You say "well duh", but PG makes no effort to eliminate any "type" of large organization. He claims with no equivocation that working for
all large organizations sucks. Surely you must admit that there must be smart people in many,
many other large organizations, and not the exclusive domain of us super-smarties here at CERN! And those people see something of value in their circumstances and cannot be justifiably lumped along with caged lions (I know this metaphor causes uproar every time this article comes up, but he chose it not me!).
Also, as to your last point, if it is in refernce to what I was talking about Polio, it _is_ endlessly interesting. UN gets a bad rap for being bureaucratic to the point of statis, but in fact, some of the hardest working people I know are employed there.
Here's more about Polio to whet your appetite, with the MASSIVE caveat that this is second hand, non-expert knowledge vomited out off-the-cuff.
Polio has been eliminated virtually everywhere on Earth with the exception of Pakistan, Afghanistan and Nigeria. There are some other places where vaccine-derived (kind of, there is more to it that I don't fully get) Polio sometimes rears its head when ineffective propagation occurs, specifically in Syria, where the war zone threw the entire operation into chaos. But mainly, it is problematic in the three countries. The trouble is, big parts of these regions are inaccessible, and therefore we don't know the details of how bad the situation may be, and how many households are unvaccinated. So one big challenge is how to make sure these countries (with Taliban controlled regions for example) get the distribution sorted.
Further, Polio was unprecedented in the sense that W.H.O. (and others) managed to set up the VERY complicated infrastructure of mobile testing labs, vaccine distributions, but most importantly, door to door canvassing through the enormous amounts of hard work of poorly-paid LOCAL volunteers (MANY women) who go door to door, month after month, conducting surveys and understanding the plight of the local populace. They are the ones who could tell us, down to the household, who had been vaccinated and who hadn't. On a global scale. Imagine the complexity.
And because this infrastructure was in place, OTHER departments could use it too, for instance to study Malaria rates etc. All on Polio money. But now with funding soon to be sunsetted, the issue is how we can maintain the good of the program: the door to door stuff, the mobile labs etc., with no Polio funding?
Other things are complicated too, such as health ministries not being fond of their for-years-guaranteed Polio funding going away. This is perhaps ok in non-corrupt countries, but in less fortunate countries, their representatives must argue for greater share of the funding for THEIR government, knowing full well that that money could maybe be better used elsewhere.
On the other side of the equation, you have to deal with the funding agencies: the Gates etc., who would love nothing more than to be able to see the fruits of their labour paid off as soon as possible, since they've been waiting for a decade. Patience is an ever-scarcer commodity, and it's hard say that I don't sympathise with them, given how many resources they've invested into the project.
And WHO is liable for everything it states, so all outreach must be carefully vetted. So you need a big PR team/lawyers etc. There are just endless complications. W.H.O. has to manage ALL of this, and that is exactly why they require a big staff.
This stuff is not limited to just the UN btw. All big companies face such challenges. By contrast, PG's article seems more to be desigend to caress his ego rather than express something truly useful for the world to consume and learn for.