Gro Harlem Brundtland answers your questions

The head of the World Health Organisation (WHO) does not shy away from controversy.

Gro Harlem Brundtland has spearheaded campaigns for worldwide bans on tobacco advertising and has tried to browbeat rich pharmaceutical companies into lowering the price of their HIV drugs for developing nations.

How good a job do you think the WHO is doing? What should be its priorities for the region where you live?

Dr Brundtland took your questions on Talking Point ON AIR, the interactive phone-in programme of the BBC World Service and BBC News Online.

Select the link below to listen to Talking Point ON AIR

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What is WHO doing about the Aids pandemic in sub-Saharan Africa besides giving scary statistical updates on the deaths?
Gerald, South Africa

I am concerned about the dictatorial manner of the WHO approach to tobacco. The WHO seems determined to not just to campaign in favour of public education on the risks of tobacco use, but actually is determined to outlaw it worldwide.
Graeme Steel, Surabaya, Indonesia

There is no other product on the market that when used as it is intended will kill half of its users

Gro Harlem Brundtland on tobacco

There is no other product on the market around the world that when used as it is intended will kill half of its users. Nobody has suggested banning or outlawing tobacco. What has been suggested is to increase the tax, and ban or strongly restrict advertising.
Gro Harlem Brundtland

Given the WHO's interest in the links between poverty and disease, where do you see the priorities for poverty reduction through programmes targeting infectious diseases?
Dr Tim Inglis, Perth, Western Australia

Poverty leads to ill health, but in turn ill health also leads to poverty

Gro Harlem Brundtland

I feel it is necessary to re-establish in people's minds, or even establish, the fact that it is not only so that poverty leads to ill health, but in turn ill health also leads to poverty. That's why we need to vaccinate, we need to ensure that mothers are given care during pregnancy, we need to see that children have clean water and are treated early and effectively when they have diarrhoea. There are many basic functions of any health system that are essential for the health of nations and therefore also to be able to abate poverty and these services should be available to all.
Gro Harlem Brundtland

What is the WHO doing to tackle the ever-increasing problem of resistant malaria? What is going on with administering vaccines? I have heard of a vaccine in Columbia that was not administered because the WHO opposed it?
Alex Gabriel

There is work going on to look for a malaria vaccine and sometimes we are in an advisory situation with regard to the scientific basis for these and we make our evidence-based decisions about them. Most people say it will take at least five years, and some say ten years to develop a vaccine. Resistant Malaria is a major problem, but we have made a 'medicines for malaria' venture to inspire getting new medicines for malaria onto the market.
Gro Harlem Brundtland

How can I as a private individual and a member of a wealthy country be most helpful to people in developing countries who are struggling to cope with the devastation being caused by AIDS.
Paul van den Bosch, UK

As individuals we can be part of democratic debate, entering into the issue of a global health threat, as citizens, and by that we can also increase our governments willingness to be focusing on health linked to poverty. You can support NGO's or WHO or UNICEF in the programmes.
Gro Harlem Brundtland

Does the WHO have a strategy for protecting refugees from the spread of HIV/AIDS virus, especially in refugee camps along the boards of Sudan/Uganda and Sudan/Kenya?
Akuei Malwal, Arlington, VA , USA

There is a big gap in the funding for HIV/AIDS prevention

Gro Harlem Brundtland

We work together with UNICEF on the question of AIDS, but there is a big lack of resources. I am calling for more help in Sierra Leone etc, because there is a big gap in the funding for HIV/AIDS prevention.
Gro Harlem Brundtland

Sorry if I am a little behind the flow, but regarding tobbacco. The callers seem to be thinking only from their national situations whereas the WHO must surely look at the whole. I lived in Eastern Europe for four years and was horrified at the way the tobbacco industry is able to 'push' its product. The WHO may have a perfect approach and may not always be right, but surely we should be trying to find ways in which we can get things right on a global basis and not just complain based on the effect it has on our own nation, after all it is the World's health under consideration.
Alan Harrison, London, UK

Would you please comment about whether the world community should be concerned about a future outbreak of smallpox from biological weapon stockpiles?
Mark Weiner, US

What are the results of the WHO's drive to provide access to AIDS treatment drugs? How many people have actually gained access to aids-treatment because of lower prices?
Ellen Verheul, The Netherlands

