A Reporter’s Diary: Where Is The Public In Public Health?

Find a room somewhere on this floor was one of first things I was told when I joined World Health Organisation (WHO) in Geneva some twenty years ago. I picked a nice corner room with large windows and splendid sunlight. I h just finished arranging my books and bags when a worried man, a medical doctor, walked in saying I couldn’t sit in room, t even if I were a P. What’s a P I asked him and reby hangs tale of nsense, corruption and nepotism in world of public health where entry is controlled, conversations and questions are banned and deals are fixed.

I told harried doctor to take a flying leap out of one of my windows. immediate consequence was I was asked to move into a pigeonhole that amply reflected suspicion and despair that hangs over multilateral organisations and ir extension in Geneva wailing that y save world as y go from conference to conference in lovely destinations (discussing poverty in Bellagio is my best), making powerpoint presentations prepared by unpaid and pding mselves with friendly NGOs who depend on m for grants.

Mediocrity is interestingly competitive because ne kws where top or bottom is. Geneva and New York-based healthocrats (two groups I kw) compete t to get best of public health kwledge to most people in world or fight for access to medicines. se people compete to become a P5 (professional diplomatic status) which brings with it international business class travel, large tax-free salaries, subsidised education for children till first college degree and subsidised healthcare, all paid home leave and pencils, pens are rubbers y can steal at will. re’s almost zero accountability – who is going to ask whom?

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Working in public health is t same thing as working for a techlogy company or car manufacturer. re’s a strong ethical (some say moral) reason and standards to which people that help to save ors from life and death must be held to. It’s called accountability and it must be transparent because it is our money. I genuinely believe re are brilliant investigative pieces out re waiting to be done, as rot is rar visible. Global Fund to Fight Against Aids, Malaria and Tuberculosis saw a chief leave under serious corruption charges and ar, more recently under charges of sexual abuse. This happens in or organisations too but re’s a big difference – people working in public health think body can question m because y are doing good work.

Well, ir time in sun is probably shrinking and shrinking fast t only because development aid and assistance is looking inward (re’s less money) but also because human rights groups and civil society vocates are calling out nsense.

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That’s what happened in sourn Indian city of Hyderab recently for 50th Union Conference on Lung Health. @AnantBhan a researcher (bioethics), junct Professor, past President @AIBioethics and Mentor @SangathanIndia me much-needed conversation happen on Twitter and in some newspapers. He did t attend event despite being part of an accepted symposium. He cited exorbitant fees and referred to @RemaNagarajan speaking to same issue. Many journalists wrote and Médecins Sans Frontiers (Doctors Without Borders) std a silent protest about access to TB drugs. His position was one of solidarity and empathy with people who should have been re but couldn’t afford to.

How could y? lunch menu for international delegates suggested baguettes when what India needs desperately is Bedaquiline. re was apparently stock out of food and frill when TB drugs face stock-outs regularly. If this doesn’t churn your stomach, what can?

Yes, this makes me sick. Multi-drug resistant (MDR) strain of TB from where return is difficult if t impossible is all around us in India. Eight years ago when I wrote that international staff of organisations was vised to take tests for TB, if y coughed for long periods, I was laughed at. That only happens to poor people was refrain. I wasn’t only one. Many people were ringing alarm bells. But TB is a poor person’s disease, romanticised in films and love stories. Polish composer and pianist Fréderic Chopin spluttered blood as he played pia, dying of tuberculosis. Indians wrote love stories as y bread ir tuberculosis driven last.

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Within 500 metres of each or in Geneva re are at least four large multilateral organisations all working on TB, HIV/AIDS, Malaria and n-Communicable Diseases (NDCs). Surely, right – surely y can come toger to save money and time, but that would put Ps and Ds in danger. fight to he se organisations is bitter – one he hired personal spies to spy on spies who were spying on him. Some deces ago a bitterly contested fight saw de fish in fountains, all in name of public health. I’ve h two careers since and I return a little to public health in Geneva, I find same people saying same thing with a tinge of Artificial Intelligence lingo and ethics thrown in to appear relevant. If it wasn’t for how grotesque it is to see people hiring ir friends, families and significant ors to jobs, it would make a for a good comedy film.

Twenty years ago panels rarely h women and certainly t women of colour. Geneva is home of panels and re’s a new twist. Women are brought in as moderators t from city that has more public health experts than cars, but from London. In recent years I have ticed something interesting. During one major meeting of WHO I saw a British editor – a usual suspect – raise voice and shout at health ministers as if y were schoolchildren.

Speeches, oh, how could I forget! I wrote many 20 years ago. That time y went something like this. We must t leave anyone behind; we must put people at centre of health; Women must le; feed a woman you feed a family; Public health is a public good.

same lines are being still parroted. But medical doctors have gone from kwing what y do to agriculture experts to climate change pundits – who say public health doesn’t follow money! Sustainable Development Goals (SDGs) is soon getting pasée. United Nations (UN) family is coy about publicly working with pharmaceutical industry but takes money and resources from ir foundations. y are unwilling and unable to call out conflicts of interest because y are sitting on so many mselves. That places an entire chain of command and actin into jeopardy.

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People are t data or numbers to fill an Excel sheet for next round of grants. se are human beings we are dealing with. Taking selfies with m is neir funny r intelligent. It’s arrogant.

I want to end this piece with a positive mess to all those who are going out to claim ir public health rights democratically. Do so with dignity and cour. Something is giving – we’ll have to hold toger when it does to push it over edge. Public health is one area where social media can play a very serious role. It’s happening.

PS. I didn’t write much about diseases. That’s for ar column. big battle w is to keep focus on leers and ir retinue who skew policy and resources pitch by switching off lights. Hyderab may have just started something.

( views and opinions expressed within this article are personal opinions of author. facts, analysis, assumptions and perspective appearing in article do t reflect views of Republic TV/ Republic World/ ARG Outlier Media Pvt. Ltd.)