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Public health refers to efforts to create conditions that promote the overall well-being of populations. It therefore entails measures such as the provision of clean water, efficient waste disposal systems, and even road safety. It is thus distinguished from medical care by the fact that the latter focuses on the doctor-patient relationship. Nevertheless, the ethical principles of public health mitigations presume the ethical principles of medical care such as commitment to promoting the patient’s highest good and protecting his/her privacy.
The state of international public health has changed dramatically since the advent of COVID-19. While relatively few people had heard much about the World Health Organisation before then, almost everyone heard about it again and again once the COVID-19 tests, lockdowns, mask mandates, vaccine mandates and vaccine passports were enforced. Then talks of a Pandemic Treaty (later referred to as a “Pandemic Agreement”) and amendments to the International Health Regulations (IHRs) gathered momentum, matters about which I contributed articles to this publication in April and May 2024, respectively. Nevertheless, health freedom advocates, who emphasize the need for a human rights approach to medical care and public health mitigations, have consistently expressed deep concern about the current direction of international public health. In particular, they are concerned that international public health is moving away from a human rights orientation towards an increasingly authoritarian one.
Centralization blurring the line between medical care and public health
In an earlier article here, I pointed out that over the past several decades, there has been a concerted move towards centralization in various spheres of life, including banking, education and medical care, among others. With regard to medical care, I noted that this centralization manifests in a number of ways. Hospitals, insurance companies and governments with their varied interests all bring pressure to bear upon the doctor with regard to what course of treatment to provide for patients. In particular, hospitals founded as business outfits strive to minimize costs and maximize profits, as do the insurance companies that settle most of the bills in such hospitals; pharmaceutical companies give financial incentives to doctors who prescribe their drugs; hospitals vociferously gather data about patients’ medical histories and courses of treatment and sell these to pharmaceutical and insurance companies; governments, on their part, demand that the same doctors comply with whatever medical policies they put in place, whether out of their own initiative, or as a result of commitments that they have made to the WHO. In all this, age-old principles of medical ethics grounded in the sanctity of the doctor-patient relationship are violated with utter abandon.
Yet the centralization of medical care was most evident in the advent of COVID-19, when medical doctors were under intense pressure to deploy only those vaccines, therapeutics and medical devices approved by their governments under the direction of the WHO. This was effectively a subjecting of medical care to public health mitigation, resulting in the violation of age-old principles of medical ethics, namely, beneficence (doing good to the patient), non-maleficence (refraining from causing harm to the patient), patient confidentiality (protecting the patient’s personal information from third parties), and informed consent (furnishing the patient with adequate information about the potential benefits and harms of a course of treatment and respecting his/her decision to accept or decline it). It was even a violation of research ethics, as the vaccines were administered under Emergency Use Authorization. This meant that the vaccines were being administered before adequate trials had been undertaken to confirm their safety and effectiveness, and yet the public was repeatedly told they were “safe and effective”, thereby violating their right to informed consent.
Commercialization through medicalisation
Over the past one and a half century or so, corporatized Western medicine has sidelined and even vanquished other systems of healing through a variety of strategies. In a video titled “Dark Origins of Big Pharma”, former history professor Colin Heaton explains that in the early twentieth century, the US government, urged on by an influential businessman, banned natural healing methods, got doctors using natural remedies thrown into prisons, and had hospitals that used natural healing methods threatened with being shut down. In this way, he promoted antibiotics, vaccines and synthetic drugs (those that simulate healing properties from natural sources, often using petroleum-based substances that are cancerous), all of which are the cornerstone of Big Pharma today. He also invested large sums of money to train and employ doctors, clinical researchers and chemists who were at his beck and call, thereby putting natural healing practitioners out of operation. He then got the US Congress to enact the establishment of the General Education Board, which went on to stop federal funding for medical colleges and universities that were teaching natural healing methods. He also created strong partnerships with pharmaceutical companies in other parts of the world.
No wonder the current dominant Western approach to healing is therapies and vaccines produced by Big Pharma and approved by Western-based regulatory bodies. Recall how anyone who dared to suggest that there might be ways of managing COVID-19 apart from those recommended by the WHO was dismissed as being “anti-science”. In line with this outlook, the WHO’s IHRs and Pandemic Agreement have much to say about vaccines and therapies manufactured by Big Pharma, very little about other systems of healing, and nothing about the promotion of healthy lifestyles.
