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

[PierredeFermat]

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?

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[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

[bjourne]

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]

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]

> 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]

> 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."

[tcbasche]

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.

[PierredeFermat]

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

[dragonwriter]

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]

> 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.

[aww_dang]

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]

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?

[dragonwriter]

> 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.

[aww_dang]

Exactly, state sponsored universities could create some of the same conflicts of interest we've seen with COVID-19.

[PierredeFermat]

True. How do you think this could be overcome? Crowdfunding? Donations?

[aww_dang]

Allow competing voices to coexist without presuming to act as an arbiter of 'truth'. Politics would remain, but the end user could choose.

[kleer001]

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]

I don't think it's an ignorant opinion. How do you imagine it being solved?

[kleer001]

I don't have the hubris to suggest anything.

[krapp]

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

[PierredeFermat]

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]

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]

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.

[krapp]

>I'll agree on your definition of "politics", which - correct me if I'm wrong - is any activity that involves decision making.

I'm actually trying to imply something more realpolitik - that China defines what's political in this case.

Because understand, anything less than fully recognizing that Taiwan is a province under the lawful control of the Chinese government and submitting to that authority means this organization would be recognized by China as extremist and any Taiwanese involved with it would be considered enemies of the state, and censored at best, or arrested at worst. And the more popular and useful this organization became, the harder China would crack down on it.

This is why I'm saying an organization like this can't be apolitical - that's not something the world recognizes or allows.

[PierredeFermat]

Data/reporting scope could be made anonymous and more local; on a city/town level (e.g. "Dec 22, 2019 | Severe flu case reported in X district of Wuhan (30°34'21.2"N 114°12'30.0"E) - potential for outbreak").

At high level of exposure, as you said, the Chinese gov may track down anyone behind such report, despite the anonymity. It may even block investigative entry/inquiry to the entire city. How do we solve that? I don't know but I suppose that, in the grand order of things and following this pandemic, we shouldn't be living in a world where any government is allowed to work against such public health efforts and get us into another quagmire that we could have simply avoided, which again rolls back to international relations, politics and trade and is tricky to solve but shouldn't stand in the way of trying these things out. We can't simply give up to the way the world is set up at any point in time.

[MiddTech]

Problem with that is that "best possible outcome" is all about perspective.

I'm not sure if there is a subjective way to quantify such a thing without first taking a stance.

Once you take a stance, the only difference between you and the existing WHO is the particular stance you have taken (assuming it's a different position)

[PierredeFermat]

I don't see the problem with taking stances. The very act of thinking about such thing is a stance by itself.

You can simply take stances that would reduce harm, avoid collapse and (optionally) maximize benefit for everyone. The current stance of WHO doesn't seem to be in that realm and something could/should be done about it.

There's no action without a stance.

[tcbasche]

> let's make the good ones with the best possible outcome, regardless of their nature/definition.

Is that the best possible outcome to Taiwan? or to China? Because arguably 'best' in this case is subjective

[MiddTech]

Makes sense, but how would that be labelled. Any documentation or written/printed representation would need a label (preferably a consistent one).

Taiwan, China or just Taiwan?

What happens if you need to display a map of a contested area? any represenation you show will raise the hackles of some nation state or other.

"Which country it is shouldn't matter much." is an admirable goal, but at the risk of being pessimistic, it just isn't how nation states work.

[PierredeFermat]

You simply report/label on a very local level (city/town level) because that's what will really matter for further action. If necessary, report coordinates.

[dragonwriter]

> If a severe case was reported by medical staff

How do you, without any policy or political positions, determine what is or is not “medical staff”?

[PierredeFermat]

It's a bit disappointing that all the discussion's momentum/energy here got wasted on the letter of the proposition and not the spirit.

Clearly and pragmatically, anyone certified to work directly with patients at a hospital, clinic, etc. is "medical staff" regardless of where they are.