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World Health Organization:
inappropriate methods

The credibility of an organisation depends on the reliability of its working procedures, which must be transparent

Each year, the WHO publishes a large number of recommendations relating to clinical practice, public health and health policy, and is generally reputed to be the supreme authority on health issues, especially in poor countries.

Unfortunately, this image is a long way from reality, and comes in for heavy criticism from the September issue of la revue Prescrire.

Experts in evaluating the quality of health recommendations investigated whether the WHO applies the rules of good practice nowadays considered vital in the drawing up of recommendations, in particular when it comes to transparency concerning the method and to drawing on systematic reviews of available evidence. Officially, the WHO’s method has been based on this approach since 2003.

Interviews with a number of WHO managers in 2004 reveal that in practice almost none of them had applied nor intended to apply these rules, and that some did not even see the value of them. They continue to rely on experts’ opinions, despite the known risks of this method in terms of lack of transparency in their choice, a weak rationale for the experts’ recommendations, and potential corporatist or industrial conflicts of interest. WHO managers have acknowledged the failings identified and promised to rectify these in future.

This survey is a reminder that an organisation, be it global like the WHO, or "supreme" like the French National Authority for Health (HAS), is only credible if it rigorously applies transparent and methodical working procedures.

©Prescrire Septembre 2007

Source: "OMS : faites ce que je dis… mais pas ce que je fais" Rev Prescrire 2007 ; 27 (287) : 697-698. 

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