7 ms·

Ask HN: Is it time to start an apolitical, decentralized version of WHO?

There has been a lot of red flags on the WHO recently, from misreporting data [1, 2] to confusing guidance on masks [3] to the controversial case of Taiwan [4, 5]. Does anyone here feel that such bureaucracies wouldn't/shouldn't survive long? And that they could be easily replaced by an efficiently-operated, software-powered non-profit (something similar to Our World in Data)? One starting point that I could get couple universities and hospitals behind is a simple portal for any medical staff around the world to report severe flu or whatnot cases (with anonymized record/evidence) that they suspect to be a stem for a new disease outbreak. Would anyone here be interested in helping to build such initiative? Or any thoughts? Suggestions? Counter-arguments? -- [1] https://ourworldindata.org/coronavirus-source-data#world-health-organization-who-situation-reports-our-previous-data-source [2] https://edition.cnn.com/2020/02/14/asia/coronavirus-who-china-intl-hnk/index.html [3] https://blogs.bmj.com/bmj/2020/03/11/whos-confusing-guidance-masks-covid-19-epidemic/ [4] https://in.reuters.com/article/health-coronavirus-taiwan-who/taiwan-says-who-not-sharing-coronavirus-information-it-provides-pressing-complaints-idINKBN21H1BS [5] https://edition.cnn.com/2020/02/14/asia/coronavirus-who-china-intl-hnk/index.html

aww_dang 7y ago
How do you propose to keep it apolitical? Even Wikipedia has a political slant. I agree with your concerns, but I don't know if what you propose can keep politics out. It is still probably worth a shot either way.
- PierredeFermat 7y ago
  Not entirely sure yet. However, that's exactly why verified, anonymous data reporting would be a good starting point. But I assume your concerns are more about [the difficulty of] neutral funding?
  - aww_dang 7y ago
    Exactly, state sponsored universities could create some of the same conflicts of interest we've seen with COVID-19.
    - PierredeFermat 7y ago
      True. How do you think this could be overcome? Crowdfunding? Donations?
      - aww_dang 6y ago
        Allow competing voices to coexist without presuming to act as an arbiter of 'truth'. Politics would remain, but the end user could choose.
  - dragonwriter 7y ago
    > However, that's exactly why verified, anonymous data reporting would be a good starting point Verification is probably the first place that the apolitical goal falls apart.
krapp 7y ago
What would this organization's apolitical policy be regarding Taiwan?
- PierredeFermat 7y ago
  Close coordination with the Chinese government :) No, there would (almost) be no policy. That's the point. It's one planet - one health. Which country it is shouldn't matter much. If a severe case was reported by medical staff in Taiwan, North Korea or where ever it would/should instantly show as potential breakout warning signal on some webpage or dashboard, without having to travel weeks through broken bureaucracies and press.
  - krapp 7y ago
    There has to be a policy. Either you deal with Taiwan though China and on China's terms, which is a political position, or you deal with Taiwan on its own terms, which is a political position, or you ignore Taiwan altogether because of the controversy around its status, which is a political position. Choosing to ignore bureacuracies and the press is a political decision. Choosing which data to post and what sources to trust is a political decision. There's no such thing as an organization which operates internationally and is also apolitical.
    - PierredeFermat 7y ago
      In the broad definition of what makes something "political", that is definitely the case. No disagreement. However, to not drift this discussion into definitions, I'll agree on your definition of "politics", which - correct me if I'm wrong - is any activity that involves decision making. Let's assume, in that or any case, every decision and action to be political. Then the important question here becomes: how do we make political decisions that would ensure the most transparent, decentralised, instant and honest reporting? Would that mean trusting all medical facilities/staff of any kind or excluding some? Point is: if every decision is political, then let's make the good ones with the best possible outcome, regardless of their nature/definition.
dragonwriter 7y ago
