Who is WHO?

As USA begins to withdraw from WHO, we should ask what exactly does WHO do? An answer nobody seems to know.

If you don’t know how to start a blog, start with an aphorism that nobody can disagree with. In that spirit, I will start mine - All events have second order effects. They might not have third order or fourth order effects. But they definitely have second order effects. That’s my current assertion.

So does the current pandemic that we are part of. Corona, among doing other naughty things, has done some annoying shit. For one, it has resulted in events hitherto unseen by humanity:

• Maximum number of people staring at exponential graphs & logarithmic scale

• People talking about WHO and wondering why their brand of hand-sanitizer is not mentioned in their guidelines

WHO has been on news for a while now. From being an obscure organization, WHO has been shoved into the spotlight and made the Dalai Lama for the pandemic. Everyone wants to know if their disinfectant or neighborhood mom & pop store is following WHO guidelines. They seek the Oracle of WHO to know when vaccines will come out. If tomorrow, WHO says Covid is just a tom-tom, I am sure people will say screw you to social-distancing, even though tom-tom means nothing and a word I just made up.

While this pandemonium rages on, came a vague headline couple of days back- “US begins to withdraw from WHO”. And people reacted. We all felt that this withdrawal was another deeply-tragic thing that 2020 wants to throw on our face just to make our lives a tad bit more miserable. My guess as to what went on everyone’s brain was - US is big. WHO must be big. So if the two biggies breakup, we are screwed. Anthropologists call this reptilian-thinking. Like my cat died. Socrates died. So Socrates must be a cat. But I realized I have no clue what WHO does either. I know what it stands for (World Health Organization duh!). But what on earth does WHO do? I didn’t know. Obviously I didn’t ask anyone and risk exposing my ignorance (Image management is the first thing you learn in B-school). I thought it might be a good time to look into a bit deeper on what WHO does, how does it maintain ‘world’ health, are they puppets of Beijing etc.

Before we get there, here is something important - Most explanatory articles like this start with history. “WHO was started in year…”. Not important here. Take it from me. I didn’t spend even a minute reading it and figured I can always read it later to rationalize why it is not important. Let us start with 2020 where WHO exists and we want to know what they do.

WHO has a nice little website where they have a section aptly named “What we do”. Half hoping I can copy paste that here, I went in. Much like most ‘disruptive’ companies, their mission statement was vague, high-level (so high that SpaceX could send a rocket there) and filled with words you would want to read, such as “Improve access to healthcare in affected countries”. Because any tangible, measurable goal would hold people accountable and responsible. Being a “world” health organization, to take on such unnecessary risk is not prudent.

Enough with dissing the WHO. Let us get our hands dirty and begin with some basic operating models and try to see what insights come out of it.

Operating Model of WHO

Think of WHO has a dishwasher sponge. The sponge takes in water from tap and dishwasher liquid and spits it on to a dirty plate. Poor analogy, I get it. But WHO does exactly that. On one side, it has countries, charitable foundations, individuals and other organizations that donate money. This money can be given to do whatever the heck WHO wants which is then considered Voluntary donation or it could be given specifically for a program, making it an Assessed donation. WHO basically takes all this money and deploys it into various programs such as Polio eradication, tropical diseases, outbreak prevention etc. To do all this, WHO has to run a HQ, regional offices, letter-pads, hoodies, free-coffee etc. They take a certain %ge of donations to run these stuff.

As of 2020, US donates close to $440-450 million per year to World Health Organization. Please note this is USA as a country. Taxpayer money going to WHO coffers. This would not include private donations such as Bill & Melinda Gates Foundation (BMGF) who also donate close to $250 million per year. (Yeah, BMGF alone donates 1/2 of what entire US donates). Overall WHO donation in 2020-2021, two year period was $4.5 billion. To put that in perspective, Apple’s net income (Profits = Income - Cash in tax havens, paying Chinese sweat-shops, pointless IP infringement cases) in one quarter was close to $10 billion. Basically the entire world paid more for iPhones and Apple TV+ than we paid to combat polio, tropical diseases and help African people access better health care. Humanity is ready to pay 20 times more, conservatively speaking, for their personal entertainment and communication than to save lives. Which brings me to the real issue - WHO is massively underfunded.

They have over 7000 workers battling to solve some of the most critical healthcare problems in various parts of the world. And I am not even talking about the new kid in the block - Covid. I am talking about the guys who have been in the hood for decades - Mr. Malaria, Tuberculosis, Polio. Now let’s talk - Chinese influence. China has better chance of influencing global healthcare investing in Novartis, GSK, Novo Nordisk etc. than investing in WHO. This is not vindicating that WHO is an unbiased organization that spits pure white light of energy and consciousness. All I am saying is, we expect a $4B organization to help stop a GLOBAL pandemic, expecting to give us funky dashboards, coordinate multinational efforts, create vaccines and remain unbiased. That is like expecting India to come up with an Indian TikTok. We could do it, but it will be terrible.

WHO spends close to 20% of it’s total funds combating Polio in African and other at-risk countries. This is their biggest funded program. Not Covid. Not vaccine development. But just ensuring there is no Polio outbreak. For those of us who thought Polio is eradicated, it is. But it takes a WHO and $400 million just to keep this at bay. Which brings me to my next point - WHO is a very good value redistributing vehicle but not a great value-creating one. Less than 2% of the funds go to any program with “Research” being a key word in it. Rookie mistakes. Over time, they have developed a keen sense of where help is needed and what aid needs to be deployed. But if you are global organization with member countries looking up to you for help, you have to make 1 + 1 = 5 and not 2. If our enemies are exponentially growing, we can’t hope for a linear growth in deployment to tackle them. Of course this is my opinion after spending not more than few hours on WHO reports. But hey, that is still more than most national media houses do (And I don’t even get paid to do this shit).

But WHO does something well which no one is talking about. Well they are talking about it but not just from WHO perspective - Data! WHO collects population-health, healthcare infrastructure, disease spread data like no other pharmaceutical company does. Owing to their large on-ground footprint, there is no global organization that collects such high quality data. And best of all - It is free! At this juncture, we need a system like WHO to continuously collect such high-fidelity data to tackle our healthcare problems. WHO provides insights to countries that no pharma player does. And for them to scale this, they need - wait for it - here it comes - Money!

Armed with these new insights, you are probably thinking - “Hmm maybe this US withdrawal will hurt WHO, but not as much as we thought”. If you thought that, congrats! You are telepathic because that is the next insight. Taking away 20% of funding suddenly is going to hurt them. But the real problem is not US withdrawing. US simply didn’t fund it enough even earlier. The real problem is WHO needs to be 10x bigger than what it is right now. At a time when we have to ramp WHO funding, we are curtailing it. Maybe, just maybe, if WHO sells a banner-space on their covid-dashboard, they would rake in another 400 million effortlessly. The moral of the story is, always make your dashboards look like a formula-1 car. Ridden with logos, & corporate sponsorship because WHO, my friend, should monetize the attention they are getting now.