World Health Organization

YMUN TAIPEI 2014Yale Model United Nations

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Dear Delegates,It is with great enthusiasm that Blake and I welcome you to the World Health Organization committee for YMUN China 2014!

My name is Aaron Berman, and I am currently a second-year student at Yale University planning to major in History of Science, Medi-cine, and Public Health. At Yale, I am an active member of the Yale International Relations Association (YIRA): in addition to working on the secretariat for YMUN China, I am also an editor for the Yale Review of International Studies and have run committees at both of Yale’s on-campus Model UN Conferences. In December of 2012, I traveled with YIRA to Beijing as part of a trip to document China’s “One-Child” policy. Outside of YIRA, I write for a number of campus publications and volunteer as a health education teacher for local middle school students.

I have been studying Mandarin Chinese since I arrived at Yale in 2012 and spent last summer studying the language in Beijing, so I am thrilled to be coming back to China for a third time! Given my interest in public health and healthcare, moreover, I am especially excited to be engaging with a health-focused committee at this conference. In particular, I am eager to see how you, acting in your roles as defense ministers, take into account the underlying international and political aspects of the pressing health issues that face our society today.

Please do not hesitate to contact us with any questions, comments, or concerns you might have leading up to the conference. Good luck, and I look forward to meeting you all in Shanghai!

Sincerely,

Aaron Bermanaaron.berman@yale.edu

YMUN TAIPEI 2014Yale Model United Nations

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TABLE OF CONTENTS

History of the Commitee

Topic A —The Toxic Pipeline: A Need for Food, Drug, and Consumer Product Intervention

Topic B—Disease Outbreak Simulation

Suggestions for Further Research

Glossary

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History of the Committee:

The World Health Organization is a specialized United Nations agency, created in 1946 to discuss and com-bat issues concerning international public health. It is a global body of leadership that directs and aids in research, provides policy recommendations based on empirical data, and sets global health standards. Its con-stitution states that its objective is “the attainment by all people of the highest possible level of health.” WHO was the first specialized agency in the United Nations to which every member nation subscribed. Its constitution was ratified in 1948, and its first leaders were Andri-ja Stampar, a Croatian medical scholar, and G. Brock Chisholm, a Canadian First World War veteran. WHO was preceded by the Health Organization, an agency of the short-lived League of Nations.1

The first primary objective of WHO at the time when it was founded was to eradicate malaria, tuberculosis, and sexually transmitted infections, as well as to improve ma-ternal and child health in compromised and vulnerable areas. The agency’s initial efforts included a mass tuber-culosis vaccination drive in 1950 and a malaria eradica-tion drive in 1955. Later, WHO began to coordinate its efforts with other international organizations, including the United Nations Development Program (UNDP), the World Bank, and the Food and Agriculture Organization (FAO). The agency also began to broaden its perspective when it enacted a resolution on Disability Prevention and Rehabilitation in 1976.2

One of WHO’s earliest and most prominent victories was the eradication of the only known human disease to be completely eliminated –smallpox. In 1967, some 15 million cases of smallpox (an incurable and often deadly disease) were occurring in more than 30 endemic coun-tries. This prompted the launching of the Intensified Smallpox Eradication Programme, which initially aimed to curb the spread of the disease through mass vaccina-tion.

Though the agency’s theoretical goal was to vaccinate 100% of the population, a regional outbreak in Nigeria provided insight into a novel and more feasible strategy. Using a new technique of surveillance and containment, vaccinating vulnerable populations and isolating infected individuals, the transmission chain of smallpox could be broken even if less than half the population received the vaccination. In this way, WHO-led efforts managed

to halt the spread of smallpox and officially released a statement in 1979 announcing global eradication of the disease. Thereby the process of institutional memory and local adaptation became essential to WHO’s prog-ress and development, setting the stage for many other global health-related achievements.3

Other historical operations of WHO included a list of “essential medicines” compiled in 1977, which forms the basis of national drug policy in both developed and developing countries. This also means that governments of sovereign states refer to WHO for guidelines regard-ing national health expenditures. In 1989, the agency began a global program to combat HIV/AIDS, followed up by UNAIDS in 1996 to coordinate comprehensive global action regarding the AIDS epidemic. In 1988, the Global Polio Eradication Initiative was established.4

Though international progress in medical technology and health policy has led to shifts in WHO’s focus, its general objectives remain the same, as outlined in its Constitution: to act as a directing and coordinating glob-al authority on health matters; to assist governments in strengthening health services; to promote the improve-ment of nutrition, sanitation, and hygiene; to collaborate with scientific and professional groups that contribute to the advancement of health; and to make recommenda-tions regarding health policy.5

Topic History A - The Toxic Pipeline: A Need for Food, Drug, and Consumer Prod-uct Intervention

The international community – an interconnected global web of trade, ideas, and culture – certainly benefits from the interconnectivity of its members. The wise Greek

194 member states of the WHO

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philosopher Aristotle once stated, “the whole is greater than the sum of its parts”, which is to say that the more that nations (“parts”) participate in exchange, the better off the expansive international community (“whole”) will be. Understanding trade and its benefits will help to better explain our discussion of product safety and, in some cases, product recall.