Conflicts of interests in the funding of research and approval of drugs and devices
In The Professional Ethics Toolkit, Christopher Meyers points out that a central feature of professional ethics is the imperative to refrain from conflicts of interests – situations in which people in decision-making positions on behalf of the public use the said positions for personal gain. The English say that he who pays the piper calls the tune; the Jewish people say that he who has the wallet has the agenda. In short, money is regularly used to control human behaviour not only in personal interaction, but also in legislation and in the formulation of public policy. By their very nature, conflicts of interests are injurious to the public. For example, I pointed out in a previous article that in Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Healthcare, Peter Gotzsche shows that drugs are the third leading cause of death after heart disease and cancer, and illustrates how despite the supposed oversight of health authorities, pharmaceutical companies have developed toxic drugs that have caused untold suffering to many.
Since it is often said that when the US sneezes the rest of the world catches a cold, its experience in regard to conflicts of interests is instructive for other countries. According to Dr Scott Atlas, Senior Fellow at Stanford University’s Hoover Institution, there is a very unhealthy entanglement in the control of scientific research between people in the US National Institutes of Health (NIH) with people in universities who need to get the funding to enable them to conduct research and be promoted. According to him, the people who review the grant applications also review articles for the major medical journals, so that there is a very small cartel that controls everyone’s career progression. For Atlas, this explains why scientists who depend on funding from the National Institutes of Health (NIH) found it difficult to speak out against the real Big Pharma-driven misinformation and censorship around the management of COVID-19 in the US.
The US has been influential in shaping public health policy in most countries as well as at the WHO partly because of its financial donations, and partly because of the perception that its health system is efficient and transparent, guided solely by science rather than by private interests. At the head of its health system are the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). Thus, many countries are inclined to approve any drugs approved by the FDA.
However, in 2021, Michael White, pharmacist and medication and dietary supplement safety researcher, observed that in the late 1950s the FDA refused to approve the use of thalidomide to treat morning sickness, sparing the US numerous debilitating birth defects such as the ones recorded in Europe and elsewhere. However, with the advent of HIV/AIDS from the early 1980s, AIDS activists agitated against long delays in getting experimental HIV drugs studied and approved by the FDA. Consequently, Congress passed the Prescription Drug User Fee Act in 1992, which President George H. W. Bush went on to sign into law, turning the FDA from a fully taxpayer-funded entity to an institution financed through tax dollars and new prescription drug user fees that manufacturers pay when submitting applications to the FDA for drug review and annual user fees based on the number of approved drugs they have on the market. Thus according to White, in 2021, of the FDA’s total US$5.9 billion budget, 45 per cent came from user fees, but 65 per cent of the funding for human drug regulatory activities were derived from user fees. The net effect of this change in FDA funding is that the manufacturers have acquired greater say in the approval process.
More crucially for the rest of the world, as I wrote recently, over the past four decades or so, the proportion of the WHO’s budget received as core contributions from member states has been dwindling, while specified contributions from governments, private individuals, philanthropic organizations and big pharmaceutical companies have been rising phenomenally. David Bell explains that most of the finances from private entities are strictly tied to projects chosen by the financiers. I pointed out that the import of this is that the influence of unelected entities over the WHO is increasing while that of the peoples of the world through their elected representatives is dwindling, and this is, in effect, the erosion of state sovereignty, which, as I have explained elsewhere, is the right of a state to conduct its internal affairs without any interference from other state and non-state actors.
It should therefore not have been surprising that while virologists have known about the effectiveness of natural immunity for decades, very little was said about it at the height of the COVID-19 drama, giving the false impression that humanity’s hope lay only in the vaccines, as though humanity has not weathered numerous viruses without vaccines for millennia. Yet this fact would only have been correctly factored into public health policy if conflicts of interests had been kept out of the processes of policy formulation and implementation, thereby keeping the pharmaceuticals from puppeteering the enforcement of needless booster shot mandate after needless booster shot mandate.
