World Health Organization spends more on travel than AIDS | Hacker News Reader

World Health Organization spends more on travel than AIDS

apnews.com

41 pointsdacm23 comments

And is the WHO primarily an aid agency, where very high travel costs would be a problem, or is it primarily a coordination body, where high travel costs would be the point? The article is just missing this piece of information how is the WHO supposed to work. (Next exercise for journalists, supposed according to the people who founded it, not supposed according to the guy who writes about it.)

More concretely, if the primary mission is getting high level officials into one room to talk about malaria, AIDS, etc. then travel expenses is precisely what the WHO is designed to do. If the WHO is designed to ship medication to third world countries, then it may be, that the WHO is doing it wrong. However travel into third world countries is expensive, you need to rent a car, hire translators, get equipment that can keep vaccines cool during transport, etc. It may be that these expenses are billed as travel expenses and only the actual vaccine is billed as cost of malaria. In that case the travel expenses should raise an eyebrow, but is still only some indication that something may either be wrong or the accounting is not optimal for PR purposes.

Actually that is a argument I notice too often, X should work like this and they're doing it wrong, according to the author, and when one looks into the matter a little bit, then it turns out that the organization in question has very good reasons to not work like this.

Another expense in areas with ongoing humanitarian crises or less stable government institutions is security. It tends to be expensive.

Because the WHO is part of the United Nations, it operates primarily in diplomatic circles. This means protocols matter. For example, when negotiating with local officials on the ground, the political implications for the local officials are different if the party with whom they are negotiating arrives in a limousine from a top hotel or arrives by bus from the Motel6. One allows the local official to present the negotiated result as a compromise between equals, the other may provide an opportunity for political opponents to cast compromises and concessions or just plain reasonableness by the local official as weakness.

The WHO has a unique political capability in regard to reaching consensus on international health policies. It is better equipped to get political commitments from local political leaders when it comes to issues like getting medical supplies across the borders of a dozen countries. In no small part this is because the WHO provides the cover of legitimacy for local political leaders. And with no doubt part of that legitimacy comes from the WHO's ability to project an image of power...it is backed up by UN peace keeping policies. As with diplomacy in general, the WHO travel budget is cheaper than military deployment.

Interesting; I hadn't considered that. Thanks for raising this viewpoint.

I don't buy this, it still sounds like hypocrisy. The power of WHO (and UN) doesn't come from their image, but from the fact that they are backed by the mightiest nations on Earth. I'm sure WHO representatives would be taken seriously by some local bureaucrats even if arrived to the meeting on bicycles.

There are several aspects of what I described that do not align with the way I would like the world to work and would prefer if alternative methods were practical. In the world of politics and diplomacy, I don't think they are because politics and diplomacy require engagement with actors who are not driven by scientific methods, generally praised moral theories, or a strong sense empathy or who simply cannot do positive things without first caring for their political survival.

The WHO has the political ability to operate at the ministerial and executive level above regular bureaucracy. A technocrat may not care if a senior WHO official arrives on a bicycle, but the WHO does not always deal with technocrats and a meeting planned with a technocrat may turn out to be a meeting with a politician as well or instead.

That's part of why protocols matter for the WHO more than for Médecins Sans Frontières. Protocols also matter more for the WHO because its primary role is at the diplomatic level even during an emergency. During the same emergency, Médecins Sans Frontières primary mission is on the ground delivering services at the endpoint.

We had a local politician who was caught using money to fly first class instead of economy. They defended themselves by saying "You can't step off economy to meet with the leaders of the world."

But it doesn't matter. If you are part of WHO and arrive at your destination, you aren't going to be greeted on the plane. You're likely going to get off the plane, get in a car, and head to your hotel.

In other words, other people rarely have anything to do with it. Most meetings take place inside a meeting room, not a plane or limo.

Does the WHO buy most of the vaccines and treatments, or most of the countries buy their own doses?

This looks like a true but misleading title, like "The United Nations Security Council spends more in coffee than in tanks, battleships and bombers combined"

The WHO isn't a direct aid organization.

It's a political organization it defines policies and helps to execute and oversee them.

If say a country needs vaccines the WHO can help them secure funding usually through the world bank or other financial institutions as well as potentially better prices by facilitating deals with the drug companies directly.

People think that the WHO is the red cross or Doctors Without Borders or the UNHCR.

But in its mandate and in practice it's more closer to the IAEA and other similar UN organizations.

I think these kind of comparisons are a little miss guided.