Our modern everyday life is filled with materialistic goods that our ancestors did not have the benefit of. These goods, in the form of foodstuffs, drugs, and consumer products, exhibit themselves in many forms and often aim to assist or facilitate our lifestyles. Follow-ing the Industrial Revolution and the switch to manu-factured production of goods, output became plentiful, prices plummeted, and access to such products became easy. In the current Technological Age, ordering nearly any good is one click away on the Internet. Now, nearly two centuries after the Industrial Age, consumers do not think twice about the safety of manufactured goods. In-dustrial production is so part of our culture, in which we assume its efficiency, expediency, and, most importantly, its safety.

Yet, product safety is a major issue in manufacturing industries worldwide that consumers often times over-look. From the United States to China, no country is immune to product defects, as myriad countries trade with one another, industries are constantly looking to “cut corners” and produce goods as cheaply as possible, and the federal agencies employed to inspect products often underperform on their tasks or, in some cases, are bribed by the many industries looking to sell such tainted goods. In the following paragraphs a summary of major instances of product recall will be discussed to provide the context in which products are withdrawn from the market in an effort for consumer protection and health safety.

In the mid-20th century, product recalls became a more prominent occurrence in the international community. While they still remain under scrutiny, vehicle recalls remain some of the earliest cases of unsafe consumer products. In 1978, the Ford Pinto, an American-made automobile with a fuel tank positioned near the trunk of the car received concerns of rear-end collisions causing the cars to go up in flames. Following a lawsuit, Ford recalled 1.5 million Ford Pintos prior to remodeling the automobile.6 In 1973, 103,000 Triumph vehicles were recalled in the United Kingdom over fears of a front

suspension collapse during driving, which, in such a situation, would disallow for proper steering.7

In 1982 yet another product safety concern made international headlines. In the fall months of that year, seven Chicago citizens were reported dead after alleged consumption of Tylenol Extra-Strength that was laced with potassium cyanide – a very potent poison.8 While the “Tylenol Killer” is unknown to this day, Johnson & Johnson, the major pharmaceutical company responsible for the production and distribution of acetaminophen (the active drug in Tylenol), recalled nearly 31 million bottles that were in circulation (a totaled $100 million in retail losses).9 Following this disastrous incident, which caused fear among the public, losses to Johnson & John-son, and the dispatch of dozens of Chicago policemen to prevent further death from poisoned Tylenol cap-sules, beneficial regulations were implemented which are still in existence today.

In fact, whenever any medication bottles are purchased from a U.S. retail store, they are mandated by the Food and Drug Administration (FDA) in the U.S. to have safety-seals that, if broken before purchased, cannot be legally be sold10. These “tamper-proof seals” were im-plemented due to the fact that prior to the 1982 Tylenol scandal, medication such as Tylenol, was delivered in the form of a capsule that was composed of two pieces that came apart easily by the use of one’s fingers. How-ever, following the scandal, the pharmaceutical industry also moved to the use of solid caplet, which are single capsule-shaped medications that cannot be opened by the hands (and therefore tainted with poisons, such as potassium cyanide).

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Following the Tylenol tampering, there was another scandal in 1986 with the intentional poisoning of Exce-drin – an over-the-counter headache/pain reliever – by a woman who tampered with the medication of her hus-band and other close individuals. She was sentenced to 90 years in prison for murder and product tampering.11

Fast-forwarding to the 21st century, recalls have be-come more commonplace as international markets have surged both in demand and in interdependence. As such, the incessant desire for goods often leads manu-facturing companies and agricultural companies to make unwise decisions that often reduce their costs, in an effort to increase profits, yet lead to unsafe products that are often recalled.

One of the best examples of this point was the beef re-call of 2006-2008 in the U.S. The United States Depart-ment of Agriculture (USDA), which ordered the largest beef recall in U.S. history, ordered 143 million pounds of beef to be removed from shelves and elementary schools (where 37 million pounds were used in school lunches).12 The recall was prompted by videos released by the Humane Society – an animal protection activist group – that showed downed cows being kicked, jabbed, and rammed by employees of the Westland Meat slaugh-terhouse. Once the USDA got wind of this news, the re-call was implemented almost immediately as slaughtered downed cows are a health hazard since they have weaker immune systems and are more prone to infections by E.coli or can have Mad Cow disease. Clearly this rep-resents a precautionary recall, as it wasn’t prompted by a sick consumer, but instead by speculation of the poten-tial health hazards, but dozens of other examples exist in which foods are found to possess harmful microbes.

A manufacturer of hamburgers, steaks, and other meat products for nearly 80 years, the Topps Meat Company in New Jersey, U.S. went out of business after the USDA recalled 21.7 million pounds of their ground beef after concerns of E. coli contamination.13 In 2009, Setton Pis-tachio –a California-based pistachio supplier – recalled thousands of pistachio products as the FDA received complaints of salmonella contamination.14 In 2009, the Swiss chocolate giant, Nestle, recalled its refrigerated cookie dough products after 66 individuals became sick after consuming the products, 25 of which were hospi-talized with kidney damage.15 The FDA and Centers for Disease Control and Prevention (CDC) warned against consumption as the products likely contained a poten-tially deadly form of E. coli.