Thus, vaccine mandates, while issued and enforced by governments, may be directed by the puppeteering hand of pharmaceutical companies with leverage over underfunded public health institutions, so that they may be the result of conflicts of interests. Readers might recall how CEOs of pharmaceutical companies that manufactured the COVID-19 vaccines routinely appeared on mainstream media stating how often people needed to receive “boosters”. It did not seem to occur to many that anyone who sells a product cannot be relied upon to give sound advice about how much of it, if any of it at all, one ought to buy, for that would be a blatant case of conflict of interests.
Thus in February 2023, Esther de Haan wrote: “Pfizer, BioNTech, Moderna, and Sinovac made an extraordinary USD 90 billion in profits on their COVID-19 vaccines and medicines in 2021 and 2022.” According to de Haan, “SOMO’s new report Pharma’s Pandemic Profits shows that these enormous gains are largely due to decades of research funded by public investment, billions in grants for development and production, and tens of billions in Advanced Purchase Agreements (APAs) with governments.”
The securitization of public health
By “securitization” I refer to deliberate efforts to present dangers to public health as dangers to the survival of states. When states feel that their very existence is on the line, they unleash all the tools of violence at their disposal to defend themselves, which is to say that they declare a state of war. Countries in a state of war typically suspend civil liberties such as freedom of speech, movement and assembly in the name of public security, which is exactly what we saw in the advent of COVID-19 through lockdowns, curfews, vaccine mandates and vaccine passports, among others. Thus towards the end of 2021, Mutahi Kagwe, Kenya’s Health Cabinet Secretary in the Uhuru Kenyatta regime, sought to justify COVID-19 vaccine mandates by invoking the Public Health Act, whose Section 36 addresses situations in which Kenya appears to be existentially threatened by any formidable epidemic, endemic or infectious disease.
Similarly, Article 17 of the recently adopted WHO Pandemic Treaty talks of managing “pandemics” through “whole-of-government and whole-of-society approaches”. This is the language of a large and pervasive state which, at the height of the Cold War, the West routinely described as a “totalitarian state” – one which asserts the supremacy of the state as the embodiment of the will of the people. Thus, in a totalitarian state, all social, political, economic, intellectual, cultural, and spiritual activities are subordinated to the purposes of the rulers in the name of “the common good”. Put simply, a totalitarian state routinely violates personal freedoms such as those of assembly, movement and expression.
Yet, draconian measures in the name of public health have a significant colonial angle, as they have their precedents in the international sanitary conferences that France initiated in 1851, resulting in internationally standardized quarantine regulations. Thus, as Delaram Akhavein, Meru Sheel and Seye Abimbola observe, the securitization of public health has colonial roots: “International Health was shaped through the colonial encounter – the need to protect the ‘metropole’ from the periphery – as these International Sanitary Conferences sought to safeguard Europe from the perceived threat posed by ‘exotic’ diseases. Such tendencies continue to inform how international health policies (most notably those related to infectious diseases) are developed and disseminated – enabling modern sovereign powers to maximize their power and control.” They also note that “existing power dynamics in global health are produced and maintained through political processes. Securitisation of health, which facilitates urgent and exceptional measures in response to an event, is a politically charged process with the tendency to further marginalise already marginalised individuals, groups, and nations.” Such securitization also justifies the deployment of surveillance, censorship and propaganda, to which we now turn.
Enhanced surveillance through digitisation
The centralization, commercialization and securitization outlined above would be close to impossible without surveillance, which, as I pointed out elsewhere, the Merriam-Webster Dictionary defines as “close watch kept over someone or something (as by a detective)”. For millennia, the ruling classes have deployed surveillance through what we would today refer to as intelligence services – people who listen to what the subjects are saying and report back to their bosses. In 1791, British philosopher Jeremy Bentham published the architectural drawings for a panopticon, which the Encyclopedia Britannica explains was “a prison consisting of a circular, glass-roofed, tanklike structure with cells along the external wall facing toward a central rotunda; guards stationed in the rotunda could keep all the inmates in the surrounding cells under constant surveillance.”
