"Behind Closed Doors: Michael Bloomberg's Shadowy Grip on WHO Policy and Power"

Lawrence O. Gostin, a prominent figure in global health law at Georgetown University Law Center, who is recognized for his role as Director of the World Health Organization Collaborating Center on Public Health Law and Human Rights, described Michael Bloomberg's activism in the health field as "a meddling nanny-an elitist dictating to largely poor and working-class people about how they ought to lead their lives".


Summary

Michael Bloomberg exerts considerable influence within the World Health Organization (WHO) despite lacking an official role on its management board. Serving as WHO's Global Ambassador for Noncommunicable Diseases and Injuries and a substantial financial contributor, Bloomberg enhances his impact within the organization. His status as a prominent media figure and one of the world's wealthiest individuals further amplifies his influence, enabling him to shape decision-making processes within WHO.

Strategically leveraging his affiliation with WHO, Bloomberg not only seeks to enhance his personal and organizational reputation but also actively engages in challenging competitors and solidifying his legacy. His involvement in global health initiatives complements his business interests, particularly through the Bloomberg Terminal, a critical data aggregation platform in global financial markets that underpins his wealth accumulation.

Bloomberg's ties with WHO afford him access to crucial health data, particularly from low- and middle-income countries (LMICs), where governance gaps provide avenues for influencing political leadership through partnerships with NGOs, lobby groups, and businesses. This strategic approach not only aligns with his financial interests but also extends his global impact, shaping public health policies and practices in diverse international contexts.


What's World Health Organization (WHO) and how it operates?

The World Health Organization (WHO), established in 1948 as a specialized agency of the United Nations, plays a pivotal role in coordinating global health initiatives and responding to international health crises, exemplified most recently by its efforts during the COVID-19 pandemic. Headquartered in Geneva, Switzerland, WHO operates through 6 regional offices that oversee a spectrum of activities ranging from universal health coverage and emergency response to sustainable health system development.
WHO's financial framework relies primarily on membership dues calculated based on countries' gross domestic product (GDP), supplemented by voluntary contributions from member states, United Nations agencies, philanthropic foundations, and the private sector. While membership dues constitute a minority share, contributing less than 20% of WHO's total budget, voluntary contributions constitute the majority and are often earmarked for specific programs or initiatives. This funding structure, while essential for supporting WHO's diverse activities, also poses challenges by limiting the organization's budgetary flexibility and its autonomy in setting global health priorities.

The financial constraints faced by WHO are further exacerbated by the earmarking of funds, which can restrict the organization's ability to respond promptly and effectively to emerging health crises. Major contributors to WHO's budget include traditional donors such as the United States, Germany, the United Kingdom, and the European Commission, alongside significant philanthropic entities like the Bloomberg Philantropies, which contribute approximately 3.5% of WHO's total budget. Historically, WHO has navigated periods of financial instability, including frozen contributions from member states during the 1980s and 1990s, which compelled the organization to increasingly rely on voluntary funding. Today, voluntary contributions comprise about 80% of WHO's budget, reflecting a funding structure that necessitates more flexible and reliable financial support mechanisms to bolster the organization's capacity to respond to global health challenges effectively. However, this reliance on voluntary funding also opens avenues for influential contributors like Michael Bloomberg to exert considerable influence over WHO's decision-making processes and strategic direction, raising concerns about transparency, accountability, and the autonomy of international health governance.

What's Bloomberg's role in WHO:


Michael R. Bloomberg assumed the role of WHO Global Ambassador for Noncommunicable Diseases (NCDs) and Injuries in 2016, securing his third term during the 77th United Nations General Assembly in September 2022. His tenure has been marked by efforts to address major health challenges like heart disease and diabetes, primarily through partnerships with city leaders globally. Leading initiatives that emphasize prevention strategies, Bloomberg's team provides strategic leadership, develops evidence-based tools, and advocates for increased investments in public health, particularly in economically disadvantaged regions.

