Did the World Health Organisation contribute to Syria's polio outbreak?

WHO's response to Syria's polio outbreak, and its close relationship with the Syrian government, have been called into question.

A New York Times report has highlighted the failures that contributed to Syria’s polio outbreak, and suggested that “the United Nations itself has aggravated the situation”. The authors, Adam P Coutts, a researcher at the London School of Hygiene and Tropical Medicine, and Fouad M Fouad, a Syrian doctor, suggested that the World Health Organisation’s (WHO) close links with the Syrian government could have contributed to its failure to vaccinate children in the Deir al-Zour area – where cases of polio were detected last year. WHO is housed in the Syrian health ministry building, and some of its staff members are ex-government.

The New York Times reports that WHO argued that Deir al-Zour was not included in their 2012 vaccination campaign because “the majority of its residents have relocated to other areas of the country”, but says there is no evidence that this is true. In fact, the UN World Food Programme continued delivering food aid to Deir al-Zour until 2013.

Once polio had broken out, WHO was also slow to respond. The authors found it took three months for the first cases of polio to be confirmed after they were detected in July 2013. It then took several weeks for a vaccination programme to begin. These delays increase the risk of polio spreading, particularly as it’s not clear how the vaccination programme will cover the hundreds of thousands of Syrian refugees in Lebanon.

There is no doubt that the WHO is operating under extremely challenging circumstances. It is trying to implement an immunisation programme in an active warzone, and among refugees spread over vast distances. It is easy to see why it is struggling to contain polio. Like most UN agencies, WHO is often accused of being an unwieldy bureaucracy that can be slow to react, so this isn’t unique to Syria.

But then, this is also not the first time in recent memory that the UN has been accused of contributing to a public health scandal. If you haven’t read this report on how the UN inadvertently caused a cholera epidemic in Haiti and then covered it up, you should. It’s little wonder WHO and other UN agencies’ credibility is in question.

The incident also exposes shortcomings in how UN agencies operate. The UN’s humanitarian and development organisations work in partnership with their host countries and in wealthier developing countries they will be part or fully funded by their host government. There are strong arguments for working in this way: the long-term aim is to strengthen government departments so that with time they no longer need the UN’s expertise. UN agencies don’t want to impose their decisions and values on the countries they work in; instead they want governments to fully embrace goals like reducing maternal mortality or increasing school enrolment or protecting national heritage sites. In some countries, UN agencies are able to operate where other NGOs can’t, precisely because of this close partnership. But there are downsides.

For 18 months from 2008, I worked for the United Nations Development Programme in Libya. The vast majority of UNDP Libya’s funding came from the Libyan government, then headed by the country’s longstanding dictator, Muammar Gaddafi. UNDP Libya did it’s best to promote ideas like better women’s rights, improved environmental protection and poverty reduction in Libya, but it couldn’t ever do anything the government didn’t agree too. The Libyan government didn’t agree to much. At times, UNDP Libya tried too hard to ingratiate itself with its government funders: it appointed Aisha Gaddafi, Gaddafi’s daughter, as a local UN Goodwill Ambassador, for instance.

In countries like pre-revolutionary Libya, the UN has to strike a difficult political balance. In Syria, this balance is even harder to maintain. It’s no surprise that WHO in Syria would come under considerable pressure from the Syrian government, and that the Syrian government could easily limit what WHO is able to do in the country. It is also likely that WHO’s close relationship with the government is the reason it’s still able to operate in Syria - and ordinary Syrians would be much worse off without any WHO presence in the country. But in excluding Deir al-Zour from its vaccination programme, WHO has made a tragic misjudgement.

A Syrian child gets a polio vaccination at a clinic in Damascus on November 20, 2013. Photo: Getty.

Sophie McBain is a freelance writer based in Cairo. She was previously an assistant editor at the New Statesman.

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Stephen Hawking's enthusiasm for colonising space makes him almost as bad as Trump

The physicist's inistence on mankind's expansion risks making him a handmaiden of inequality.

“Spreading out may be the only thing that saves us from ourselves,” Stephen Hawking has warned. And he’s not just talking about surviving the UK's recent run of record breaking heat. If humanity doesn’t start sending people to Mars soon, then in a few hundred years he says we can all expect to be kaput; there just isn’t enough space for us all.

The theoretical physicist gave his address to the glittering Starmus Festival of science and arts in Norway. According to the BBC, he argued that climate change and the depletion of natural resources help make space travel essential. With this in mind, he would like to see a mission to Mars by 2025 and a new lunar base within 30 years.

He even took a swipe at Donald Trump: “I am not denying the importance of fighting climate change and global warming, unlike Donald Trump, who may just have taken the most serious, and wrong, decision on climate change this world has seen.”

Yet there are striking similarities between Hawking's statement and the President's bombast. For one thing there was the context in which it was made - an address to a festival dripping with conspicuous consumption, where 18 carat gold OMEGA watches were dished out as prizes.

More importantly there's the inescapable reality that space colonisation is an inherently elitist affair: under Trump you may be able to pay your way out of earthly catastrophe, while for Elon Musk, brawn could be a deciding advantage, given he wants his early settlers on Mars to be able to dredge up buried ice.

Whichever way you divide it up, it is unlikely that everyone will be able to RightMove their way to a less crowded galaxy. Hell, most people can’t even make it to Starmus itself (€800  for a full price ticket), where the line-up of speakers is overwhelmingly white and male.

So while this obsession with space travel has a certain nobility, it also risks elevating earthly inequalities to an interplanetary scale.

And although Hawking is right to call out Trump on climate change, the concern that space travel diverts money from saving earth's ecosystems still stands. 

In a context where the American government is upping NASA’s budget for manned space flights at the same time as it cuts funds for critical work observing the changes on earth, it is imperative that the wider science community stands up against this worrying trend.

Hawking's enthusiasm for colonising the solar system risks playing into the hands of the those who share the President destructive views on the climate, at the expense of the planet underneath us.

India Bourke is an environment writer and editorial assistant at the New Statesman.

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