Furthermore, as I observed in a previous article, with the advent of refined digitization now referred to as the Fourth Industrial Revolution, surveillance has become much easier to undertake and the information thus acquired much more detailed. Thus, through digital platforms, hospitals, insurance firms, pharmaceutical companies and governments all acquire the personal health information of citizens along with the courses of treatment that doctors deploy with utmost ease. Besides, personal email, social media pages, and numerous digitized government documents such as birth certificates, identity cards and passports all provide massive information about each individual. Moreover, artificial intelligence (AI) can be deployed to quickly process all this information to produce an accurate and detailed profile of each individual. The loser in this arrangement is the patient whose privacy has been reduced to shreds as a multiplicity of unsolicited and unauthorized agents treat his/her personal information like this morning’s newspaper, thereby achieving the goal of Bentham’s panopticon way beyond anything he might have imagined.
Censorship and propaganda
“Censorship” refers to any action intended to thwart the expression and dissemination of certain views and thus to influence public opinion in the direction preferred by the person engaging in it. Governments typically enforce censorship by promoting a culture of fear through threats, arrests, prosecutions, detentions without trial, and even forced disappearances and murders. Such measures also often result in people becoming accomplices of the censorship by urging each other to stay silent to avoid getting into trouble. In “Anatomy of Censorship in the COVID-19 Era”, I pointed out that with the advent of COVID-19, several measures have been deployed to promote censorship, including intimidation through distortion of science, the silencing of dissent on social media, surveillance, and propaganda. Besides, those expressing views that question official positions have been denied financial services (“de-banking”), their social media accounts have been closed (“de-platforming”), and their public appearances boycotted (“cancelling”). Besides, medical doctors with dissenting views about the COVID-19 public health protocols have had their practising licences withdrawn. It is noteworthy that while such measures are not as openly deployed as they were in 2020 to 2022, many of those who were subjected to them are yet to see the restitution that they evidently deserve.
According to the Encyclopedia Britannica, propaganda is the deliberate dissemination of facts, arguments, rumours, half-truths, or lies to influence public opinion. With the advent of COVID-19, sustained propaganda was deployed to reinforce censorship. Those who questioned official narratives about the effectiveness of the COVID-19 protocols were labelled as “conspiracy theorists”, “anti-science”, and spreaders of “misinformation” and “disinformation”, among others. Those who declined the COVID-19 “vaccines” were accused of being unmindful about other people’s welfare, and even of exposing the vaccinated to danger (a tacit admission that the “vaccines” were ineffective). Besides, articles were published in hitherto credible academic journals to reinforce official lines, the most notorious of which was the now infamous “Proximal Origin of SARS-CoV-2” in the journal Nature Medicine, which advanced the now discredited view that “SARS-CoV-2 [the virus that causes COVID-19] is not a laboratory construct or a purposefully manipulated virus.”
The unwarranted expansion of public health through the “one-health” approach
The so-called one health approach, embraced by both the WHO’s amendments to the IHRs and the Pandemic Agreement, is based on the view that the health of people, domestic animals, wildlife and the integrity of ecosystems are all so interconnected that they must be addressed jointly. While this sounds commonsensical due to the interdependence of various life forms, it is dangerous when pushed beyond reasonable limits, because it can be used to degrade human dignity by equating the value of human life to that of other life forms – a view already being promoted by proponents of deep ecology. Indeed, the One Health Initiative website declares: “One Health Initiative will unite human and veterinary medicine.”
Besides, the “one-health” approach can easily feed into the definition of “health” in the WHO’s Constitution as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. While this definition might appear holistic, it can be used to justify the WHO’s intervention in a wide range of issues such as military conflicts, noise pollution, marital dissatisfaction, road safety, or environmental pollution, among many others, thereby expanding its mandate to cover almost every aspect of human life in the guise of promoting public health.
Indeed, at the present time, the WHO’s definition of “health” is being used to reinforce the message of the corporatized environmental movement whose aim is the so-called Net-Zero, which ScienceDirect defines as “a state in which greenhouse gas emissions are balanced by the amount removed or eliminated, aiming for a decarbonized economy by 2050”. Thus, health freedom advocates are concerned that at one point the WHO might advocate for climate lockdowns along the same lines that it overtly or covertly advocated for COVID-19 restrictions, thereby again harming the most vulnerable in society while the middle class “works from home”.