Bloomberg's influence stems from his substantial philanthropic contributions totaling $2.5 billion, with nearly $200 million directed towards WHO initiatives over the past decade. His endeavors include the Partnership for Healthy Cities and the NCD Investment Case, which aim to demonstrate the economic benefits of health interventions and advocate for policy changes. Despite these efforts, critics argue that Bloomberg's approach may prioritize technocratic solutions over addressing broader systemic issues in global health governance, potentially reinforcing existing power dynamics in international health policy.

Michael Bloomberg's influence extends beyond financial contributions to the World Health Organization (WHO), playing a pivotal role in attracting additional donors. According to the WHO's Mikkelsen, Bloomberg Philanthropies' support facilitated the creation of the organization's initial investment cases for Noncommunicable Diseases (NCDs), inspiring other donors to follow suit. Notably, Norway became the first government in 2019 to allocate specific funding within its foreign aid for preventing noninfectious diseases, influenced by Bloomberg's initiatives.

Vital Strategies:

Bloomberg Philatropies affiliated, Vital Strategies collaborates globally with governments to tackle critical public health challenges, spanning areas like air pollution, alcohol policy, childhood lead poisoning prevention, civil registration, and vital statistics. At the core of their efforts is the Data for Health Initiative, which aims to enhance data access and utilization in low- and middle-income countries. This initiative strengthens civil registration systems, establishes cancer registries, and provides global grants for data collection and analysis, enabling effective policymaking and resource allocation. The focus on these countries arises from institutional deficiencies that have hindered comprehensive data collection. The data that has been collected is subsequently presented in the Bloomberg Terminal, utilized by bussinesses and Michael Bloomberg for investment decisions. Moreover, this data enables Bloomberg to leverage NGOs, civil society organizations, and lobby groups to exert pressure on governments, thereby creating opportunities to influence the decision-making processes of these governmental bodies. This initiative aims to strengthen civil registration systems, establish cancer registries, and provide global grants for data collection and analysis, thereby facilitating effective policymaking and resource allocation.

Part of Bloomberg Philanthropies' Data for Health Initiative, Vital Strategies' Data Impact program collaborates with leading institutions and operates across 22 countries with over 90 projects. It trains personnel, produces policy briefs, and influences policy changes, emphasizing the strategic use of health data to align government priorities with public health needs.

Examples of the intervention of Bloomberg in WHO:

Michael Bloomberg's involvement with the World Health Organization (WHO) has enabled him to advance his narrative and leverage his influence to ensure decisions and actions that align with his interests. These are some examples of the controversial decisions:

a) Bloomberg and Pharmeutical Companies :

Olga Chetverikova, a Russian historian and religious scholar, criticize the World Health Organization (WHO) for allegedly serving the interests of major pharmaceutical corporations rather than global health. In 2009, Mayor Michael Bloomberg defended pharmaceutical companies and their CEOs, declaring that they "don't make a lot of money" and shouldn't be scapegoats in the health care debate. The billionaire mayor made these comments on his radio show on Friday. However, the compensation packages for some pharmaceutical executives in 2008 told a different story. Abbott Laboratories Inc. Chairman and Chief Executive Miles White had received $25.3 million, while Schering-Plough Corp. Chief Executive Fred Hassan had received $16.2 million. In 2020 during his Presidential Election campaign Bloomberg's spokesperson was Stu Loeser, before joining Bloomberg's campaign, he had been retained by Purdue Pharma, the makers of OxyContin, to help combat widespread criticism that the company had fueled the opioid addiction crisis. There are rumors that by being heavily involved in the WHO, Michael Bloomberg also lobbies for the interests of pharmaceutical companies. In exchange, these companies allegedly purchase products offered by Bloomberg.