What WHO does is intergovernmental public health coordination. It is inherently a political function. The decentralized version is just local public health authorities acting without the WHO.
- PierredeFermat 7y ago
  > What WHO does is intergovernmental public health coordination I'm afraid that's a normative and oversimplistic statement. Have you seen, at least, the WHO Twitter/FB feeds? It's acting as a teacher for the global public. So "intergovernmental public health coordination" is definitely not its only job, which it doesn't seem to be doing well. There's no disagreement that it's inherently political but in any case, that wasn't a function I proposed to replace in the first place. > The decentralized version is just local public health authorities acting without the WHO. That actually goes with the original proposition and that's the way to go. But the early warning system for these authorities is broken - they got their intel too late.
kleer001 7y ago
Sounds great. I love it. Sadly I fear that's not really how humans work. Very motivated, intelligent, and well meaning humans have been trying for centuries to decouple function from politics. It's not going to be solved by any technology or technique we have today. But that's only my ignorant opinion.
- PierredeFermat 7y ago
  I don't think it's an ignorant opinion. How do you imagine it being solved?
  - kleer001 6y ago
    I don't have the hubris to suggest anything.
bjourne 7y ago
I can only speak for myself, but the "red flags" that you speak of [1-5] aren't very convincing to me. That there are errors in WHOs data isn't surprising, nor that it needs to make pragmatic decisions in trying to get authoritarian regimes to cooperate. That WHOs guidance sometimes is confusing is what you'd expect from a world-wide organization in large part made up of volunteers run on a relatively tiny budget. Unless you are an expert in epidemology or international humanitarian politics, I don't think the organization you would form would do a better job than WHO. Therefore I'm not interested in helping you. If you want to help improve worldwide health then you could enroll in one of its many volunteer programs. That way, you would gain valuable experience in how the organization operates which would help you if you decide to create an alternative.
- PierredeFermat 7y ago
  I don't think we should just give up to the fact that it's normal to have errors coming from these big Orgs operating at such a sensitive front. Look what some small errors and delays are doing. If an organisation gets too big to keep its act together, perhaps it's time to make it more decentralized and dynamic (the original proposition). I also honestly don't think working as a volunteer would really get you to understand how something like the WHO is being actually run. I'm not an expert (would never say otherwise). But the world is full of experts locked in dogmas and lacks those couragious enough to break free, look stupid and try new things.
  - tcbasche 6y ago
    > perhaps it's time to make it more decentralized and dynamic (the original proposition) Honestly, what does that even mean? Wouldn't it be even more chaotic?
codingdave 7y ago
> easily replaced by an efficiently-operated, software-powered non-profit No, one of the biggest problems I see in our industry is startups jumping into problem spaces they do not fully understand, and flailing around for a year or so, maybe getting enough people talking to them to refine their product, learn their own market, and finally get "product/market fit". Maybe. I don't feel that we should try to replace the WHO with such a failure-prone process just because they have some problems. I do feel that you can certainly start down that path with a long-term goal to learn that space and improve upon it... but it will be a journey, not a quick fix. It cannot be simplified down to: "bureaucracy is broken, lets replace it with some code."
- PierredeFermat 7y ago
  I totally agree that startups aren't the solution to every single problem we have on the planet but I'm not sure you've tackled the original proposition, rather you expressed a general concern/dissatisfaction and that's understandable. Software-powered != Software-only. Nonprofit != Startups. Propositions != Complete, bulletproof solutions
- tcbasche 6y ago
  I think a lot of people in our industry think the solution to an inherently human problem (not to mention one as complex and delicate as health!) is to throw code at it and demand billions of dollars in return.

