Only weeks into his role as the World Health Organization's (WHO) first staff ethicist, Dan Wikler has embarked on an ambitious project to draw on the expertise of a team of hand-picked philosophers and economists around the world to provide advice to the WHO on ethical issues.

Dan Wikler

The team of 10–12 consultant ethicists will include John Broome from the department of moral philosophy at St Andrews University, UK, Frances Kamm at New York University and Jiwei Ci from Hong Kong University. They will be briefed by WHO staff before participating in a series of meetings over the next 12 months that will culminate in the publication of an official WHO book on ethics. The work will be on display at the biannual World Conference in Bioethics, to be held in London next September.

Wikler is on sabbatical from the University of Wisconsin and was head-hunted to join the "Global Burden of Disease Project," led by Chris Murray and Alan Lopez, which aims "to expand the empirical basis for international public health." Wikler says the WHO is "dipping its toe" with his appointment, as the position of staff ethicist did not exist previously. His recruitment is in line with the organization's efforts to hire specialists rather than rely on career WHO employees (Nature Med. 5, 249;1998). Murray is on leave from Harvard University and Lopez from the World Bank.

WHO provides advice on healthcare issues to its member states and the type of ethical questions that Wikler must consider include the analysis of cost-effectiveness in healthcare. "For example, cost-effectiveness is often calculated in number of years of life gained per dollar spent. But is it right to measure this directly because this makes it biased towards the young rather than the old. Is every year of life equally worthwhile?" he asks.

Wikler will host a WHO meeting on cloning and related issues such as stem cell research later this year. Beyond that, he says that the area of commercial organ transplants must be re-examined: "Thinking around the world has not crystallized on this issue and there are roughly two perspectives: sale of organs should be banned outright, or it's too late to stop and should therefore be regulated." the WHO plans to update its guidelines on the sale of organs after a series of large-scale consultations.