Chetverikova claims the WHO's initiatives and events obscure its true motivations. According to Chetverikova, the WHO's ties to pharmaceutical interests have led post-Soviet states, including Russia, to rely on treatments endorsed by the organization, funded significantly by corporations like Roche, Pfizer, and Johnson & Johnson. Chetverikova critiques the WHO's shift towards prevention over treatment, attributing this to pressure from pharmaceutical stakeholders who benefit from promoting vaccines over lifestyle and environmental factors. She also criticized the WHO's reluctance to recognize the Russian Sputnik V vaccine during the COVID-19 pandemic, alleging bias favoring vaccines from financially influential countries and corporations. Additionally, she condemned the WHO's support for methadone substitution therapy, claiming it benefits companies like Eli Lilly and Company, undermining Russian authorities' drug policy efforts. In summary, Chetverikova's critique portrays the WHO as compromised by corporate interests, influencing global health policies in ways that prioritize profit over public health outcomes, particularly in Russia and other post-Soviet states. Her perspective raised concerns about the WHO's transparency and independence in its mission to safeguard global health.


b) Medicago Case:

The World Health Organization (WHO) blocked the approval of the Canadian COVID-19 vaccine Covifenz, developed by Medicago, citing a policy against engaging with tobacco-related entities, as Philip Morris was a minority shareholder in Medicago. Despite receiving approval from Health Canada and demonstrating 71% efficacy against COVID-19, WHO's decision prevented global adoption of the vaccine. This led to Medicago shutting down, causing job losses and drawing criticism from public health advocates who argued WHO's approach was excessively rigid and detrimental. The fallout impacted global vaccine equity efforts and Canada's future vaccine production capabilities.

Following WHO's rejection, Bloomberg Philanthropies funded tobacco watchdog's policy paper alleged Philip Morris attempted to leverage the decision to enhance its public image. The paper recommended governments define "tobacco industry" clearly to include all entities related to tobacco production and funding, including subsidiaries and affiliates of tobacco companies and pharmaceutical firms financed by them.


c) Philip Morris

The Foundation for a Smoke-Free World is an organization focused on smoking harm reduction founded in 2017. In May 2024, it changed its name to Global Action to End Smoking. This organization is funded by the Philip Morris International (PMI). PMI has adopted a smoke-free approach focused on transitioning from traditional combustible cigarettes to reduced-risk products (RRPs). Their strategy includes the development of smoke-free products, such as heated tobacco products (e.g., IQOS) and nicotine-containing vapor products, which are designed to deliver nicotine with fewer harmful chemicals compared to traditional cigarettes. PMI also engages with governments and public health organizations to establish regulatory frameworks that support the adoption of smoke-free products, advocating for science-based regulations that recognize the harm reduction potential of these products. Overall, PMI's smoke-free approach aims to reduce the health impact of smoking by encouraging smokers to switch to less harmful alternatives.

The World Health Organization (WHO) has cautioned Member States and the public health community regarding the Foundation for a Smoke-Free World, which has rebranded as Global Action to End Smoking funded by Philip Morris International, this organization continues to promote strategies that WHO considers misleading about the risks of tobacco and nicotine. Johns Hopkins Bloomberg School of Public Health issued a similar statement. WHO specifically highlights concerns about initiatives aimed at youth and children. WHO advises governments and public health entities to prioritize independent efforts in combating tobacco and nicotine use, urging caution against partnering with such funded organizations.

Michael Bloomberg views Philip Morris International as a significant competitor, particularly in the realm of public health policies and tobacco control. Through his influential position and financial support within organizations like the World Health Organization (WHO), Bloomberg has actively campaigned against tobacco companies, including Philip Morris. His initiatives often focus on promoting anti-smoking measures, advocating for stricter regulations, and funding research that highlights the health risks associated with tobacco use. By leveraging WHO platforms and supporting global health initiatives, Bloomberg aims to diminish the reputation and influence of companies like Philip Morris, aligning his efforts with broader public health goals and his personal stance against tobacco consumption.


d) Anti-vaping:

Through organizations such as Vital Strategies and Campaign for Tobacco-Free Kids, Bloomberg funds anti-vaping studies, public health organizations, and international NGOs. For instance, he provided over $2.7 million to the Truth Initiative through a strategic alliance grant. Critics argue that Bloomberg's funding influenced the CDC (Centers for Disease Control & Prevention) to produce negative guidance on vapor and reduced-risk products, contributing to widespread public misinformation campaigns.