aww_dang 7y ago

How do you propose to keep it apolitical? Even Wikipedia has a political slant. I agree with your concerns, but I don't know if what you propose can keep politics out. It is still probably worth a shot either way.

PierredeFermat 7y ago
Not entirely sure yet. However, that's exactly why verified, anonymous data reporting would be a good starting point. But I assume your concerns are more about [the difficulty of] neutral funding?
- aww_dang 7y ago
  Exactly, state sponsored universities could create some of the same conflicts of interest we've seen with COVID-19.
  - PierredeFermat 7y ago
    True. How do you think this could be overcome? Crowdfunding? Donations?
    - aww_dang 6y ago
      Allow competing voices to coexist without presuming to act as an arbiter of 'truth'. Politics would remain, but the end user could choose.
- dragonwriter 7y ago
  > However, that's exactly why verified, anonymous data reporting would be a good starting point Verification is probably the first place that the apolitical goal falls apart.

krapp 7y ago

What would this organization's apolitical policy be regarding Taiwan?

PierredeFermat 7y ago
Close coordination with the Chinese government :) No, there would (almost) be no policy. That's the point. It's one planet - one health. Which country it is shouldn't matter much. If a severe case was reported by medical staff in Taiwan, North Korea or where ever it would/should instantly show as potential breakout warning signal on some webpage or dashboard, without having to travel weeks through broken bureaucracies and press.
- krapp 7y ago
  There has to be a policy. Either you deal with Taiwan though China and on China's terms, which is a political position, or you deal with Taiwan on its own terms, which is a political position, or you ignore Taiwan altogether because of the controversy around its status, which is a political position. Choosing to ignore bureacuracies and the press is a political decision. Choosing which data to post and what sources to trust is a political decision. There's no such thing as an organization which operates internationally and is also apolitical.
  - PierredeFermat 7y ago
    In the broad definition of what makes something "political", that is definitely the case. No disagreement. However, to not drift this discussion into definitions, I'll agree on your definition of "politics", which - correct me if I'm wrong - is any activity that involves decision making. Let's assume, in that or any case, every decision and action to be political. Then the important question here becomes: how do we make political decisions that would ensure the most transparent, decentralised, instant and honest reporting? Would that mean trusting all medical facilities/staff of any kind or excluding some? Point is: if every decision is political, then let's make the good ones with the best possible outcome, regardless of their nature/definition.

dragonwriter 7y ago

What WHO does is intergovernmental public health coordination. It is inherently a political function. The decentralized version is just local public health authorities acting without the WHO.

PierredeFermat 7y ago
> What WHO does is intergovernmental public health coordination I'm afraid that's a normative and oversimplistic statement. Have you seen, at least, the WHO Twitter/FB feeds? It's acting as a teacher for the global public. So "intergovernmental public health coordination" is definitely not its only job, which it doesn't seem to be doing well. There's no disagreement that it's inherently political but in any case, that wasn't a function I proposed to replace in the first place. > The decentralized version is just local public health authorities acting without the WHO. That actually goes with the original proposition and that's the way to go. But the early warning system for these authorities is broken - they got their intel too late.

kleer001 7y ago

Sounds great. I love it. Sadly I fear that's not really how humans work. Very motivated, intelligent, and well meaning humans have been trying for centuries to decouple function from politics. It's not going to be solved by any technology or technique we have today. But that's only my ignorant opinion.

PierredeFermat 7y ago
I don't think it's an ignorant opinion. How do you imagine it being solved?
- kleer001 6y ago
  I don't have the hubris to suggest anything.

bjourne 7y ago

I can only speak for myself, but the "red flags" that you speak of [1-5] aren't very convincing to me. That there are errors in WHOs data isn't surprising, nor that it needs to make pragmatic decisions in trying to get authoritarian regimes to cooperate. That WHOs guidance sometimes is confusing is what you'd expect from a world-wide organization in large part made up of volunteers run on a relatively tiny budget. Unless you are an expert in epidemology or international humanitarian politics, I don't think the organization you would form would do a better job than WHO. Therefore I'm not interested in helping you. If you want to help improve worldwide health then you could enroll in one of its many volunteer programs. That way, you would gain valuable experience in how the organization operates which would help you if you decide to create an alternative.

PierredeFermat 7y ago
I don't think we should just give up to the fact that it's normal to have errors coming from these big Orgs operating at such a sensitive front. Look what some small errors and delays are doing. If an organisation gets too big to keep its act together, perhaps it's time to make it more decentralized and dynamic (the original proposition). I also honestly don't think working as a volunteer would really get you to understand how something like the WHO is being actually run. I'm not an expert (would never say otherwise). But the world is full of experts locked in dogmas and lacks those couragious enough to break free, look stupid and try new things.
- tcbasche 6y ago
  > perhaps it's time to make it more decentralized and dynamic (the original proposition) Honestly, what does that even mean? Wouldn't it be even more chaotic?

codingdave 7y ago

> easily replaced by an efficiently-operated, software-powered non-profit No, one of the biggest problems I see in our industry is startups jumping into problem spaces they do not fully understand, and flailing around for a year or so, maybe getting enough people talking to them to refine their product, learn their own market, and finally get "product/market fit". Maybe. I don't feel that we should try to replace the WHO with such a failure-prone process just because they have some problems. I do feel that you can certainly start down that path with a long-term goal to learn that space and improve upon it... but it will be a journey, not a quick fix. It cannot be simplified down to: "bureaucracy is broken, lets replace it with some code."

PierredeFermat 7y ago
I totally agree that startups aren't the solution to every single problem we have on the planet but I'm not sure you've tackled the original proposition, rather you expressed a general concern/dissatisfaction and that's understandable. Software-powered != Software-only. Nonprofit != Startups. Propositions != Complete, bulletproof solutions
tcbasche 6y ago
I think a lot of people in our industry think the solution to an inherently human problem (not to mention one as complex and delicate as health!) is to throw code at it and demand billions of dollars in return.