The list for tainted food and drug contamination is quite long, detailed, and found all across the globe; not only in the U.S., UK, or China. One last example of consumer product defects is found in children’s toys. Arguably more examples of product recalls are found in the children’s toys industry than in any other manufac-turing business on the market. From choking hazards, to toxic chemicals found in toys, children’s toys represent a prime example of the need for intervention in a lucra-tive consumer product market that deals with the health and safety of our society’s children.

The previous examples represent isolated case studies that each has wide-ranging effects on society, in partic-ular for human health. China has had its own slew of food, drug, and consumer product safety issues in its past and has received international scrutiny for its im-proper regulations of such goods. The current situation in China is one that deserves international attention by a body such as WHO, as China recently surpassed the United States as the world’s largest trading nation.16 As this new title brings in revenue, it also reigns in massive

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responsibility on behalf of the Chinese government for adequately dealing with the regulation of the goods that it exports to all of its trading partners (nearly all of which are members of the WHO), in the effort to pro-vide a safer, healthier international community.

Current Situation in China

Similar to the United States’ recent product recall of the last four decades, China too has had several prod-uct safety scandals. As a major exporter of agricultural goods, manufactured goods, and pharmaceuticals, China is clearly a prime example of the topic at hand. As China began to decollectivize agriculture to the household (and not under the state) under Deng Xiaopeng’s ad-ministration in the late 1970’s, rural industry began to surge. From this point forward, Xiaopeng’s economic reforms would have rippling effects on the future state of China’s economic policy. A decade later, China began to decentralize control on privately-owned business, the Shanghai Stock Exchange reopened, foreign investments came pouring in, and economic productivity surged at a growth rate (from 1978-2005) around a 9.5% increase in GDP per year; a feat seen by no other country in the world for such an extended period of time.17

This rapid economic growth, coupled with agricultural surpluses, especially in cash crops like rice and grain, and trade liberalization that led to China becoming a major exporter of agricultural foodstuffs.18 Since 1978, China catapulted itself to become the largest producer of industrial goods such as steel, concrete, textiles, and automobiles.19 With the reduction of the overall tariff rate, trade barriers, and the aid of a globalization agenda, China has reached a degree of “openness”, with regards to its borders, that its around 63.5% of its GDP (as of 2005) is owed to trade – a figure that stood at nearly 10% prior to Xiaopeng’s reforms in the late 1970’s.20 As trade represents a significant portion of China’s econo-my, it is extremely important for China to regulate and inspect exports and imports to ensure the safety of citizens worldwide.

China’s unbridled economic growth and exports reached a turning point in 2007 when multiple Chinese exports were recalled and even banned by the product safety agencies in the U.S., Canada, Australia, New Zealand, and the European Union. These bans were in response to the reported product defects and safety concerns, leading to an overall decline in the confidence of im-

ported Chinese goods thereafter. The following sections will be broken down into the type of product safety and the response on behalf of China and its various agencies in order to remedy the issue at hand.

A. Food Safety

From counterfeited baby formula in 2004, to the car-cinogenic Sudan I red dye in 2005, to turbot fish being fed carcinogenic metabolites in 2006, no year was as bad for food safety in China than 2007. In 2007, there was palpable unrest seen amongst Chinese citizens. Notably, in May of 2007, the General Administration of Qual-ity Supervision, Inspection, and Quarantine (AQSIQ) revealed to the public that two Chinese companies intentionally exported pet food ingredients to the U.S. containing melamine, which can cause kidney failure and, ultimately, death.21 AQSIQ did what transparent international organizations call “name and shame”, in which the two companies – Xuzhou Anying Biologic Technology Development Co. and Binzhou Futian Bi-ology Technology Co. – were found to intentionally add melamine to wheat gluten and rice protein in order to meet the contractually demanded amount of protein in the pet food that was exported.

This instance of “cutting corners” represented one of the largest pet food recalls in U.S. history, in which the harmful fake protein, melamine, caused the death of 8,500 pets. This adulterated and mislabeled pet food cer-tainly gained the two aforementioned companies more profits, except in this instance the “name and shame” tactic by AQSIQ led to their products’ recall in nearly 100 brands. In addition, AQSIQ responded by shutting down both companies for their non-compliance with international food standards. In late April, 2007 the U.S. FDA banned all imported gluten and protein vegetable

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goods – for either human or animal consumption – from being sold.22 Lastly, the Chinese Foreign Ministry banned the use of melamine in food products on April 26, 2007.23 Lastly, in October of 2007, the WHO com-mended Li Changjiang – the head of AQSIQ at the time – on the efforts that China had made following the initial crisis in May. AQSIQ had arrested hundreds and was quoted saying, “Every country in the world should join hands cooperatively to improve and ensure food safety”.24

The year 2007 was certainly a blow to China’s interna-tional trade and confidence with its major trading part-ners ebbed. However, to their dismay, yet another set of scandals continued to plague the Chinese nation. In January of 2008, Japanese citizens who consumed Chi-nese-produced pork dumplings suddenly became very sick, after which it was discovered that such dumplings were contaminated with a prominent toxic insecticide called methamidophos.25 After inspection, it was also found that pesticides were found in these dumplings as well. The Ministry of Public Security (MPS) in China underwent investigations and stated a month later that the methamidophos was likely added to the dumplings in Japan, although Japanese authorities claim that there must have been contamination in China prior to export.

