As many of us have noted lately, the federal Centers for Disease Control, known originally for their work against infectious and communicable diseases, have shifted focus in recent years to supposed public health menaces like beltless driving, gun ownership, social drinking, and suburban land use patterns. CDC director Thomas Frieden came recommended to President Obama because of his national fame as Mayor Michael Bloomberg’s health commissioner, in which capacity he oversaw portion sizes and donut recipes, restaurant smoking policies and anti‐salt campaigns, as well as the occasional infectious disease issue.
If national nannyism strikes you as bad enough, get ready for the international kind. As the Wall Street Journal noted the other day:
The United Nations‐run WHO has long been a growing irrelevance, as director‐general Margaret Chan spent the week not in Monrovia but Moscow, pontificating at a WHO conference aimed at raising global tobacco taxes. … Since the 1990s, the WHO has gradually transformed itself from a disease fighter to what Dr. Chan calls “a normative agency” that makes international public health rules and promotes political goals like universal coverage.
The ideology behind this is driven by ideas fashionable in the West, particularly that of rolling out the “tobacco control” model to other consumer goods like food and alcohol. This summer in Nature, for example, much‐quoted Georgetown law prof Lawrence Gostin outlined such an agenda under the headline “Healthy Living Needs Global Governance.” According to the abstract of his article, “researchers have identified a suite of cost‐effective NCD [non‐communicable disease] prevention measures” and now it is time for international regulatory bodies to step forward to impose them.
Stronger global governance could spur national action by providing funding, creating stronger norms and holding states accountable. The UN’s comprehensive review on progress in NCD prevention, held in July 2014, offered an opportunity for the international community to take concrete steps in strengthening global prevention efforts. This article proposes four concrete steps for a long‐term solution: creating a dedicated fund for NCD control and prevention; regulating industry to improve nutrition and restrict alcohol and tobacco marketing; altering the built environment to promote physical activity; and prioritizing prevention in all sectors of government and in the global regimes that govern NCD risk factors.
Barriers to quick adoption of such measures, Gostin laments, include “philanthropic action favoring swift wins in infectious disease control, and the framing of NCDs as an individual rather than collective problem.” That second point you might be right to interpret as annoyance at libertarians and individualists who keep arguing that people choose, and should have a right to go on choosing, what they eat. But pause for a moment to take in Gostin’s first point about how narrow‐minded philanthropy is to favor “swift wins in infectious disease control.” The rest of us may see it as inspiring, even heroic when a tech billionaire donates a zillion dollars to roll back the scourge of malaria, Ebola, or some less familiar tropical disease. If you were truly advanced, however, you would see this as a distraction from the task of organizing to regulate pretzel consumption.
Agencies like WHO promoted their mission to skeptics as a way of addressing communicable diseases that, like Ebola, can quickly jump borders. Why let it arrogate more power to itself than it would need for that purpose?