Inconvenient truths

Uncivil servant

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Maria Neira is an international civil servant. She is supposed to work for you and me.
As a leading figure at the World Health Organisation (WHO), her role is to implement decisions taken by international governments.

Sworn oath

She is meant to be neutral and impartial and has even sworn an oath to “exercise in all loyalty, discretion, and conscience” in her duties and “regulate (her) conduct with the interests of the World Health Organisation only in view…”
And yet Dr Neira, head of the WHO’s public health and environment department, seems to think she knows better than the democratically elected officials.

On the issue of asbestos Dr Neira seems to believe she has the right to ignore carefully thought through policies thrashed out by health ministers from global governments at the World Health Assembly (WHA), which directs the WHO’s work.

Differentiated approach

Those elected officials, after much careful deliberation, decided that the best way to eliminate the terrible blight of asbestos related diseases was “a differentiated approach to regulating its various forms – in line with the relevant international legal instruments and the latest evidence for effective interventions”.
With much care, they acknowledged, that dealing with asbestos-related disease needed to reflect the different forms of asbestos; on the one hand, deadly blue and brown amphiboles, and on the other, white chrysotile, which is safely used in the majority of countries around the world.
But despite this careful reflection and well thought through orders, Dr Neira has decided she knows better – mirroring the clarion call of lobbyists and lawyers making millions from asbestos lawsuits – even going so far as to post her views on YouTube, she is backing a global ban on asbestos, including chysotile.
Spaniard Dr Neira, who earns more than US$100,000-a-year funded by taxpayers, said: “WHO considers that it will be feasible to go for the elimination of asbestos-related diseases, and obviously the most efficient way to do that will be to eliminate the cause of asbestos-related diseases, so stop the use of asbestos, all types of asbestos.”

Not differentiated forms of asbestos

But what about the WHA’s order to take a “differentiated approach”?
According to Dr Neira, “there is a sentence that says ‘with a differentiated approach’ but this is related to the legal instruments you want to use at country level, but it is certainly not referring to any differentiated forms of asbestos. For us, all forms of asbestos including obviously chrysotile are carcinogenic”.
Really? So what did the WHA – “the supreme body for our policy recommendations”, as she calls it – mean when it referred to “various forms”?
Apparently, she, like her friends in the asbestos ban lobby, has simply chosen to ignore what the WHA clearly acknowledged, that there are different sorts of asbestos and the risks associated with them are also different.

Dr Neira says: “We have a resolution where all member states request the WHO to develop a Global Plan of Action on Workers Health and part of that resolution asks us to go to for a global campaign on elimination of asbestos-related diseases. So we have a very solid basis for conducting our work, plus the fact that people have been suffering from asbestos-related diseases for years now and the evidence now is overwhelming.”
So she has evidence that chrysotile, as well as blue and brown asbestos, is responsible for the spread of disease?

No evidence

Well, actually, no, as she says: “The evidence is there, I mean there is extremely solid evidence. It’s true that asbestos cancer, asbestos-induced cancer, will take 20 years to appear so it will be difficult to differentiate lung cancer caused by asbestos and by other causes like tobacco for example in countries where you don’t have these epidemiological studies linking exposure in the working environment to asbestos to a type of cancer. In developing countries, in many of them we don’t even have cancer registries. There are no reasons to think that in Africa it will not happen the same or in Asia. Therefore for us the evidence is there. We know that cancer is happening. And we don’t want to wait 20 years until we start to count the number of deaths and to look at the increase in the number of cancers.”

So what is going on? The participants at the WHA specifically inserted the language about a differentiated approach to reflect the fact there are different types of asbestos and different risks associated with them.

Supreme body

But Dr Neira, has unilaterally chosen to completely ignore this, directly contradicting the orders of the WHA, the “supreme body”, as she calls it.
Dr Neira has become a global anti-asbestos activist, repeatedly saying: “The most efficient way (to eliminate asbestos related diseases)…will be to stop the use of all forms of asbestos….”

How has this happened? How has a legitimate health issue, the very toxic affects of amphiboles, morphed into an ugly business filled with fraud and undue pressure on developing countries?

The WHO, led by Dr Neira, seems to have been completely taken in and is deliberately misinterpreting its mandate. It is ignoring its democratically elected leadership – and enacting a set of policies that are odds with formal and official policy.

Has the WHO gone rogue? Is it in the pocket of the powerful anti-asbestos lobby – fuelled and funded by those who make millions from lawsuits or by supplying substitutes? Dr Neira would appear to have many questions to answer.