Later that year, in September, what became known as the “Chinese milk scandal” was the largest food safety incident in Chinese history. A massive outbreak of kid-ney disease or failure in infants ages 3 years and below was seen all throughout China. A reported 294,000 babies fell ill, 52,000 were hospitalized, and 6 died.26 It was found that the culprit was baby formula tainted with melamine, likely for the same reasons discussed above. The major supplier of the milk – Sanlu Group – a well-known Chinese brand was artificially spiking the pro-tein content in the baby formula by adding the harmful contaminant melamine. Sanlu, however, claimed that the problem came from milk suppliers, although many international groups believe that is unlikely as melamine addition was likely a corner-cutting effort by Sanlu to make greater profits in the short term. Sanlu was or-dered to cease production, destroy, and recall all of its baby formula products. Following the incident, nearly 25 countries stopped importing Chinese dairy products as they banned all milk products at their respective federal levels.27

The WHO responded by asking why it took so long for the news of contaminated milk to reach the public. The WHO believed that there had been a cover-up of a pre-vious inspection and thereafter urged Chinese safety au-thorities and institutions to conduct mass dairy product inspections.28 The Chinese Ministry of Health put out a statement in October, 2008 stating that the legal limit for melamine content in baby formula is 1 part per million (ppm) or 1 mg/kg, and 2.5 ppm in other dairy products. The Chinese CDC noted that any melamine content above 1 ppm would be suspicious and highly indicative of melamine addition being intentional.29

After the milk scandal in 2008, China’s image and reputation for a high-quality exporter of food became tarnished. In addition, Chinese citizens realized that this instance was a prime example of corruption with-in the many inspection agencies in China. In fact, two individuals who were highly linked to the lacing, pro-ducing, and selling of melamine-contaminated formula were sentenced to death, three were sentenced to life in prison, and two others were prisoned for 5-15 years. The above examples are just some of the many horrible instances of food security scandals that have occurred in China and the response by both internal and interna-tional institutions. Yet, even with the many legal changes in China, the firing and hiring of new officials to head agencies like AQSIQ, and collaboration with its trading partners in inspections doesn’t seem to be enough, as it may not occur to a degree that is required for thorough examination. In addition, food safety scandals happen annually, even after legislation was passed. In 2013 alone, there were numerous meat recalls and claims of cat meat being shipped from slaughterhouses across China. This is clearly an issue that deserves international attention.

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B. Drug Safety

Analogous to the United States, China has had its fair share of drugs safety issues in the past. In 2007, it was discovered that hazardous toothpaste products from China were being sold in international markets. The first to respond to suspicion of toothpaste hazards in two toothpaste brands from China – Spearmint and Trileaf Spearmint – was the European Commission’s RAPEX system, which is an EU-wide rapid alert system that facilitates the dissemination of risks of potentially harm-ful non-food products.30 The toothpaste products were found to possess diethylene glycol (DEG), an antifreeze cousin chemical that is very toxic when consumed. In fact, more than 50 people were killed in Panama as a result of Panamanian medicines possessing DEG from a batch of poisoned Chinese toothpaste. Following Spain, Italy, and Portugal immediately took these toothpastes off of their shelves, tested the medicine for DEG con-tent, and found toxic levels in the toothpaste. In addi-tion, the Dominican Republic and Australia reported receiving deadly batches of toothpaste and the U.S. FDA temporarily banned toothpaste made from China.

Consistent with corner-cutting mentioned above, the addition of DEG is a cheaper way of thickening tooth-paste – a job usually reserved for the chemical com-pound known as glycerol. While companies certainly saved money in producing these toxic toothpastes, they also received immediate international attention, recalls, as well as shame. In the same year, the Chinese gov-ernment cracked down on a senior Chinese official – Zheng Xiaoyu, the former head of the State Food and Drug Administration (SFDA) from 1998 to 2005 – for bribery charges. Zheng was convicted of taking nearly $1 million in bribes from companies and individuals in order to allow their products to bypass the necessary and mandated inspections. Many of these goods, includ-ing the tainted toothpaste, that were responsible for the deaths of many individuals in China and abroad have been linked to the dereliction of Zheng.31 Zheng was sentenced to death by trial court in Beijing. This move was seen as a bold one by the international community and many believe it was in response to the spate of 2007 scandals that China had to deal with.

Zheng was found to have personally approved unsafe medicines after taking bribes from pharmaceutical com-panies. This counterintuitive twist of fate becomes even

more nauseating when the scale of bribes is realized. It is reported that Zheng personally approved anywhere from 150,000-170,000 new medicines each year as head of the SFDA. If this number doesn’t seem alarming to you, the U.S. FDA approves around 140 medicines per year. Chinese officials sought to reapprove or deny many of those undetected approvals after Zheng’s execution.

