Tobacco Documents Online

I ! I I I I I I I ! I I i I I I I I I -23- SCIENCE AND TECHNOLOGY Smokescreens The World Health Orgartisation is showing signs of,a/lowing politics to get in the way of the truth I'S THE bodythat wiped outsmallpoxand ~ has done so much to promote mass vac- cination losing its way? In recent weeks reputalion of the World Health Organisa- tion (WHO) has suffered a number of blows, as cnti~ have accused it of bowing to lx>. litical pressures rather than publishing un- palatable re.search finding. One instance emerged this week. A controversial new study which looked for links be~'een lung cancer and passive smoking found that non-smokers married to, working with or growing up with smok- ers were not at significantly more risk from lung cancer than anyone else. The research, commissioned by. the who and inated by Rodolfo Saracci of the WHO'S In- ternational Agency for Research on Cancer, involved a seven-year-long study of 650 lung-cancer palien~ Since it was one of the biggest single piec~ of re~.arch conducted into the issue, its results were eagerly awaited by. the medtcal world and lobby groups. But instead of being released with a Fanfare, they were summarised in three short paragraphs and buried in a bulk}, WHO internal document. Those paragraphs emerged in the Brit- ish press-undoubtedly tipped off by the country's tobacco lobby--and were ac- companied by gleeful accusations that the WHO was ti'ying to suppress the findings. Certainly, the conclusions will have been an embarrassment to the organisation. Though the who has long admitted that the links between lung cancer and passive smoking are weak, it has nonetheless used the perceived dangers to rally public sup- port against the tobacco industry, particu- larly in pressing for a worldwide ban on smoking in public places. Surely, say its critics, if this study had supported the WHO'S anti-smoking position, it would have trumpeted the fact. But the study not only clashes with the tenor of the who's own anti-tobacco cam- paign" it also appears to undermine the American government's war on public smoking. Unsurprisingly, many fear that the who's agenda is no longer governed solely by scientific principles. Rather, they suspect it is influenced by its biggest pay- mas~er-the United States. This view is rein- forced by the stance the wHO has seemed to t~.ke on another awlcvvard issue: the links between radiation and thyroid ~ancer. Sources close to the organisation allege that Keith Baver~ock, a leading scientist at the WHO, has been put under unrelenting internai pressure to leave the organisation following his work on the incidence of thy- roid cancer after the Chernobyl nuclear ac- cident in 1986. This research, which found cancer rates thal were more than 1oo times normal in some areas of the Ukraine and Belarus, conflicts with work done by the Amehcan government in its own s~udy of dangers to public health from nuclear test- [ng in Nevada in the ~.95os. That study, published by the govern- ment's National Cancer Institute (NCl) last year, was inconclusive, and failed to tackle the issue of cancer risk./ndeed, it left out a vital piece of research by the NcI's own sci- entists. This had found a high incidence of thyroid cancer associated with radioactive iodine.An independent committee was set up by America's National Academy of Sci- ences to look into the NCI'S conclusions about the health risks from nuclear testing. Dr Baverstoak is the only WHO employee on that committee. A smoking gun? Why should Dr Baverstock be under ~uch pressure? One explanation is that, if the health risk~ associated with nuclear