Unprocedural adoption of amendments to the WHO’s International Health Regulations
On 1 June 2024, the WHO’s 77th World Health Assembly (WHA) voted in favour of Amendments to the International Health Regulations (IHRs) through Resolution WHA77.17 amidst protests from health freedom advocates. As I explained elsewhere, the WHO’s own rules in Article 55 of the International Health Regulations (2005) require that state parties be accorded a minimum of four months to consider any proposed amendments to the Regulations. This meant that in the run-up to the 77th WHA which commenced on 27 May 2024, the deadline for the WHO Director-General to submit such proposals to the WHO’s member states was 27 January 2024. However, as Dr Silvia Behrendt explains, “A new official version was first published on 17 April 2024, containing numerous previously unknown provisions. Further changes followed in a May 20, 2024 version and finally in the adopted June 1st version – none of which were properly notified within the required time… Even the Who Secretariat previously acknowledged that without a final draft by end of January, only a status report – not a vote – should occur.”
In the run-up to the 77th WHA, David Bell, Silvia Behrendt, Amrei Muller, Thi Thuy Van Dinh & others wrote an Open Letter to the WHO point out that in the Terms of Reference (para.6) of the IHR Review Committee (2022), the deadline for the Working Group on the International Health Regulations (WGIHR) to submit a draft set of amendments for state parties to consider was set at January 2024 in line with Article 55(2) of the IHRS. They further observed that although the draft WHO Pandemic Agreement and amendments to the IHRs contained significant health, economic and human rights implications, they were being negotiated unprocedurally by various committees.
Furthermore, the authors of the Open Letter to the WHO observed that the draft amendments to the IHRs had been developed with unusual haste on the premise that due to “climate change”, there was a rapidly increasing urgency to mitigate pandemic risk caused by transmission of pathogens from animals to humans (“zoonotic diseases”). This, they pointed out, was despite the fact that the alleged high risk of a pandemic in the short-to-medium term had been shown to be contradicted by the data and citations on which WHO and other agencies had relied. The position of the authors of the Open Letter to the WHO was fortified by a University of Leeds report which illustrated that the risk of such zoonotic diseases is not growing, and may even be lower than before, but the impression is easily created of heightened risk due to great improvements in technology for detecting infections (“diagnostic capability”).
Thus, there is broad agreement among health freedom advocates that the adoption of the amendments to the IHRs on 1 June 2024 was an instance of gross violation of procedural justice, as it placed at a serious disadvantage countries with limited resources requisite for an adequate interrogation of the amendments before the vote. Other health freedom advocates have misgivings beyond the violation of Article 55 (2) of the IHR (2005). For example, according to Dr Behrendt, there were violations of voting procedures for the amendments to the IHRs at the 77th WHA, including lack of transparency, lack of quorum verification, and non-compliance with essential rules. However, other health freedom advocates with whom I have spoken insist that the only violation has to do with Article 55 (2) of the IHR (2005).
Questions about negotiations for the WHO’s Pandemic Agreement
According to a WHO News Release, the WHO’s 78th World Health Assembly (WHA) adopted the Pandemic Agreement by consensus (rather than by a vote) on 20 May 2025. In an earlier News Release of 16 April 2025, the WHO had announced that its International Negotiating Body (INB) had reached consensus on a draft Pandemic Agreement. In that News Release, the WHO was emphatic that several matters against which health freedom advocates had been agitating throughout the COVID-19 era were excluded from the draft:
The proposal affirms the sovereignty of countries to address public health matters within their borders, and provides that nothing in the draft agreement shall be interpreted as providing WHO any authority to direct, order, alter or prescribe national laws or policies, or mandate States to take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns.
However, some health freedom advocates hold that the negotiations for the Pandemic Agreement have also been shot through with violations of procedure. Article 19 of the WHO’s Constitution states:
The Health Assembly shall have authority to adopt conventions or agreements with respect to any matter within the competence of the Organization. A two-third vote of the Health Assembly shall be required for the adoption of such conventions or agreements, which shall come into force for each member when accepted by it in accordance with its constitutional processes.