A last example of counterfeit medicine that was export-ed from Chinese pharmaceutical companies occurred in 2008, in which heparin – a blood-thinning molecule – was found to cause at least 80 deaths of U.S. citizens and nearly 800 reports of serious injuries and health complications.32 The U.S. FDA found that the culprit in this case was synthetic, in vitro produced derivative of a sulfur-containing compound in heparin. This caused the heparin starting material to be much cheaper, however the counterfeit products created major health prob-lems in those patients taking the medication. The FDA recalled heparin batches from across the U.S. and even inspected the Chinese heparin supplier. It found that the facility was not up to cleanliness and health-grade stan-dards. However, it should not be the job of the United States FDA to be inspecting a Chinese company when-ever it wants to engage in trade. This, along with the above examples, represents major flaws in the inspecting agencies responsible for the counterfeit drugs.

C. Consumer Product Safety

In 2007, the children’s toy industry in China took a major blow to production, as a number of scandals and recalls became almost commonplace. However, the main issue at hand in these toys was relatively similar: lead paint. RC2 Corp, for instance, recalled its Thomas & Friends wooden train toys because of the degree of

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lead paint in their products.33 Marvel Toys and Dolgen-corp soon followed behind RC2 by pulling its Curious George Plush dolls and Children’s Fashion Sunglasses, respectively, from the market due to excessively high levels of lead paint on the surface of their products.34

In November of 2007, Australia’s Toy of the Year, known as Bindeez, that was imported from China was readily recalled after officials realized that the toys were coated with a chemical that, when metabolized, is a known anesthetic called GHB (or, as some people call it, “grievous bodily harm”). GHB is an illegal drug in many countries, including Australia, U.S., UK, Canada, and others. This compound is the active ingredient in “date-rape” drugs and can kill humans at high enough doses. In Australia, three children became suffered seizures and needed intensive hospital care after they swallowed the GHB-coated toy beads. It was found that the dangerous chemical 1,4-butanediol was introduced in the manu-facture of Bindeez, whereas the safe 1,5-pentanediol is normally used. 1 million Bindeez toys were recalled in Australia.35

However, the world’s largest toy company – Mattel – received the biggest blow to their toy production, by recalling millions of products, in a short span of four weeks from August 1 – September 4, 2007. On August 1, Mattel recalled 1.5 million of its Sesame Street and Dora the Explorer toys due to the unapproved levels of lead paint used. On August 14, 7.1 million Polly Pocket toys, 600,000 Barbie dolls, 1 million Doggie Daycare toys, and thousands of others due to exposed magnets that can be swallowed by children. In just two short weeks, Mattel had to recall millions of its toys. Interestingly, all of the recalled toys were manufactured in China.36 Two weeks after that, 800,000 Barbie doll

accessories were recalled due to the outer lead paint found on such toys. It is well known that nearly 80% of the world’s supplies of toys are manufactured in China. Thus, these four weeks in late 2007 sent a shock throughout parents worldwide who previously felt like they didn’t have to worry about the safety of the toys their children played with.

In fact, this incident took such a toll on the Chinese toy manufacturing industry, that the co-owner of the Lee Der Toy Company, a company which supplied Mattel with the Sesame Street and Dora the Explorer toys, committed suicide at one of their factories. On August 11, 2007, Zhang Shuhong was found in an abandoned factory where he hanged himself, likely due to the stress of the millions in recalls in the toys that his company manufactured.37

The deputy policy director of the SFDA, the organiza-tion that Zheng Xiaoyu headed, named Yan Jiangying was quoted saying, “As a developing country, China’s current food and drug safety situation is not very sat-isfactory because supervision of food and drug safety started late. Its foundation is weak so the supervision of food and drug safety is not easy.”38 In other words, the rapid expansion of the Chinese economy in four, short decades outpaced China’s infrastructural capacity to reg-ulate and inspect every single aspect of its food, drug, and consumer product exports. Yan’s statements were not too optimistic about the future of China’s food and drug regulation. However, as will be discussed below, it will be up to the WHO to attempt to try and irreversibly change this for China. The days of toy recalls, counter-feit drugs, and contaminated foodstuffs are over. China, like many other developed nations on the planet, certain-ly has the capability and resources to properly inspect and regulate its goods. However, just as each aforesaid recall involved many nations in the international com-munity, it is therefore up to the international community as a whole to come up with better solutions for food, drug, and consumer product safety in China.

D. Chinese Government Departments for Product Safety

China’s infrastructure for product safety has changed throughout history and has included as many as a dozen government departments, agencies, and ministries under the State Council. Such institutions are:

· National Health and Family Planning Commis-

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siono This institution included the former

Ministry of Health, which was dissolved in March, 2013.

· China Food and Drug Administration (CFDA – formerly the State Food and Drug Administra-tion, or SFDA)

o Founded upon the SFDA (which was created in 2003), although the name officially changed to the CFDA in March 2013, and this agency is directly below the State Council containing ten depart-ments that regulate and oversee aspects of food and drug law.39

· State Drug Administration (SDA)o Established in 1998, yet it merged with

the SFDA in 2003, it is a consolidation of many former agencies that dealt and deals with drug policy.

· Ministry of Agricultureo Often handles regional farm-level food

safety policies, as well as animal health. Chemical usage, such as pesticides, falls under this Ministry’s purview.

· State Administration for Industry and Com-merce (SAIC)

o Directly under the State Council and has many duties (as listed in their mission)40, but it works to enforce market standards.

· General Administration of Quality Supervision, Inspection, and Quarantine (ASQIQ)

o A law enforcement agency that has nu-merous departments that supervise food exports and imports.