Criticism of Bloomberg's impact on the WHO focuses on tweets from January that falsely claimed e-cigarette liquid is highly flammable and that second-hand vapor is lethal to bystanders. In August, a WHO report funded by Bloomberg criticized e-cigarettes, accusing the industry of deceptive marketing practices. Bloomberg's influence is also criticized for perpetuating the misconception of vaping as a gateway to smoking and for misinforming the public that vapes are as harmful as cigarettes. Despite calls from tobacco and public health experts to engage with harm reduction evidence, Bloomberg reportedly declined meetings, raising ethical questions about influential individuals imposing personal beliefs on global health policies and potentially undermining public health outcomes.


Bloomberg Philanthropies has poured $160 million in 2019 into a campaign to ban flavors and restrict e-cig advertising, a move backed by 76 public health, medical, education and parenting organizations. While that effort is aimed at the U.S., the approach is going global. The WHO recommended banning flavors in a 2021 report.


Why WHO and Health Important for Bloomberg:


Bloomberg LP, founded by Michael Bloomberg in 1981, is a global leader in financial information, with its flagship Bloomberg Terminal serving over 350,000 finance professionals worldwide. In addition to the terminal, Bloomberg has expanded its services to include Bloomberg Law, Bloomberg Government, and Bloomberg Beta, thereby broadening its market reach and service offerings. Bloomberg's success is based on delivering accurate and timely data that is essential for investment decisions and market analysis.

The Data for Health Initiative, under Bloomberg Philanthropies, extends these data-driven solutions to public health by improving data collection on births and causes of death, thus enhancing global policymaking. The philanthropic work carried out by Bloomberg-affiliated organizations enables the collection and analysis of data that is subsequently added to the Bloomberg Terminal. This process allows businesses to access critical information that is not available elsewhere, particularly data from low- and middle-income countries. This unique capability to gather and utilize exclusive data strengthens Bloomberg's market position by providing invaluable insights for investment and strategic decision-making.

What Bloomberg aims to achieve through philantropy?


Michael Bloomberg's philanthropic activities serve multiple strategic objectives beyond their charitable facade. Firstly, they bolster his influence within key political and institutional circles, enhancing his ability to shape public policy and opinion. By directing substantial funds towards causes like gun control and public health, Bloomberg not only advances his personal agendas but also cultivates a positive public image aligned with progressive values.

Secondly, Bloomberg's philanthropy acts as a form of soft power, enabling him to build alliances and garner support among influential stakeholders. His generous contributions to advocacy organizations, think tanks, and local parties create dependencies and alliances that can sway decision-making in his favor. This network-building approach extends beyond mere financial support, positioning Bloomberg as a crucial player in shaping the agendas of these entities.

Moreover, Bloomberg's charitable endeavors serve as a means to mitigate criticism and opposition. By funding community organizations and initiatives, he can preemptively pacify dissent and minimize resistance to his policies and projects. This tactic, observed during his tenure as New York City mayor, where he used philanthropy to neutralize opposition, underscores his strategic use of financial resources to maintain control and influence.

Critics argue that Bloomberg's philanthropy, while ostensibly beneficial, raises ethical concerns about its impact on democratic processes. By leveraging his wealth to fund campaigns and initiatives, Bloomberg blurs the line between genuine altruism and self-serving political maneuvering. This practice, they contend, undermines the democratic principle of equal representation and accountability, favoring those with financial means over grassroots movements and diverse voices.

In essence, Bloomberg's philanthropic activities are a calculated extension of his political ambitions, aiming to consolidate power, shape public perception, and secure strategic advantages in both electoral politics and policy-making arenas. These efforts highlight the complex interplay between wealth, influence, and democratic governance in contemporary political landscapes.


However, Michael Bloomberg's 2020 presidential bid underscored significant challenges in public perception, revealing his unpopularity among American voters as indicated by various polls. In response, Bloomberg has been leveraging his considerable wealth through philanthropic efforts in hopes of reshaping public opinion and garnering more favorable views. By investing in initiatives that address pressing societal issues like public health, education, and environmental sustainability, Bloomberg aims to pivot public perception towards viewing him as a proactive and socially responsible leader. These efforts are part of a broader strategy to rebuild trust and goodwill among the public, demonstrating his commitment to making a positive impact beyond the political arena.


