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This is the first study of WHO for many years, and the author's familiarity with it from the inside and his practice of medicine enable him to analyse the organisation from different angles. Starting with the crisis of confidence in the UN, he examines the influence of political and other factors on WHO's effectiveness in its efforts to achieve universal membership, to evolve a workable, decentralised structure, and especially to eradicate (or at least control) malaria. Through the author's use of internal documents and interviews, WHO's achievements are assessed. He concludes that, although WHO has been affected by constraints and structural failings, Western charges of 'ineffectiveness' and 'politicisation' miss much of the complexity revealed by a more searching evaluation of these concepts.