· Ministry of Commerceo Many food trade and other domestic and

international market scandals fall under the domain of this Ministry.

· Ministry of Science and Technology (MST)o Regulates product quality and attempts

to improve production, manufacture, and quality of market products.

· National Institute of Nutrition and Food Safety (NINFS)

o Research institution that aims to study nutrition, food hygiene, and food borne illnesses.

· National People’s Congress (NPC)o Primarily responsible for food safety

laws. It passed the Food Hygiene Law of

1995, which continues to regulate most food-related issues to this day.

· Chinese Center for Disease Control and Preven-tion (CCDC)

o While not under the State Council, the CCDC works to improve the health of the Chinese public through research, ed-ucation, and information dissemination during disease outbreak.

What is important to note is that there is no single agen-cy in China responsible for all of China’s food safety regulations, inspections, and laws like there are in other countries in the international community. This often leads to department overlap between the many organi-zations above. In addition, China has local, regional, and national levels of agencies that have no clear-cut hierar-chy. The SFDA (as discussed above) was created primar-ily to resolve many of the bureaucratic discrepancies, although it has yet to fully deal with this.

Our committee, the WHO, needs to come up with a comprehensive plan to better deal with the outbreak of food, drug, and consumer product contamination, identifying populations at risk for contact with a said contaminant, providing proper medical attention to those affected by the contaminated products, facilitating collaboration between China’s internal aforementioned agencies and those of the international community, assisting in altering the legal framework of China follow-ing an outbreak, as well as helping to prevent any such instances from ever occurring.

Questions to consider:

• Even though the SFDA was created in order to resolve the extensive overlap and bureaucracy seen with the numerous institutions beneath the State Council, it is still quite inefficient and many of the agencies are not fully aware of which institution is most responsible for a given crisis. Thus, how can Chinese citizens raise complaints about food, drug, or consumer product secu-rity effectively? Also, does this structure lend itself to some of the improper inspections seen before? That is, could inspections be carried out in a more appropriate fashion if there were more clearly-defined roles of each agency?

• The case with Zheng Xiaoyu, the former head of the

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SFDA, was quite a bold response on behalf of the Chinese courts to many of the drug recalls of 2007. Zheng appealed to the death sentenced, and eventually lost, as he thought the punish-ment was too austere. There is something to be said for either side of Zheng’s case, although the evidence for his indictment is crystal clear: the SFDA, a federal institution, received bribes to pass thousands of drugs through the pipeline annually, regardless of proper safety tests. How can we ensure corruption of this magnitude doesn’t occur again? Should the drug approvals been checked by a higher institution? What does the difference between China’s massive drug approval (~150,000/year) versus that of the U.S. (~140/year) say about drug safety, or, alterna-tively, about the stringency of inspections?

• Melamine made its way into international headlines on multiple occasions, despite the laws created by China in response to the pet food scandal in 2007. Most of the topics above discussed Chi-nese exports harming the citizens and children of other nations, however, the 2008 milk scan-dal affected hundreds of thousands of Chinese infants. Thus, do you think China did enough in response to its largest dairy product recall in history? Other than laws, what other ways can China ensure that the toxic artificial source of protein doesn’t find its way in any other prod-ucts?

• China is a very sectionalized or regionalized nation, in which its food and drug safety standards actually vary across the country. Maybe the most difficult issue in dealing with the crises presented above are that streamlined, blanket, or national food and drug safety standards haven’t been estab-lished, so reform is very hard to do. In addition, inspections that are left up to regional offices might be responsible for the unsafe products that have been shown in the news in the last decade. Is there a better way to make food, drug, and consumer product safety regulations more binding? What happens to farmers, manufac-turers, and companies who do not follow these regulations or who do not pass inspections?

• The main crux of this topic is “corner-cutting” or the idea that to make a quick profit, one can

easily substitute something that’s cheaper, but something that’s potentially hazardous. As we have seen in many of the examples above, from melamine, to DEG, to 1,4-butanediol, many Chinese companies, from agricultural, to phar-maceutical, to industrial, all seem to have the desire to make profit over the desire to provide a reliably safe product. How can the international community and the members of the WHO more appropriately change this mindset of Chinese corporations? Does it start with regulations or sanctions? Does it start with more oversight? Can partnerships be created with foreign na-tions to better check the safety of these goods? Should institutions like the FDA play more of an active role in Chinese society, or is this impinging upon national sovereignty?

Role of the Committee

Today the World Health organization has a budget of almost four billion US dollars and acts as the United Nation’s principal health advisory organ. WHO continu-ously monitors the global health landscape and assesses new trends in health. It is the leading authority on inter-national health issues within the United Nations and sets standards and guidelines for health. WHO experts help countries to address their public health needs by con-ducting research and identifying promising practices in health. WHO also serves as a network for governments to jointly tackle global health problems. Currently, the organization has 193 member countries and two associ-ate members.

As the most recognized player in the international health sphere, WHO provides health leadership and deals with health-related emergencies or initiatives that require joint effort. WHO sets a research agenda and creates publications on a wide range of health issues in order to disseminate critical knowledge. Furthermore, the orga-nization sets reasonable goals and standards for public health, with means of monitoring the implementation of these standards. WHO also contributes to health by setting research-based, ethical policies. Lastly, it serves in a supporting role by providing technical support to help nations around the world build holistic, quality, and sustainable health systems.