TAnti-retroviral treatment can cost $15,000 a year, and even with a reduction of 85%, the price is much too high for most developing countries

Gro Harlem Brundtland

The initiative in this case came from five companies who said they were willing to look into the issue with the UN system, so we have been working with other UN agencies and the World Bank with the companies, but it is not an easy task because the price of anti-retroviral treatment can be $15,000 a year, and even with a reduction of 85%, which has happened in some cases, you still have a price much too high for most developing countries. There are several countries that have seen this happen, in Uganda and Senegal. A lot of things are happening but it is not a success yet.
Gro Harlem Brundtland

I hope some time will be devoted to discussing the issue of the hazards from tobacco, the power of the tobacco lobby and what the WHO can and cannot do in the face of the lobby's pressures.
N. Jayaram, Hong Kong

International financial institutions are defeating the objectives of better health pursued by WHO

Mohansingh, India

Organisations such as the World Bank and the IMF in their lending decisions to the developing world insist on cutting taxes, thereby leading to drastic reduction in public expenditure that supports essential services like health and education. In applying rigid, short-term economic criteria that may be applicable in affluent societies to communities which are not so well off, the international financial institutions are defeating the objectives of better health pursued by WHO.
Mohansingh, India

Can you put the record straight on the WHO position on depeleted uranium
Ken Beddow, UK

The question is one of evidence and based on what we now know, that data that is available about the link between uranium and cancers, there is no definite reason to say it has created increased cases of cancers. However, we have a lack of information about the situation and before we have more information we cannot exclude that there is a threat.
Gro Harlem Brundtland

The target of Health For All by Year 2000 is now well behind us with little to point to in the way of success

Thomas Murray Les Carroz, France

WHO is to be congratulated for its many achievements over the years, especially the eradication of smallpox. However, much remains to be done. The target of Health For All by Year 2000 is now well behind us with little to point to in the way of success. The big pharmaceuticals - which once considered a "preferential price" for developing nations - have now reportedly taken the position that their contribution will be in Research and Development, leaving the responsibility for the delivery of AIDS therapeutics to governments. This is ludicrous. How can counties with a per capita GDP of less than $1 per day afford the purchase of these drugs? What is the prognosis for Health for All by whatever date?
Thomas Murray Les Carroz, France

Would it be possible for the WHO to establish regional research institutes to deal with local health issues so that they take into account the social, cultural and economic environment of the population they serve - instead of depending on the Pfizers and Glaxo-Welcomms of this world?
Mohansingh, Kingston

I have recently returned from East Nepal where I was teaching microbiology. WHO/AMDA/SCF and others are pouring large amounts of money into AIDS prevention, which is NOT a big problem, but I was unable to persuade them to buy a decent microscope to diagnose malaria and TB. Which should be the priority?
Anthony Mellersh, Derby

WHO's finest hour was the eradication of smallpox through innoculation. A similar worldwide effort is underway against polio. When will that be complete and what disease is next most likely to be treated in the same manner?
Peter Sime, Dunedin, New Zealand

Everyone in the world needs safe drinking water. Over 50 years have passed since man-made fluoride was first added to drinking water in an attempt to reduce tooth decay. In view of the many eminent people who still dispute its effectiveness and safety, and the massive public resistance to its use, is it not time for the WHO to do its own investigation, instead of continuing to recommend it?
Mark Barlow, Cirencester, UK

If a link between depleted uranium and serious diseases is scientifically proven, would the WHO, or you personally, support the idea of the US and the UK facing a war crimes tribunal on the issue, as Iraq has suggested?
Michael Mehr, Canada

I think the new challenge for the WHO is the spread of HIV in South Africa and Russia

Zulfiqar Ali

I believe that ever since the inception of the WHO, it has done a wonderful job in stopping the spread of different diseases in different parts of the world, especially Africa. I think the new challenge for the WHO is the spread of HIV in South Africa and Russia. I would like to suggest one thing to the WHO officials - they need to do something about the expensive medicines which not everybody can afford, and to promote and spend more funds on research into locally developed alternative medicines.
Zulfiqar Ali, Oklahoma City, USA