Bloomberg's Investment Portfolio:


Michael Bloomberg, through his investment portfolio managed by Willett Advisors LLC, spans diverse sectors including consumer banking, insurance, energy, and retail. Notable investments include a stake in Metro Bank, a London-based consumer bank, and holdings in FGL Holdings, a Cayman Islands-based life insurance company. His involvement in the oil and gas sector, including investments in firms like White Star Petroleum, has sparked environmental and ethical concerns due to controversial practices like fracking.In addition to traditional sectors, Bloomberg's portfolio encompasses technology, media, real estate, healthcare, and utilities. Bloomberg's access to healthcare data in the U.S. is one of the reasons he is an investor in Oscar Health, an American health insurance company. His ability to leverage detailed health data informs his investment decisions and supports the strategic direction of his investments, further integrating his influence within the healthcare sector.


Case Study Kazakhstan: Assessing Bloomberg's Efforts in Tobacco Control


The effectiveness of Bloomberg's campaign can be evaluated through the various projects and initiatives executed by him and the NGOs he funds globally. Given the availability of data and the robust networks he has established within decision-making bodies, Kazakhstan was selected as a case study to assess the impact of his projects.

Despite significant investments from Bloomberg-funded NGOs in tobacco control initiatives, smoking statistics in Kazakhstan highlight a concerning trend that questions the effectiveness of these efforts. Advocacy and public health campaigns have been prominent, yet the persistence of high smoking rates suggests a need to reassess strategies and interventions.

From 2014 to 2024, Kazakhstan's anti-smoking policy has yielded minimal results, with smoking rates remaining largely unchanged. Official statistics from the Ministry of Health indicate a stable number of smokers, but independent research by Euromonitor suggests these figures are significantly understated. According to the 2019 Global Adult Tobacco Survey (GATS), the number of smokers in Kazakhstan remained steady at 2.8 million from 2014 to 2019. In contrast, Euromonitor reported 3.8 million smokers in 2019.

Despite the Ministry of Health's efforts and collaboration with NGOs like the Bloomberg Philanthropies-affiliated Temekisiz Foundation, led by Jamilya Sadykova, which advocates for the complete ban of smokeless products, the overall impact on smoking rates has been negligible. In Kazakhstan, banning alternatives to cigarettes led to unintended consequences, including increased cigarette sales and growth in the illegal cigarette market. The failure of Kazakhstan's anti-smoking strategy over the past decade is attributed to unprofessional approaches by activists and misaligned policy measures. Efforts to increase cigarette excise taxes and ban alternative products have not effectively reduced smoking rates. Additionally, foreign lobbying and funding, such as those reportedly involving Sadykova, have not resulted in meaningful progress. Sadykova, a prominent figure in Bloomberg-funded anti-tobacco initiatives, has allegedly received significant funding but has seen limited success. The influence of such activists has shaped Kazakhstan's anti-smoking strategy, often prioritizing global lobbying efforts over effective, localized solutions.

i) Hookah Culture vs. Hookah Ban in Kazakhstan


On March 14, 2013, the Chief State Sanitary Doctor issued a decree banning hookah smoking in various public venues, including catering establishments, cinemas, theaters, sports arenas, and other indoor facilities designated for mass recreation. This prohibition was expanded in 2021 to include bus stops, playgrounds, the metro, and underground passages. Additionally, the sale of tobacco products and hookah mixtures was restricted to individuals aged 21 and over, with a requirement for sellers to verify the age of buyers through identity documents. Sales were also prohibited within healthcare, educational, and sports facilities.