tests and accidents have" been underestimated or understated, the Ameficafl government could face new lawsuits on everything fi'om the Nevada t'es~s to the Three Mile Island nuclear accident in 1979. And there is a third instance where the w~o has apparently been embarrassed by its own findings, and embarrassed Amer- ica into the bargain. On February 21st New $cie~r/st claimed that the who had "caved in to political pressure" by failing to in- clude data suggesting that cannabis is less harmful than alcohol or tobacco when it published a report on the effects of the drug. New Sde~t'h't alleged that the WHO was pe~uaded not to publish by warnings

I I I I I I I I I I I ! I I I I I Abus~ and a~ ~m ~e Umted ~at ~ ~nd[n~ wou)d play into ~e han~ o£~rou~ ~mpa~nm~ to l~alise ~ ~e WHO h~ countered some of ~e accusauons, ~ou~ ~t would not comment sue ~s ~'een h~m and h£s r~£onal tot, In ~e ~e oF ~e p~s~ve smokin~ ~dy, ~ard Peto, an ep~demiologist at O~rd Umv~iW who advis~ ~e WHO, ~ that a~c~at~ons of a cover-up am non- ~ns~ ~e WHO tn~ to get 1~ findin~ published by ~e ~ Me~ J~ late I~t y~r, but ~ were rej~ on grounds that ~e BMJ hadj~t publish~ a mu~ bi~er "recta-analogs" s~dy on sire smoking, ¢ollatm~ almo~ 4o r~ pa~ on more ~an ~ooo ~ncer patien~ ~is la~er ~dy ~me to ~e conOu- s]on that ~ere w~ inde~ an incr~ nsk of lung ~ncer ~m passive smoking ~2~ hi~er ~an ~r ~ose li~ng in a smoke-~ee env~nment~ but ~at it ~ nny compar~ with ~e Looo% incr~ nsk ~r active smoke~ ~e BMJ ~ere~re d~lded ~at the WHO'S r~ul~ were not not~'o~hy enou~ to pnnL~e WHO ~ it Is Stall l~n~ to have the study publish~ It submltt~ the r~ to ~e J~ the N~n~ ~nc~ l~mte in Feb~a~ and i~ waiting ~r it to ~ ~er-r~'~ ~ ~r the study of~e impact of~nna- his, ~e o~anlsat~on dem~ ac~tio~ ~ppr~lng dat~ ~an ~ who m~- ag~ ~ su~tance-abuse p~mmm~ ~ the decmon to ~hold the findin~ on ~nnabis w~ ~use epidemiol~i~l data on the dm~ are l~s reliable ~an,~ ~r alcohol or tobacc~ ~ere a~ l~sons, ~ou~, in the ~ ~ whi~ ~e WHO'S motiv~ have ~n impu~n~ by ~¢epti~ It IS dan~em~ to come mvolv~ in ~mpai~ns ~at am not ~lidly ~ on ~i~nt]~c ~denc~ ~or stin¢~ ~'en the small ill~ oFpassive smokin~ ~und by the meta~nal~is were • e r~ult of~mnic ~um at home orat wor~ not ~sual whi~ in a pub.~ou~ ~s[ve smoking is unpl~nt and imtat- m~ ~r non-smoke~ ~at alone ~nnot j~- tffy banning it in public plac~ ~e dan~er, iF ~e who ap~m to ~mpalgmn~ a~ain~ p~ive smoking manly ~r ~liti~l r~n~ is ~at it ~[I w~ken the m~te a~ut ~e ~l ~s~ smoking (whi~ ~ 6~ of all d~s and ~s the world's ~t~t~n~ killer a~er ~ Ds~ ~e o~ani~uon oust m~ to con- ¢~tmte on ~e~e i~ r~r~, m~er than ~liti~ l~ds i~ Un~nately ~e stmcmm of~e WHO m~ th~ di~l~ It ~ at ~e plate oF i~ ~91 mem~r st~t~ ~i~ finance but demonstrate no ~l undemandin8 how to ~n I~ [~ r~ional ~ir~o~ am ap~nted not ~' the o~ani~tion's dir~- tor-~enera, bul'm~'~ndently ~ h~hh rninlstr[es in each country. Because the member countries pay the fi~ and ap- point the directors, the WHO could find it difficult to resist pressure to support their political agenda. Critics claim that the suit is an organisation which is dicpirited, confused and lacking in vision. The WHO needs once again to become a neutral arbiter of health information, ready to put its advice into practice, as it did in its fi~t to eradicate smallpox. Them am hints of change. The new dir,~or-gen- eral, Gro Harlem Brundtland, who will re- place Hiroshi Naka/ima this summer, is considering altering the way regional direc- tom are ap~inted to make them more di- r~-,ctly answerable to the organisarion. With the WHO turning 50 this year, it needs to overcome its mid-lif~ crisis.