Do you think that your and the WHO's strong focus on the dangers of tobacco is appropriate in a world where people do not have access to safe water? It seems to me that your Western background is leading you to focus on a problem which for most people in the Third World seems a joke compared to the lack of clean water and all the diseases that come with that. Although tobacco is a great problem, the WHO should focus on things that matter and leave the tobacco issue behind until safe water is guaranteed for everyone, not only people living in Oslo or Geneva.
Hans Egil Offerdal, Mexico City, Mexico

I would like to congratulate Mrs Brundtland for her sterling work in the WHO especially in her persistent leadership of the anti-tobacco war. It takes a person of great character to spearhead such an issue. For once we see the WHO tackling an issue that touches the lives of each and every person on this planet irrespective of where they are from.
Maria Ellul, Floriana, Malta

I am concerned about the dictatorial manner of the WHO approach to tobacco.

Graeme Steel, Surabaya, Indonesia

I am concerned about the dictatorial manner of the WHO approach to tobacco. The WHO seems determined to not just to campaign in favour of public education on the risks of tobacco use, but actually is determined to outlaw it worldwide. This goes too far. I am in favour of programmes which point out the risks of tobacco use and even the implementation and enforcement of laws to prevent those under the age of 18 from smoking, but I do believe that for adults it is a matter of freedom of choice and individual responsibility. The WHO is an instrument of the "nanny state" in attempting to forbid of what it personally disapproves of. It uses tyrannical rhetoric to do this, turning all smokers into pariahs, "child abusers" and third class citizens. I accept the risks of smoking and wish to be informed about them. But in the end I wish to be allowed to make up my own mind.
Graeme Steel, Surabaya, Indonesia (British citizen)

Many people around the world are concerned that agreements made at the World Trade Organisation will lead to commercial interests being placed above health concerns in areas such as food safety and access to medicines and health services. What is the WHO doing to ensure that trade policies and the WTO do no harm to health?
Mike Rowson, London, UK

Since malnutrition is such a serious aspect of poverty, how will you persuade donors to focus upon local food security?
Aly Ercelawn, Karachi Pakistan

Misuse of benzodiazepines is becoming a new drug "plague" worldwide due to its availability and severe addictive properties. What action will the WHO be taking to tackle this escalating problem which may overtake opiate misuse?
Susan Bibby, Northumberland UK

I suggest fighting malaria has taken so low a priority because it makes only people of poor countries suffer and die

A. Chowdhry, Wirral, Merseyside, UK

What should be the priority- tackling malaria or tackling AIDS? I suggest Malaria has killed many more people and going to kill many more compared to AIDS , people who are afflicted with malaria have little choice in escaping from it, the solution is well known (eradicate mosquitoes) and relatively cheaper to achieve. Yet no single of the poor countries can achieve mosquito eradication alone, it needs a major multiregional approach. The funds to achieve this will be large but infinitely small compared to the fund being spent to fight AIDS. I suggest fighting malaria has taken so low a priority because it makes only people of poor countries suffer and die. If AIDS only affected the Africans it would have suffered the same fate as the fight against Malaria eradication. But AIDS has hijacked the agenda over diseases that cause far more devastation and cost much less to eradicate, because AIDS also afflicts people of the West. Could the WHO put its priorities right, despite the political difficulties?
A. Chowdhry, Wirral, Merseyside, UK

The WHO has done a fantastic job worldwide. However, there are areas which require support such as research in indigenous or alternative systems of medicine which are locally and cheaply available. Also, with the increasing availability of mineral water in developing countries the need to pursue the governments for safe drinking water through municipal corporations is abating. This needs to be looked at more seriously as drinking water will become more expensive and difficult to procure by the poor, thus, increasing their risk to water-borne diseases.
Armin Jamshedji, Mumbai, India

What is the WHO going to do about the situation in eastern Congo? I've lived there for 6 years and it's terrifying to see the development in this area and the lack of help from the rest of the world. The fact that Rwanda and Uganda have occupied this part of Congo is not well known and it's the civil population that suffers.
Trond Ludvigsen, Trondheim, Norway

Will the WHO reconsider its support for market solutions to health care provision?

