Switzerland: Free Choclate= Trouble

We were given explicit instructions in our native language. “When you enter the chocolate tasting room, you are only allowed to sample what you eat in the room. Do not leave the room with any of these chocolates.” There were about 30 different types of chocolate lined on the counter. You could move around the room, trying as many chocolates as you would like. The limiting factor for many people was lack of saliva. They consumed up to 20 kinds of chocolate, but since we were not given any beverages, the natural stopping point was a dry mouth.

 Since I consumed a large lunch composed primarily of melted Swiss cheese, my stopping point was after about 7 pieces of chocolate. After that, I just watched. I watched an older gentleman grab about 10 pieces of chocolate in his hand, cradling them tenderly, as he exited the room. I watched the chubby little boy, look around the room to see if anyone was watching, and then quietly and quickly drop a piece of chocolate into the plastic bag he was carrying. After about the 5th chocolate he had stealthily put into his bag, we made eye contact. I gave him the international “I’m watching you” sign. He started following the rules after our brief encounter. Women shoved chocolates into their purse. A few more people left with their hands, and mouths, filled with chocolates. The only explanation for my observations that I could think of was that everyone else (except me) knew that the world was going to end soon and were simply cherishing their final moments.

(Besides the chocolate factory, we also visited a cheese factory and a beautiful castle in Gruyeres. My weekend trip also included a trip to Lausanne and my first taste of fondue. Cheese+ Chocolate+ Castles= Magical Weekend)

Switzerland: WHO Funding- Facts and Problems

The WHO is funded through two sources. First, the member states fund the WHO through mandatory contributions. The amount that each of the 193 member states are required to contribute correlates with the country’s wealth and population. The second source of funding is voluntary contributions from either member states or NGOs. These contributions, termed extra-budgetary funding, are earmarked for specific diseases or countries. They fund specifically targeted programs that are set by the donors’ priorities. Within the last decade, the portion of the budget received from voluntary contribution has risen from 48.8% to 77.3%. The WHO, therefore, has full control over only 20% of its budget.

It is unsustainable to have nearly 80% of the budget come from voluntary donations and this earmarked funding skews public health priorities. For example, approximately 60% of WHO’s budget is directed towards infectious diseases while only 3.9% on non-communicable diseases and 2.4% on injuries. Yet, non-communicable diseases and injuries make up a much larger percentage of the global burden of disease (62% and 17%, respectively).

Additionally, the WHO had a $300-million deficit in 2010. At this year’s World Health Assembly, the member states corrected this budget deficit for the following two years by reducing the budget from a requested $4.8 billion to $3.96 billion. The immediate effect of this decrease in budget was laying off 300 of the 2,4000 individuals who work at the Geneva Headquarters. Part of the budget deficit can be attributed to the decline of the US dollar in relation to the Swiss franc. The dollar is the currency in which the WHO receives its contributions, while the Swiss franc is used to pay staff and other costs at its headquarters.

The decline in the budget is surprising given that funding for global health has ballooned over the past decade. Investment by all donors (including governments and foundations) in global health has increased from $5.6 billion in 1990 to $26.8 billion in 2010.

One solution to the budget problems at the WHO is to set higher member state contributions. The member states should focus on working together to set unbiased global health priorities and should avoid making voluntary contributions that are specifically earmarked for a certain country or disease. If the WHA cannot take decisive actions to fix the problem of reducing the earmarked funding, then perhaps the WHO should consider charging overhead costs for each earmarked funds in order to supplement its core budget.

Switzerland: The Art of Bullshitting

I sat at the WHO Bulletin Meeting with 4 men and women who work at WHO and who have degrees in research design. We were deciding whether to accept or reject articles that were submitted to the Bulletin. We were currently looking at an article written by MDs and PhDs from Harvard. I was observing the meeting as an intern until I heard, “Well Liz, what do you think?” I momentarily froze. I wanted to tell them I was just a little guy with little to no knowledge on the subject. Who was I to critique and study written by Harvard professors? …Or to open my mouth about research methods around the world’s experts? Instead, I spurted out, “Well, I think the study was methodologically weak since the utilization of a case-control study does not provide the necessary data needed to test their hypothesis. Additionally, incorporating the survey into the appendix would increase transparency as well as clear-up many of my questions and concerns about the research instruments and the validity of the independent variables.” I have no idea what the hell I just said. But I looked around to nodding, smiling faces. For what might be close to the first time in my life, I successfully bullshitted.

I’ve always be enthralled by bullshitters- and tricked by them too. They seem so smart. I, on the other hand, would say “I’m not sure,” or “I have nothing to add” unless I thought of something new and was greater than 75% certain I was correct. A year of pretending to be a doctor (Yeah, for sure I feel the patient’s femoral pulse. Of course I hear that heart murmur..… uhh…) really gave me bullshitting confidence. It took me 25 years to learn (while I realize it takes most other people 5 maybe 10 years to learn) that to be successful as a bullshitter, all you have to do is follow this equation. Listen carefully+ think a tiny, teeny bit+ reword what the experts just said+ add a little zest= BING!

Switzerland: McDonalds

Only 19.55 CHF (Or $22.21) to have that meal from McDonalds!!! What a deal :)