptable answer.

Mike

CAMikeat 19:18

Hmm, actually my last reply was a bit limited. I hope all of you make it, kicking and screaming. I have this feeling that the so called “hive-mind” is what will get us through the next few years <insert-your-favorite-disaster-here>. There are a lot of folks that make the FW worthwhile so thanks to all. Diversity is life.

Mike

Tom DVM – at 19:42

CAMike Thanks. By the way I thought the CA stould for Canada…maybe we will adopt you.

My first choice would be not to have a pandemic at all…then I would have had a lot of stimulating conversations with interesting colleagues.

Problem is that that is not going to happen. So then I would like all cylinders running so that every possible preventative measure is in place to limit the losses…that isn’t going to happen either.

What I would really like is for a wide range of agencies like the tin man and the lion, to find a brain but most importantly a heart. In the last approx. decade many agencies have become the ‘placators of business’ …they have become an arm of business and trade interest rather than the defender of an otherwise unprotected populace…

…I’m waiting for them to get their soul back but it doesn’t look like it is going to happen…and although the real consequences for our fellow citizens have been largely hidden so far, we inevitable have reached a point like Enron where the consequences will be seen and felt probably by each one of us. It is very disappointing.

Anon_451 – at 19:45

LMWatBullRun – at 15:23 You are correct in your assesment. The only way to get the world governments to work together and with the WHO is to show them how they would benefit.

However; that can not happen. The many medical professionals on here will tell you that AI IF it goes Pan Flu will be very destructive. All agree on that issue. What they do not agree on is the overall CFR and recovery time for infected individuals. They also do not agree that H5N1 will be the Pan Flu or when it may happen.

The Private Sector Leadership, wants to make money, the political leadership whats to insure their people that all is ok and they have it well in hand.

When I returned from Vietnam in 1971 I was at LAX in uniform (big mistake) awaiting my flight home. A very attractive young lady came up to me, while I was reading a book and having a real cup of coffee. She got my attention by spitting on me and calling me a “Baby Killer” After she left the shock wore off enough for me to go to a store in the Airport, buy some civilian cloths and throw my uniform in the trash. (I did not travel in uniform again ever).

I say this because the worker bees in the UN and at the WHO as well as the CDC are being treated just like the young soldiers were treated coming home from Vietnam. They are doing the best that they are allowed to do. The Industeral/political complex is what is calling the shots. The Vietnam war protesters got it wrong then by blaming the military when it was private sector business and their political friends that were at fault. Many here are getting it wrony as well. It is not the staff and workers in the Medical Community that are failing to release the sequeancs or keep the MSM informed of the threat it is the Industeral Leaders who want to make money at any cost and the political leaders that they support and keep in power.

If the people in this Wiki want to curse anyone, Curse your own government leaders from all political parties. They want to keep power and the way to do that is convince them that they have everything under control. If it goes Pan Flu they will beat up the Medical communittee for not telling them the truth even though they have been told the truth and have chosen to not listen.

I am on a rant I hope I have made self clear. No Bashing of the Medical Communittee to include the WHO. Bash the politicial leadership (All parties all countries) that are in charge.

Tom DVM – at 19:54

Anon 451. At what point do the workers in the WHO have an obligation to stand up…draw a line in the sand not to be crossed.

I agree completely with what you’ve said but the United States was built because some very brave people stood up and said that they were not prepared to take it anymore.

If there was ever a case for a membership to stand and be counted it is now given the repercussions of a pandemic as you have stated.

Where is the revolt, the mutiny…this agency should be leaking like a sieve…both verbally and sequences.

At some point, those nice people you talk about have to accept some responsibility for keeping their mouths tightly shut when they knew that things weren’t quite right from a regulatory medicine or ethical standpoint…

…many of your colleagues on flu wiki have done it, you may have already done it…we expect no less from them then we have done ourselves and that is the definition of leadership…leading and not following.

anonymous – at 19:58

“Objections to publication on grounds of bioterrorism risk…”, now there’s a red herring. How many H5N1 sequences are already in public databases ? More than one ? One is enough to recreate the strain in a basement lab.

LMWatBullRunat 20:19

I suspect that this effort is doomed to failure, but I agree that the attempt must be made. The trick is going to be getting the heads of government to listen. I suspect that the solution will be similar to the genesis of the Manhattan project; We need an Einstein for each country to spproach the leaders and explain the implications of failure in the event of a pandemic.

It will do no good to expostulate publicly ab out the WHO; they are subordinate to their client states in the UN. In order to produce meaningful change, we will have to alter the mindset of the leaders of a number of countries. That can be done only by reaching out to them from a personally trusted source who understands not only the science and the imperatives that each particular country operates under.

THAT strategy is the only one reasonably possible of success. The trick is going to be, Monotreme, finding the right senior people to make the case. That requires detailed knowledge of the people involved. I do not have that knowledge, but perhaps you do, or know someone that does.

Anon_451 – at 20:31

Tom DVM – at 19:54 What LMWatBullRun – at 20:19 said.

Individuals at the WHO standing up and being fired will not make the differance that is needed. Only the leading Medical authority in each of the Major Countries standing up to their individual leaders, (collectively would be better) and say. “

Hay we got a problem here and if you do not deal with it, most of the business leaders in the world are going to lose all of their wealth and they well be looking for you because you have done nothing to stop it. Now if you don’t want to deal with it, I am going to press and let them know who to blame and it is you.”

The real problem with that is, if they do it they better be ready to go to the press and be able to make the case and then the Pan Flu had better happen because if it does not happen, They will NEVER be listened to again.

Hence the problem. Can anyone here say, and be 100% sure that this is going to happen and, most importantly, when it is going to happen with what CFR rate and what infection rate.

No one can do that so it all falls on deaf ears.

anon_22 – at 20:49

thread closed for length. Continue here

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