David Price, Newcastle upon Tyne; UK

In her preface to the WHO's World Health Report 2000, Dr Brundtland says that governments should increase the role of the private sector in the provision of health care. But countries like Brazil and India, led by the IMF or World Bank to adopt pro-private sector health care policies, report that their universal public services have been undermined as a result. In the light of this evidence from less developed countries, will the WHO reconsider its support for market solutions to health care provision?
David Price, Newcastle upon Tyne; UK

Last May, you announced together with four other UN agencies and five pharmaceutical companies a 'turning point in the world's response to the poorest Aids victims'. The companies suggested a drastic price reduction for their aids drugs, which are unaffordable for virtually all aids victims in developing countries. The Washington Post recently described in disturbing detail the companies' lobby to get UN support for their initiative, and how little the companies were eventually prepared to do. Can you explain what results this initiative has brought until now? How many people have actually gained access to aids-treatment because of lower prices? Is this what you would describe a successful public-private partnership?
Ellen Verheul, Haarlem, the Netherlands

From 4-8 December in Savar, Bangladesh, the People's Health Assembly took place. More than 1500 people from over 90 countries endorsed the People's Charter for Health, reflecting the worries about WHO having lost its leading role in international health. "This Charter calls on people of the world to: Demand a radical transformation of the World Health Organisation (WHO) so that it responds to health challenges in a manner which benefits the poor, avoids vertical approaches, ensures intersectoral work, involves people's organisations in the World Health Assembly, and ensures independence from corporate interests". I would like to invite Ms. Brundtland to give her comments.
Marjan Stoffers, Amsterdam, Netherlands

The WHO should consider HIV/AIDS a priority area

Victor, Kampala, Uganda

The WHO should consider HIV/AIDS a priority area. Let us forget that it is black Africa that is most affected. Please assist all.
Victor, Kampala, Uganda

1) Do you think that the decentralisation of the WHO has proved to be successful, or do you regret the decision of spreading its offices around the world?
2) Do you believe that the lack of communication between the Bretton-Woods organisations, (World Bank and WTO) and WHO is one of the greatest threats to WHO?
3) How much of an ambassador for Norwegian opinion are you?
Arvinn Eikeland Gadgil, Tromso/Coventry Norway/England

Can I ask Mrs Bruntland why, when in Norway, the world's 2nd largest oil exporter, we pay amongst the highest rates of direct and indirect tax in the world and still people must pay to see a doctor or dentist. Compound this with having to pay sometimes hundreds of dollars a month on medicine for cancer or aids sufferers at the same time calling it a welfare state. I hope you are not running the WHO in the same way you ran the health service in Norway and your successors still are.
Philip De Vere, Sandnes, Norway

They pursue programmes that create dependence

Jim Middleton, Glendale, Arizona, USA

The World Health Organisation seems double-minded. They want to create independence in Third World countries yet they pursue programmes that create dependence. If Pakistan needs clean water, Pakistan needs to provide it. What is WHO doing to encourage needy countries to solve their own problems and address their flawed priorities?
Jim Middleton, Glendale, Arizona, USA

I would like to congratulate WHO on an excellent 2000 World Health Report on healthcare systems. This kind of objective analysis on healthcare across the world will be invaluable to policy makers and researchers who wish to develop responsive and equitable systems that promote health. Ultimately, I hope, policy initiatives like this will change systems from being government headaches into the people of the world's greatest resources. Well done!
Denis McMahon, Minnesota, USA

Although I am passionately anti-tobacco, surely the arguments against prohibition are clearly established. Driving anything underground is counterproductive, hence recent calls for the legalisation of soft drugs. In any case, the number of jobs in the tobacco industry means that a global ban would be universally unpopular for economic means. How could you justify this extreme policy?
Andy Millward, Broxbourne, UK

Don't you think your credibility as head of WHO fell a bit short when as the leader of Norway you had no compassion for and sanctioned the hunting and killing of whales in the world's oceans?
Abdulfez, Tokyo, Japan

I would like to ask Dr Bruntland what global progress has been made in dealing with the eradication of the world's most deadly insect, the mosquito? I have always held the belief that the WHO does an excellent job and long may it continue to do so.
Derek, ex-pat, Macae', Brazil