WHO is a world organization, so by definition they have to travel the world. Every time you get in a plane, car, or train, that costs. On top of that, a lot of their work has to be done in person. You can't test a local population in Africa for a specific strain of ebola in a lab in North America. A team has to be sent to do that work and exfiltrate samples. Also, there often has to be a person on the ground directing. If I'm working with a warlord to ensure the safe movement of medical supplies, that's better done in person.

I can do all the AIDS, TB and malaria research I want in a lab. We have samples that were previously taken and can be mailed. I can share my findings with people on the other side of the world with the help of the internet.

To top my argument off, even if you could reduce spending on travel, that doesn't directly translate into more effective fighting of AIDS, TB, or malaria. Many of the people that are able to do the most effective work in these fields are already doing so. Just throwing more money in the pot doesn't necessarily speed up the process. And not to get political, but if you want to look at allocations of money for medical research, look at the HUGE cuts that are about to happen at the National Institute of Health.

I think you've missed the point here. It's not against traveling, but traveling in first/business class. Most other similar charities have explicit decree that forbids traveling first/business class and mandates even the highest ranking officials to travel economy class.

Having always flown economy I recently took advantage of a cheap, domestic upgrade to business class. I had to work while on the plane and I was noticeably more productive on the flight and less fatigued than I normally would be in economy. So I think there is an argument to be made for the following categories of trips to be a step above economy:

* when the traveller is expected to get work done on the flight * when the time at the destination is short (1-3 days) and is densely packed * when the traveller is moving immediately from flying to being productive on the ground

Otherwise after flying economy it would only take a good, relaxed meal and/or a 20 minute catnap to bring me to post-business class levels of productivity.

And I agree there. If people are flouting the rules, that's an issue. However, the article seems to both say that some specific people spend to much on travel (which I can agree with), and overall shouldn't be spending as much on travel (which I disagree).

WHO is a still a political organization, which works on medical issues.

Who are the traveling expenses going to, though? WHO staff is one thing, outside experts and representatives are another. And the latter is 60% off their costs, according to the WHO.

But the WHO is not a charity. It is more something akin to the World Bank, UN, or IMF. Members typically fly businesses class.

From the article, though, it doesn't make sense that Doctors Without Borders has more than 4 times the staff but less than a fourth of the travel costs.

It's not about banning travel, it's about not traveling first class.

I would say that MSF serves a different purpose. They create long term stationary projects. That has inherently less travel, even for a larger number of people.

I think another commenter (zimzam) hits the nail on the head. While I'm against flouting travel spending rules, I do think it also depends on the type and level of productivity expected from the person traveling.

>Three sources who asked not to be identified for fear of losing their jobs told the AP that Chan often flew in first class.

I have no problem with this. There are many reasons why the Director General should fly first class. For one, she is a very public figure and I imagine first class will offer a bit more privacy.

Second, to attract the best, you sometimes need to provide the best. Unfortunately not everyone is 100% altruistic, so perks such as first class travel might help to persuade some people. I get into this discussion every time the compensation of my provincial health CEO is brought up (Alberta Health Services CEO). People complain that she makes more than $500k per year. They assume that people working for the public shouldn't make that amount. They seem to forget that she is responsible for an organization with 110,000 employees and a budget of $21.4 billion. That carries a ton of responsibility.

Just to be clear, they spend $200MM on travel for 7000 people a year, that's ~$75/day/person.

It's like this at the world bank and IMF as well.

Their senior staff travel like royalty in first class and often their fancy luggage is also paid for.

There's no doubt that these organizations like the WHO do a lot of good. But the perception of this definitely does hurt them when they want to get more funds.

"Dr. Bruce Aylward, who directed WHO’s outbreak response, racked up nearly $400,000 in travel expenses during the Ebola crisis, sometimes flying by helicopter to visit clinics instead of traveling by jeep over muddy roads, according to internal trip reports he filed."

If he needs to visit more than one site per day, the jeep is provably not workable. The next article we're likely to see is one saying the WHO had dropped off equipment and then left the locals with no instructions or coordination for weeks.

Also these are not safe areas. If you drive by road you will get stopped by bandits. It's certainly happened to me.

I had the chance to briefly meet (22 years ago) an Harvard Teacher who was also involved in AIDS research with UN.

He was going to go to Nepal to meet local doctors and authorities.

He had to "fight" to get a normal airplane ticket instead of the first class his organization was ready to pay him.

Because the first class ticket was more expensive than the Nepal AIDS fighting year budget...

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