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Suggestions for Further Research

• WHO Official Site http://www.who.int/en/

• World Bank: Health http://www.worldbank.org/en/topic/health

• WHO Publications http://www.who.int/publica-tions/en/

• NYTimes Food Safety in China http://topics.nytimes.com/top/news/international/countriesandterri-tories/china/food-safety/

• NYTimes Consumer Safety and China http://topics.nytimes.com/top/reference/timestopics/sub-jects/c/consumer_product_safety/china/

• NYTimes Drug, Health, and Product Safety in China (some articles in this series tracked the poisoned Chinese toothpaste as it made its way to Pana-ma) http://topics.nytimes.com/top/news/inter-national/series/toxicpipeline/

Glossary:

Product safety: The ability of a product, whether a crop or a drug, to be safe for its intended use. Each nation possesses its own set of rules for what is deemed the minimum level of “safe” for a given product.

Product recall: A request by consumers, regulators, or federal agencies of a specific batch or an entire good in response to the discovery of a health hazard due to a product defect.

E. coli: A bacteria that, for the most part, is harmless. However, some strains of E. coli can lead to food poisoning by causing gastroenteritis and urinary tract infections. Food contaminated with E. coli are often immediately recalled.

Salmonella contamination: Salmonella is a type of bac-teria, related to the E. coli family, that can cause food poisoning, enteritis, and even typhoid fever, depending on the strain.

Melamine: Melamine addition artificially boosts the nitrogen, or protein, content in a given food. When absorbed into the bloodstream, it crystallizes which can

block and damage renal (kidney) tubes, often causing acute kidney failure.

Diethylene glycol (DEG): An organic compound that when found in consumer products, can exhibit severe toxicity in humans often resulting in death.

Lead paint: Lead is added to paint in order to quicken the drying period, resist corrosion, and increase the durability of whatever the paint is coating. Exposure to lead has been known to cause nervous system dam-age, kidney damage, and other health complications. It is banned in the U.S. and UK, although not banned in many other nations.

(Endnotes)1 http://thewho.com/history/

2 http://whqlibdoc.who.int/trs/WHO_TRS_668.pdf

3 http://www.who.int/features/2010/smallpox/en/

4 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6224a5.htm

5 http://www.opbw.org/int_inst/health_docs/WHO-CONSTITUTION.pdf

6 http://content.time.com/time/specials/packages/arti-cle/0,28804,1908719_1908717_1908696,00.html

7 http://en.wikipedia.org/wiki/Product_recall#cite_note-Autocar197308-2

8 http://content.time.com/time/specials/packages/arti-cle/0,28804,1908719_1908717_1908535,00.html

9 Emsley, John. Molecules of Murder: Criminal Molecular and Classic Cases.Cambridge:Royal Society of Chemistry, 2008, p. 174.

10 http://www.gpo.gov/fdsys/pkg/USCODE-2010-title18/

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TOPIC B: Disease Outbreak SimulationCurrent Situation

Two salient examples reflect the growing global threat posed by infectious diseases in the 21st century, the first being the pandemic of severe acute respiratory syn-drome (SARS) that seized the attention of global media in 2002 and 2003. On November 16, 2002, a business-man living in Foshan, a small town in the Guangdong province of China, fell ill with what was then diagnosed as a case of atypical pneumonia. Several weeks later, a chef specializing in exotic wildlife presented similar symptoms and was transferred to a hospital in Guang-zhou, the capital of Guangdong. By the end of the year, dozens of cases of the same disease had been reported throughout the province.

Despite initial confusion and difficulty in isolating the pathogen behind these cases, the mysterious ailment was identified as an entirely new disease: severe acute respi-ratory syndrome (SARS). In a matter of months, SARS had spread to nearly 30 nations, likely by way of expo-sure through air travel, infecting thousands of otherwise healthy civilians. By the time the epidemic subsided at the end of 2003, the disease had infected 8,098 people and killed 774.

However, what makes SARS notable from a biosecurity standpoint is not its death toll, but rather its implications for future, deadlier epidemics. For one, international air travel has created a so-called “global village” wherein a virus can leap from even the remotest of areas and become a global crisis within weeks or even days.

In light of this development, many epidemiologists consider SARS an unequivocal call for “better global citizenship” on matters of transnational importance, stressing the need for full disclosure on time-sensitive is-sues with global consequences (the Chinese government, for example, had initially been reluctant to report SARS cases to the WHO).

Another important development in biosecurity measures came with the case of Andrew Speaker in 2007. Speak-er, an Atlanta native, was diagnosed with a rare form of multi-drug-resistant tuberculosis (MDR-TB) in May 2007. After his diagnosis, Speaker flew commercial to several different nations, including France, Greece, Italy, and Canada, before returning to the United States.

During Speaker’s travels, however, confusion arose as to the severity and contagiousness of his tuberculosis, and European health officials speculated that he might have been suffering from extensively drug-resistant tuber-culosis (XDR-TB), a much rarer form of the disease. Both European and American CDC officials attempted to apprehend Speaker and force him into isolation, and US border security came under scrutiny for allowing Speaker to cross the US-Canada border without issue.

