The WHO's Attack on Reduced Harm

How the World Health Organization's Misinformation on Vaping is Disgraceful (The Conclusion of a Three-Part Series on Harm Reduction)

This is the third part of a series on tobacco harm reduction approaches using products like e-cigarettes and nicotine pouches that have helped millions of people quit smoking tobacco products and regain their health. The first part looked at how alternative nicotine products, as a harm reduction tool, was attacked by the health activists. The second part tried to understand why regulators were introducting restrictive policies on these smoking cessation strategies. The final part of the reduced harm rejection puzzle will look at the role the World Health Organization has played in spreading misinformation, conflating nicotine with tobacco and behaving in a completely non-scientific and irresponsible manner.

In 2012, when e-cigarettes were starting to be seen as a smoking cessation tool, the World Health Organization came out against promoting vaping on the basis that it would overturn years of success in denormalizing the tobacco industry.

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It is interesting to note, from their early days of lobbying against tobacco harm reduction, that the WHO’s strategy was to conflate the two. Nicotine is tobacco, vaping is smoking, and both must be stopped. In this 2012 document, they did recognize that this stigmatization of alternatives to tobacco products was a perception / normative battle that had little to do with scientific evidence.

This 2012 statement, in a report on e-cigarettes produced by the WHO FCTC (Framework Convention on Tobacco Control), was made well before tobacco companies moved into the nicotine alternative market, when most vaping companies were small, niche players and the technologies were rudimentary. By pushing for heavier regulatory costs and burdens, the WHO actually aided in allowing tobacco companies to come in and take over the vaping market.

Since that time, the WHO’s views against tobacco harm reduction products has hardened and became even more arrogant, spreading misinformation against vaping. The latest WHO Q&A on the dangers of e-cigarettes has echoes of the Reefer Madness scare campaigns from the 1930s. The first two parts of this Firebreak series quoted and criticized the misinformation and lies coming from this document (trying to equate the health risks of tobacco and vaping, citing studies out of context to suggest lung damage from e-cigarettes, postulating non-scientific claims…). It would be really laughable if it weren’t costing so much loss of life by confusing smokers thinking of switching to e-cigarettes as a means to quit smoking.

• If the WHO simply did relative risk management (comparing vaping use with tobacco use rather than against non-smoking control groups);

• if they took a patient-oriented approach to harm reduction rather than an intransigent political position against an industry they detested;

• if they had taken a consultative approach with all stakeholders rather than a closed circle of anti-nicotine campaigers, addiction experts and foundations funding biased research;

In other words, if the WHO had done their job, then we would not be having this discussion, information to consumers would have been clear and millions of lives would have been saved following the eradication of tobacco use.

The reality is stark. The WHO’s relentless attack on vaping is an abdication of any commitment to improving public health by supporting the most effective cessation tool to support smokers trying to quit tobacco and its harmful health consequences. The WHO is not fit for purpose, does not legitimately represent public health and must be radically reformed.

Who is the WHO?

The WHO has been misperceived as a global body of health scientists working in some large offices and labs in Geneva - the best minds that unlimited transnational institution budgets can buy. This is not the case. It is, rather, a small secretariat of international civil servants drawing from a network or club of like-minded and ambitious academics and research consultants using their association with the WHO as a base to advance their careers. The longer the scientists stay in such a cesspool of intrigue and big egos, the more petty and vindictive they become. They peer-review each other’s articles and block out those who disagree with them, ensuring that any WHO policies reflect their political bias.

The WHO civil servants don’t care much about what goes on outside of their panel, unit or section (unless it would lead to a promotion). And the units are quite small. The WHO’s Tobacco Control Office in Geneva is part of the Health Promotion unit which also deals with alcohol use and physical inactivity. The unit employs five people (although it is unclear how much of their timesheets focus on nicotine and tobacco issues). Most of the WHO’s tobacco control work is done in their regional offices where they employ advisers. Their reports do not list authors or panel members which suggests they were outsourced to consultants. The Framework Convention on Tobacco Control (FCTC) is independent from the WHO and claims a staff of 28 people but only cites the name of the secretary general.

Look more closely at the CVs of the typical WHO civil servant. Many are coming from the NGO activist world. Ambitious people in the corporate world have many rungs in their career ladder to take advantage of, but NGOs are generally flat structures with maybe three levels for career promotion. Ambitious activists will likely reach the top of their career path by the age of 35. And then what? If they had been fighting industry their entire career, they would likely transition into UN agencies or European Union institutions to continue their battles from higher ground. Take for example, the former secretary general of the European Public Health Alliance, Monika Kosinska. She is now carrying on her campaign against industry as a director in the WHO’s Non-Communicable Diseases unit responsible for the Commercial Determinants of Health action plan.

Secret Handshake Activist Science Networks

I have written volumes about how the Ramazzini clique of activist scientists have used the WHO agency, IARC (International Agency for Research on Cancer), to advance their interests with funding from the US litigation industry. IARC always tries to present itself as a WHO agency, but its association is nominal as it is only accountable to its 29 members who fund it (along with 43% of its funding coming from other entities like foundations). When IARC was in crisis following their controversial monographs on glyphosate and red meat, the WHO was unable to intervene. Their arrogance toward requests for information from the US Congress was legendary, reflecting the combative Ramazzini culture.