In early 2024, the WHO released a revised draft of the Pandemic Agreement dated 13 March 2024, less than three months before the 77th WHA in which it was to be considered, again to the disadvantage of poorly resourced countries. Besides, Dr Silvia Behrendt explains that in the run-up to the 78th WHA, it became publicly known that the WHO Secretariat intended to get the draft Pandemic Agreement adopted through consensus rather than through the formal voting procedures outlined in Article 19 of the WHO’s Constitution, prompting Prime Minister Robert Fico of the Slovak Republic to call for the WHO to adhere to legal procedure and ensure a formal vote. According to Reuters, a statement by Prime Minister Fico said that the WHO Director General Tedros Adhanom Ghebreyesus had called him and asked him not to demand a vote. If this is true, it is a gross violation of the right of a sovereign state to contribute to the WHA deliberations as it deems fit. Said Prime Minister Fico: “I reiterated that the Slovak delegation is bound by the Slovak government’s instructions to demand a vote on the pandemic treaty.” Reuters further reports that there was no immediate response from the WHO on Fico’s statement.
Another health freedom advocate, Dr Meryl Nass, is equally unhappy with the way in which the Pandemic Agreement was adopted at the 78th WHA. She writes:
…, on day 1 of the World Health Assembly (WHA), its Committee A voted to accept the draft of the Pandemic Treaty that had been ironed out by the International Negotiating Body, and present it to the full WHA for adoption. (The WHO always creates committees whose names don’t identify their purpose, similar to how it changes the names of its treaties.)
Early the next morning, before the members could talk among themselves about the BioHub or other matters, the WHO bureaucracy put the Pandemic Agreement in front of the entire WHA, where a “consensus” agreed to adopt it.
I am not adequately acquainted with the role of Committee A as distinct from that of the full WHA, but Article 19 of the WHO Constitution does not make provisions for the adoption of a treaty by consensus, but only by a two-thirds majority. Besides, I would have thought that the plenary of the 78th WHA, rather than that of Committee A, should have been the forum for a final vote.
In sum, a number of health freedom advocates hold that the WHO Secretariat created a sense of urgency in the negotiations for both the amendments to the IHRs and the Pandemic Agreement, and then went on to violate requisite procedures in the guise of responding to the purported urgency. This might also explain why the draft Pandemic Agreement released on Wednesday 16 April 2025 was clearly incomplete, with Articles 8, 15, 16 and 34 missing from it, and with two versions of Article 13. However, other health freedom advocates with whom I have spoken insist that while there was a clear violation of Article 55 (2) of the IHR with regard to how the 77th WHA processed amendments to the IHR in 2024, there was nothing substantively unprocedural about the way in which the 78th WHA adopted the Pandemic Agreement.
The WHO has indicated that its next focus is the negotiations for an annexe to the Pandemic Agreement on a Pathogen Access and Benefit Sharing (PABS) system. The system is to be designed to facilitate the sharing of pathogens with “pandemic potential”, purportedly to enable pharmaceutical companies to develop “vaccines” in good time while sharing the profits they derive from the “vaccines” with the states that shared the pathogens with them. However, the University of Leeds report which I earlier referred to points out that such a system is actually unnecessary, as the risk of pandemics due to animal-to-human transmission is much lower than the WHO and its associates claim. Besides, health freedom advocates are pointing out that since the annexe must be negotiated before the Pandemic Agreement is opened for signatures and ratifications, the 78th WHA actually voted for an incomplete document to help the WHO save face, and that this, too, was unprocedural.
Conclusion
It would be irresponsible for humanity to get by without addressing the need to prevent and/or mitigate the spread of infectious diseases around the world. However, this does not call for the kind of top-down changes we have seen in the field of public health over the past few decades. What is needed are context-specific interventions by sovereign states coupled with co-operation across borders and continents that respect the sovereignty of the individual by upholding human rights and the sovereignty of states by respecting each state’s right to conduct its internal affairs without interference from external entities. After all, the UN, of which the WHO is a specialized body, claims to be committed to democratic principles in line with its Universal Declaration of Human Rights. Clearly, international public health is desperately sick: who can heal it? An adequately informed and deeply engaged citizenry can give it a try.