Healthy water is even more important than vaccine

Agha Ata, USA

According to a WHO report, 55% deaths in Pakistan are caused directly or indirectly by water alone. That's is true, because my two children died for the same reason. In rural areas the condition is even worse. Cattle and human beings drink water from the same ponds with still water that is full of malaria, hepatitis, diarrhoea and dysentery germs. I believe that supply of clean, healthy water is even more important than vaccine.
Agha Ata, USA

How much would it cost to provide the humanitarian aid of drinking water and sewage facilities available to everyone on this planet? How much did NATO spend on their humanitarian war in Kosovo? Which is more humanitarian - illuminating the ancient civilisations of the blue Danube, the Tigris and the Euphrates with brilliant fireworks of depleted uranium or providing the basic essentials of life like water and clean, hygienic living environment?
Mohansingh, India

Dr Brundtland became Director General of the WHO on an anti-corruption platform, however, little has changed, if anything the organization has moved further away from a genuine health-technical agency towards a more political body, witness for example the leadership of the WHO-SEARO office. What happened to the anti-corruption platform?
Jan Schmidt, London, UK

Do you support socialized healthcare and what factor did it play in the WHO choosing the nations with the "best" healthcare?
Freddie Brackhurst, Chicago, USA

Can international institutions such as the WHO really promote justice in the international arena?

Yiannis Tavridis, Thessaloniki, Greece

Mrs Brundtland was a respected politician and PM in her home country, Norway. Norway has a high profile in Third World and development issues, plus a series of regulations and moral restrictions in her international relations (especially with undemocratic regimes). Does the UN body she now leads show similar sensibility in such issues? Has Mrs Brundtland's new role given her more power to promote development in the Third World? Can international institutions such as the WHO really promote - according to her experience so far- justice in the international arena?
Yiannis Tavridis, Thessaloniki, Greece

I am a South Sudanese now living in America. My question: Does The WHO have a strategy for protecting refugees from the spread of the HIV/AIDS virus, especially in refugee camps along the boards of Sudan/Uganda and Sudan/Kenya?
Akuei Malwal, Arlington, VA, USA

WHO's Vaccination program for World Wide Populations is vital to the future survival of the populations around the planet. I am wondering if WHO will receive increased funding and supplies to keep the program going. Additionally, if WHO is looking for nurses skilled in vaccine immunizations programs to work with the program, I would like to obtain information on how I may apply to work in or promote this program.
Ann Sarkes, RN, Washington, DC, USA

Would you consider heading a campaign for the ban on the use of DU (Depleted Uranium) in ordinance?
Igor, Canada

How can pressure be applied to secure more realistic funding?

Dave Pearce, Manchester, England

Tropical diseases kill some 5 million people per year primarily in the developing countries. There are no real cures for Malaria or several other infectious or parasitic diseases. WHO run the TDR program. Its budget is a mere $24m per year. How can pressure be applied to secure more realistic funding for this neglected tragedy? MSF are sponsoring a 'neglected disease' campaign. At Okinawa the G8 promised $3 billion. Yet the WHO/TDR do not seem to be part of this solution.
Dave Pearce, Manchester, England

It was recently stated on a news report that the WHO supported the claims by the UK government that there is no credible evidence that depleted uranium is toxic, and may be responsible for the illnesses of servicemen and civilians in Iraq and Kosovo who have been exposed to it. Is that claim true? What is the position of the WHO regarding DU?
Richard Swain, Nottingham UK

Do you think the WHO has a role not only as a source of expertise and advice, but also as a "hands on" agency working directly with patients?
Matthew Newton, Zuerich, Switzerland

Why was half of the rating system in your countrywide health system comparison skewed toward socialized healthcare? Are you trying to make a political statement or are you inadvertently biased toward systems like France?
Reggie, NYC, USA

Do you ever see a time when the large drug companies will supply the developing world with cheaper medicines?
David Mercer, Wales

Given the WHO's interest in the links between poverty and disease, where do you see the priorities for poverty reduction through programmes targeting infectious diseases?
Dr Tim Inglis, Perth, Western Australia

How can I as a private individual and a member of a wealthy country be most helpful to people in developing countries?

Paul van den Bosch, Guildford, UK

How can I as a private individual and a member of a wealthy country be most helpful to people in developing countries who are struggling to cope with the devastation being caused by AIDS?
Paul van den Bosch, Guildford, UK