While Speaker, as it turned out, suffered from a much more treatable form of tuberculosis, the entire case nonetheless raised grave concerns over the protocols surrounding international travel barriers in the context of diseased passengers.

As far as this body is concerned, when considering these recent disease outbreaks, it is crucial to consider the sociopolitical and environmental factors that have the potential to exacerbate future epidemics. Laurie Garrett, a leading infectious disease epidemiologist and bestsell-ing author, argues in her book The Coming Plague: Newly Emerging Diseases in a World Out of Balance that certain ‘destabilizing’ factors not only facilitate the spread of diseases, but also increase the severity of outbreaks worldwide:

“While the human race battles itself… the advantage moves to the microbes’ court. They are our predators and they will be victorious if we, Homo sapiens, do not learn how to live in a rational global village that affords the microbes few opportunities.”

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Garrett and other leading global public health experts argue that this destabilization has come as a result of the breakneck speed globalization and industrialization the world has seen in the past century: human activity, including warfare, has increasingly impinged upon the natural world, collapsing and simplifying ecologies and leaving certain ‘gaps’ for infectious diseases to exploit.

What is more, it has been argued that the same reck-less human behavior has led to the advent of entirely new strains of disease—strains that are often resistant to common methods of treatment. Such strains come about as a result of frequent abuse and misuse of anti-biotics as well as reckless application of disinfectants, to which certain bacteria and viruses can develop immu-nity. The aforementioned case of Speaker’s XDR-TB is a prime example, as are recent outbreaks of Methicil-lin-resistant Staphylococcus aureus (MRSA) and several new influenza strains in the United States.

Similar links have been established in the aforemen-tioned case of SARS, with China’s rapid urbanization and accompanying “Era of Wild Flavor” contributing to the genesis of the disease, and an increase in inter-national travel responsible for the disease’s quite literal overnight spread around the world.

Delegates must decide how to effectively implement pol-icy that can work towards effective transnational coop-eration towards the management of infectious diseases while simultaneously respecting the political consider-ations that will undoubtedly come into play when deal-ing on a nation-to-nation basis.

QUESTIONS TO CONSIDER· What biological risks are associated with global-

ization and the explosion of international com-merce in the 21st century? How can these risks be minimized without sacrificing international communication and cooperation?

· Under what circumstances should travel restric-tions be imposed on the general population in order to implement biosecurity measures? Who has the authority to implement travel restric-tions? What are the ethical and political implica-tions of such restrictions?

· How much power do transnational organiza-tions, such as the UN and the WHO, have with regard to individual governments and the man-ner in which they respond to biological crises?

Using the case of SARS as an example, when should we consider full disclosure to the UN and WHO mandatory?

· Under what circumstances, if any, should trans-national organizations such as the WHO super-sede the authority of national governments on matters of bioterrorism and biosecurity?

ROLE OF THE COMMITTEE

For this half of the committee simulation, delegates will be faced with a crisis-like situation in which the mem-bers of the World Health Organization must respond to the outbreak of a new, unknown disease. Since the WHO does not necessarily have enforcement pow-ers of its own, these reactions will come largely in the form of directives and recommendations to individual governments or other transnational organizations as to how to react to the disease. Delegates in this committee, representing the interests of their respective member countries, must therefore consider and try to minimize the disease outbreak’s effect on citizens of their own countries, while also acting in the interest of overall se-curity and stability on a global level. Furthermore, since delegates will not know the details pertaining to the outbreak and spread of the disease until the conference itself, delegates must come prepared with a solid under-standing of the issues and questions they will take into consideration before reacting to new information about the disease outbreak.

SUGGESTIONS FOR FURTHER RE-SEARCHGarrett, Laurie. The Coming Plague: Newly Emerging Diseases

in a World Out of Balance.Greenfeld, Karl Taro. China Syndrome: The True Story of

the 21st Century’s First Great Epidemic.US Centers for Disease Control and Prevention. “Severe

Acute Respiratory Syndrome (SARS).” http://www.cdc.gov/sars/

World Health Organization. Global Alert and Response: SARS. http://www.who.int/csr/sars/en/

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GLOSSARYBiosecurity. Security against the inadvertent, inappro-priate, or intentional malicious or malevolent use of potentially dangerous biological agents or biotechnology, including the development, production, stockpiling, or use of biological weapons as well as outbreaks of newly emergent and epidemic disease.

Drug resistance. Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial or anti-biotic in curing a disease or condition. More commonly, the term is used in the context of resistance that patho-gens have “acquired,” that is, resistance has evolved. When an organism is resistant to more than one drug, it is said to be multidrug-resistant.

Epidemic. Epidemics occur when new cases of a cer-tain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience.

Quarantine. Quarantine is used to separate and restrict the movement of well persons who may have been ex-posed to a communicable disease to see if they become ill. Isolation separates ill persons who have a communi-cable disease from those who are healthy.

Severe Acute Respiratory Syndrome (SARS). Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus. SARS was first reported in Asia in February 2003. The illness spread to more than two-dozen countries in North America, South America, Europe, and Asia before the SARS global out-break of 2003 was contained.

Position Papers are due by May 19th for feedback and by the first committee session to

qualify for awards. Please submit your position papers to your chair via email.

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