President Trump’s recent decision to halt funding to the World Health Organization (WHO) is not the first time the United States has found itself at odds with the WHO.
Congresswoman Katherine Clark and Congressman Hal Rogers released a report in 2019 which said that Purdue Pharma began engaging in an aggressive Oxycontin marketing strategy in the 1990s involving attempting to influence the WHO’s prescription opioid administration recommendations. The report that says that “multiple aspects of Purdue’s marketing strategy were included in two WHO guidelines on opioid prescribing” almost a decade later.
12 members of Congress sent a letter to the WHO in 2017 warning that Purdue was trying to expand international drug sales by using identical fraudulent marketing tactics to the tactics which created the United States’ opioid crisis. The letter warned that this could create a global opioid crisis. The WHO’s failure to respond to the letter apparently led to the investigation which produced the 2019 report.
The report says that the WHO published a document in 2020 called Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses (Persisting Pain in Children). This document eliminated the second step on the WHO’s three-step pain treatment model. This model originally recommended that doctors start patients on non-opioids such as Tylenol, then move “up the ladder” to a combination of low strength opioids with non-opioids. It was only recommended by the WHO that doctors move up to strong opioids such as Oxycontin if step two didn’t treat the pain adequately.
The report says Purdue’s late 1990s planning documents said eliminating the WHO’s step two in the treatment model was an important piece in their marketing strategy. Persisting Pain in Children gave Purdue what they wanted, replacing step two with moving straight to strong opioids like Oxycontin. The report says the WHO also claimed that there is no maximum dosage of Oxycontin for children, despite U.S. public health agencies saying that adults prescribed over 90 morphine milligram equivalents per day see skyrocketing rates of fatal overdoses.
A 2011 WHO document entitled Ensuring Balance in National Policies on Controlled Substances, Guidance for Availability and Accessibility of Controlled Medicines (Ensuring Balance) repeated Purdue’s claim that less than one percent of opioid pain medication patients develop dependence. The report says no scientific evidence supports this claim and many studies contradict it.
The report says that there is evidence that the content of Ensuring Balance and Persisting Pain in Children was “influenced by many organizations and individuals known to have financial ties to Purdue.”