Sometimes the WHO has to keep up with the campaigns of their research circles, as seen with how the WHO Europe had to carelessly rush through a report on the Commercial Determinants of Health to keep up with the publications of a Lancet-based group of academic political campaigners. These activist scientists have pulled the WHO down a dangerous rabbit hole of demanding WHO member countries ban (tobacconize) all cooperation with industry-funded researchers (ie, most universities) and all consultations with a wide scope of industries (basically everyone who is not an NGO campaigner or an academic).

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So when the WHO rejects the scientific evidence on nicotine alternatives to smoking combustibles, it is not speaking on behalf of the body of scientific evidence, but rather a community of activist zealots and anti-tobacco warriors with a relentless axe to grind. What the WHO needs is to reform their spheres of influence and open up to wider voices within other branches of the scientific communities, creating sources for dialogue (the scientific method) rather than manufacture paths to what they call “consensus” (political advice). Instead, they seem to be closing up their dialogue process even more.

Source. Most of these people don’t work for the WHO but use it to advance their careers and political interests.

The WHO Framework Convention on Tobacco Control (FCTC) has various expert groups and working groups to prepare their documents for their regular Conference of the Parties (COP) conferences, but unlike agencies like IARC, they do not publish the members of these groups or the authors of their reports. Transparency is for the weak and the stupid.

Source The FCTC site does not publish the members of their expert and working groups. They simply list the report titles.

The lack of transparency of the advisers and members of the expert panels and working groups to the FCTC reports is no surprise. The entire FCTC process is controlled and contrived.

Where are these Anti-Nicotine WHO Scientists Coming From?

Follow the money.

Several foundations are pumping millions into anti-nicotine, anti-vaping NGOs, researchers and lobby groups (see graphic below). These same foundations are large funders of WHO programs. Michael Bloomberg for example, has been rewarded for his millions in donations with the title of WHO ambassador (which he uses to be able to attend UN intergovernmental events as a quasi head of state). As the United States leaves the WHO, the Gates Foundation will become the largest WHO donor (mostly for vaccine programs via GAVI given that the WHO also refuses to work directing with vaccine manufacturers).

Source. There’s big money in anti-vaping activist science

These foundations fund activist researchers who publish papers casting doubt on the safety or efficacy of tobacco harm reduction alternatives. If they then tell the WHO that the academics from their networks should have primary positions on WHO panels and working groups looking at e-cigarettes and other non-combustible alternative nicotine products, who within the WHO would question this or stand up for transparency and objectivity? The WHO agencies rely heavily on foundation funding so the reflex action is to follow what the philanthropists tell them. They have already excluded industry and industry-funded researchers so it would not be a major stretch to just stack the panels with anti-nicotine activist scientists associated with foundation funding.

But are their reports, advice and research then reliable?

Too bad the WHO is not transparent on who is advising their skeletal staff on their anti-nicotine policies, strategies that are then imposed on WHO Member States.

It’s not About Saving Lives: The War on Nicotine

During the height of the COVID pandemic, the WHO refused to give emergency authorization to an effective nicotine-based vaccine, Covifenz, that was inexpensive to manufacture and required no cold storage chain. This decision was based solely on the reason that a tobacco company was involved in the early stages of the vaccine’s research and development. It did not matter to the WHO decision-makers that the pandemic was taking lives in developing countries that did not have the means nor the infrastructure to distribute the first wave of COVID-19 vaccines. Letting people die rather than reconsidering one’s ideals is my definition of a zealot.

Equating tobacco with nicotine is not scientific but political. There is much speculation as to why the WHO is forcing this equation through.

• Is it merely a war on Big Tobacco and part of the wider WHO strategy of attacking and denormalizing industry?

• Is there an old guard of anti-tobacco warriors associated with the WHO that is still fighting the 1970s-80s war of attrition?

• Is there a risk of the bankruptcy of the Tobacco Bonds set up during the Tobacco Master Settlement in the United States leading the litigation industry to push for a new “tobacco” revenue stream from e-cigarettes and nicotine pouches?

Whatever the reason for conflating nicotine with tobacco, it is not scientific, it is not rational and it is not supporting better public health. The WHO is behaving in a disgraceful, vindictive manner. It is no surprise then that the United States is leaving the organization and only a matter of time until other countries realize this UN body is not behaving in a responsible manner and pull their membership as well.

Time for the WHO to Grow Up and Become Responsible

The Trump administration, on its first day, declared that the United States would pull out of the WHO. As its largest funder, this will devastate most of the WHO’s programs after the one-year notice period. But rather than use the decision by the Trump executive order to try to reform the organization, weed out the more radical elements and programs that have gone beyond any rational human health remit (like their program on traditional medicine) and try to strike a deal with the United States government, the impervious UN organization used its most recent plenary to try to increase funding from other WHO Member States. How many more empty chairs will the WHO need to see before they realize how they have been radicalized by external interests?

Basically what the WHO needs to do is grow up and get control of the vindictive and opportunistic activist scientists and NGOs speaking on their behalf (whether it is in the FCTC, IARC or the NCD programs). The tobacco industry had done some terrible things … no one is contesting that. They lost their market and their legitimacy. Now the surviving entities are fighting for their existence by competing with other players for a new market of innovative reduced harm products. The innovations are impressive and the hundreds of millions who have quit smoking tobacco cannot be denied. Non-combustibles are different, they are safer and need to be considered responsibly with respect to the best available research evidence.

The WHO needs to stop spreading misinformation, vitriol and division and consider the better health options of these reduced harm products. It is time to purge the WHO of the old guard anti-tobacco activists from their panels and working groups. It is time for the WHO to stop relying (financially and substantially) on donations and advice from philanthropists and their interest groups. It is time for the WHO to grow up and become responsible.