In August 2023, the Public Foundation "Center for Social and Political Research "Strategy," conducted an empirical study to assess the likelihood of corruption risks and compliance issues following the introduction of a ban on smoking hookah tobacco and mixtures in public catering establishments. The study involved data collection in two major cities, Shymkent and Almaty, incorporating surveys from 120 hookah consumers, 12 interviews with hookah industry entrepreneurs, and 6 expert interviews. The study revealed that representatives of the hookah industry view the ban as largely ineffective. A significant majority of surveyed industry representatives in Almaty and Shymkent reported that a robust hookah culture has developed in Kazakhstan, characterized by increased competition, the emergence of the professional "hookah man," and heightened demand for hookah products. The ban is perceived to impede industry growth and development, with negative repercussions for the state, businesses, and consumers alike. Specifically, the state forfeits potential tax revenues, government agencies suffer reputational damage, and conditions for corruption and bribery are fostered, thereby increasing business risks. Consumer survey data indicated that hookah smoking is primarily perceived as a leisure activity, often enjoyed in non-specialized establishments such as cafes and bars. Despite the ban, a significant portion of respondents indicated a willingness to continue smoking hookah in public places (40%) or at home (33%).

The study concludes that the implementation of the hookah ban has been ineffective, exacerbating corruption risks. Consequently, it advocates for the consideration of alternative or compromise solutions, such as the legalization and regulation of hookah activities. Such measures could potentially mitigate the negative impacts observed under the current prohibition regime and align Kazakhstan's approach with more effective, evidence-based policies observed in other jurisdictions.

ii) Analysis of Sadykova's Initiatives and Their Outcomes in Kazakhstan

The initiative to ban hookah smoking in public places, spearheaded by Jamilya Sadykova, has resulted in significant unintended consequences, mirroring the outcomes of her other initiatives. The prohibition, intended to reduce public health risks associated with hookah smoking, has instead fostered an environment ripe for corruption, with many hookah smokers and businesses opting to circumvent the ban. This initiative has failed to achieve its public health objectives and has stifled the development of a burgeoning industry, thereby depriving the state of potential tax revenues and damaging the credibility of government institutions. Sadykova's involvement in other public health initiatives has similarly been marked by inefficacy and adverse outcomes. For example, her campaigns against smokeless tobacco products, rather than decreasing overall tobacco consumption, have often driven consumers back to more harmful cigarette smoking. Additionally, her efforts have led to significant increases in excise taxes on cigarettes, which have inadvertently bolstered the illicit cigarette market, further undermining public health goals. These patterns of failure underscore the need for a reassessment of public health strategies in Kazakhstan, particularly those influenced by Sadykova's approach.

Conclusion


In conclusion, Michael Bloomberg's expansive influence within the World Health Organization (WHO) underscores a complex interplay of philanthropy, political strategy, and global health governance. Despite his non-official role, Bloomberg's status as WHO Global Ambassador for Noncommunicable Diseases and Injuries and substantial financial contributions have positioned him as a significant player in shaping international health policies. This influence extends beyond mere financial support, leveraging his media prominence and strategic partnerships to steer WHO's agenda on critical issues like tobacco control and public health strategies.

Critics, including prominent voices in global health law like Lawrence O. Gostin, argue that Bloomberg's involvement resembles a form of elitist paternalism, where a wealthy individual dictates health priorities to less affluent nations. This perspective raises ethical concerns about transparency, accountability, and the autonomy of international health governance under the influence of powerful donors.

Moreover, Bloomberg's philanthropic activities, while ostensibly beneficial in addressing global health challenges, also serve to enhance his personal and business interests. His investments in health data collection and analysis through initiatives like the Data for Health Initiative not only contribute to public health advancements but also integrate health data into his business operations via the Bloomberg Terminal.

In navigating these complexities, the WHO faces ongoing scrutiny regarding its independence and decision-making integrity amidst partnerships with influential figures like Bloomberg. As global health issues continue to evolve, the role of philanthropists in shaping international health policies remains a contentious topic, highlighting broader questions about the balance between private influence and public interest in global governance.


In our case study, we assessed the outcomes of Bloomberg Philanthropies' initiatives in tobacco control in Kazakhstan. Despite considerable financial support from Bloomberg-funded NGOs, Kazakhstan's smoking statistics show a concerning trend, casting doubt on the success of these efforts. The continued high rates of smoking, despite extensive advocacy and public health campaigns, underscore the necessity to reevaluate and improve current strategies and interventions.