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I I Commentary

Lorraine Mooney

Worrying about small risks is a sign of the times - at least in postindustrial economies. What sociologist, Frank Furedi refers to as
the ’anxiety about existence’ shows itself in our susceptibility to
panic about the long term health of ourselves or our environment.
It is part of man’s nature to try to improve his condition. As he
grows richer, he will tolerate less hazard and discomfort. Western
societies have come so far along this path that the remaining
dangers are no longer obvious. We would not even be aware of
many hazards that now preoccupy us if science and technology
had not developed the means to identify and measure them, and
to study their effects.
Such is our sophistication that the identification, management
and removal of risks has become the business of governments and
international agencies. But, in handing over responsibility for health
and safety to an agent, the judgement process of weighing risk
against risk - the trade-off - has been impaired. Of course, the
information necessary to make that trade-off is too much for any
individual to acquire. It is now necessary for an expert in risk
management to assess the evidence of other experts, before a
judgement can be made.
Unfortunately, cool consideration is often made impossible by
clamourers with a single implacable view of what should be done,
and who are adept at swaying public opinion. Regulation becomes
inevitable as a political expediency rather than as a problem solver,
and ’regulators ... are sometimes influenced by the public’s present
tendency toward chemophobia’ and fail to adequately weigh risks
and benefits (Malaspina 1992). For instance, US laws which prohibit
the import of produce containing chemical pesticide residue, forced
Mexican vegetable farmers in the Culiacan Valley to switch from
organochlorines to the less persistent organophosphates
recommended by the US EPA. Sadly, they are also more acutely
toxic than the ones they gave up. The consumers’ presumed gain
was made at the expense of agricultural workers in a poorer country
(Perfecto 1992).

WHO are known to recognise the value of DDT. old age. but the effort could be made. Further declaring that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being. it is difficult to say because it is so hard to understand what it means . The risk-risk trade off concerned here is balanced between the possible reproductive impairment of birds of prey and the lives of two million people a year . The international health agencies are reluctant to propose using DDT for the sake of political correctness. clothing.mainly children. to ’a state of complete physical. The new leadership of the WHO under Gro Harlem Brundtland is making its ’Roll Back Malaria’ campaign a priority. disability. sickness. At the moment. to set the standard of how things should be. or lack of livelihood in circumstances beyond an individual’s control. they are surely trivial compared to the human death toll. so it would also be interesting to see if they are brave enough to seriously consider using it again. water. education. (although Western countries stopped using DDT some have continued its manufacture) it now suffers the stigma of being rejected by the more sophisticated Americans. but there are signs that Zimbabwe is willing to try using it again to control mosquitoes. The consensus definition of these ’rights’ amongst WHO officials include ’the right to adequate food. health care. and the right to security in case of unemployment. in the case of the DDT campaign. the new leadership policy unit is busy discussing the expansion of the meaning of ‘well-being’ from the ‘absence of disease or infirmity‘ that was the understanding of the founders fifty years ago. Time and science have largely refuted the claims made against DDT. This may or may not be helpful. It is part of the WHO’Sremit to be normative. mental and social well-being’. but even if they were true. Now. reproductive health and social services.Commentary 223 As Kemm has stated. but it would be welcome if it was decided to increase the proportion of annual resources spent on it from the current five per cent. Respect for human rights and the achievement of public health goals are complementary’ (WHO 1998). That is not to say that they could all be saved. it is not even a question of a human health risk. despite there being stores of DDT all over Africa. At the time of writing details have not been released.

. There have actually been seat-belt campaigns in parts of Africa where the only vehicles for a hundred miles are aid-agency Land Rovers. how much education and what type? These statements raise more questions than they are worth. More meaningful global values such as empathy. He also suggests that WHO should defer to existing national or international agencies already operating in a country. Perhaps it is boring for WHO officials to be faced year after year with the same intractable problems to deal with. he finds that the profile of expertise in WHO offices is inconsistent with national requirements. such sentiments are of little value to those not rich enough to protect themselves from communicable diseases. Westerners want to save developing countries now from the problems that they might encounter in the future.224 Environmental Health and how it might work. but that is. cosmopolitan cities will be more enthused by health problems that are more immediate or novel to their members and funders. It is perhaps inevitable that international agencies based in rich. Now that western society has reaped the benefits of economic development in the form of long and healthy lives and high levels of consumption.a view seemingly endorsed by the WHO. And. and that their policies will reflect their own preferences. rather than help them to deal with the problems that they are actually facing today. respect for other cultures.feminism. tellingly. non-racialism and other reactionary responses to the failures of the past . universalistic and essentialist approaches to philosophy. what is expected of them. 1997). it takes them for granted. It even disparages economic growth . having found that some of the poorest countries received the smallest input of WHO resources. ethics and social policy are gradually being transformed as they come under the growing influences of multiculturalism. surely. and there is plenty more such rhetoric to philosophise over. However ’meaningful’ these sentiments are in Geneva... The way forward suggested by Dr Adetokunbo Lucas (1998) is that WHO should vary its spending in each country according to its needs. How to enforce a ‘right to adequate clothing’. rather than duplicating efforts. a deeper understanding of human rights coupled with responsibilities will replace the fads sweeping the world markets’ (Benatar. including this gem: ‘Imperialistic.

References Benatar. Bryant and J. Equity and Health for All. Gallagher. WHO at country level. Document A51/5:2. (1997). Key ethical dimensions of the renewal process at the global level: streams of global change. . WHO (1998a) Health for All in the 22st century. H. A. The Lancet. 351. J. S. in: Ethics. We further hope that Western expertise and assistance is used to help poorer people in a way that is useful to them. (1998). Lucas. Edited by Z. CIOMS.Commentary 225 amazingly. Bankowski. We hope that developing countries will not do themselves the disservice of emulating Western attitudes which are irrelevant or dangerous to them. 743-747.