The WHO has failed us again
Published by UnHerd (1st April, 2020)
Like many doctors, Bruce Aylward has been working tirelessly since this coronavirus started its rampage around the planet, although his job takes him away from the medical frontline filled with patients fighting for life. The Canadian physician, a trained epidemiologist, is one of the most influential officials in global efforts to beat this pandemic through his role as assistant director-general at the World Health Organisation (WHO).
Much of his time has been spent in the media, often praising China for its response to an epidemic that emerged last year in the central city of Wuhan. Aylward led a WHO mission there last month and was clearly impressed, even saying if he had the virus he wanted to be treated there.
He has talked in glowing terms of China’s ‘rigour’ and its ‘aggressive response’ in controlling the disease. “China is really good at keeping people alive,” he told the New York Times, complaining that sceptical journalists see the nation as “some evil fire-breathing regime that eats babies.”
China’s leaders do not eat babies. But they do run a very repressive autocracy that banned families from having more than one child, controls citizens with the world’s most sophisticated state surveillance system, jails critics and locks up Muslim minorities in horrific prison camps.
Like it or not, they merit criticism also for their failure to clamp down on the wild animal markets that almost certainly sparked our current dystopian nightmare — despite the seemingly similar emergence of SARS in 2002 — while officials stymied efforts to warn about the outbreak for several crucial weeks.
Yet Aylward, raised in one of the world’s most benign societies, panders to the crude narrative of Communist Party chieftans, who now pose as heroes of this pandemic. So when a journalist asked about Taiwan’s laudable response to the virus, he paused for several seconds, pretended not to hear the question and then appeared to hang up on her call. The reporter dialled back, but was brushed off with the reply that “we’ve already talked about China — and when you look across all the different areas of China, they’ve actually done quite a good job.”
Such words could have spewed from the mouth of a tremulous Beijing bureaucrat. China wants to reunite Taiwan with its ‘motherland’ seven decades after it became a refuge for Chiang Kai-Shek’s nationalists, defeated by Mao’s Communist forces. This desire has hardened under President Xi Jinping, who uses his nation’s growing muscle to bully any country, firm or institution showing the slightest sign of support for its minnow of a neighbour. Yet the island remains fiercely independent, as shown by recent elections, and an admirable beacon of democracy, freedom and rule of law.
Aylward’s response was significant because it spotlights the pitiful way in which WHO — a branch of the United Nations heavily funded by Britain and the United States — has appeased China and failed in its central task to co-ordinate a global response to public health threats. Such is the absurdity that Taiwan’s 24 million citizens can travel around the planet on their own passports — yet not enter a United Nations building. It is far from unique in its approach to this nation, which remains unrecognised by other international bodies such as those governing civil aviation and the Olympics. But when it comes to coronavirus, this approach raises questions over the point of this global body.
Taiwan has one of the world’s best healthcare systems. It has responded well to coronavirus, learning valuable lessons from the SARS epidemic, like some other nations in the region, and reacting fast to keep down its death toll. Yet the country, which is barred from attending key WHO summits, was excluded from emergency meetings and expert briefings on the disease. It has accused the global body of ignoring its request for information when the virus broke out, arguing that this put lives at risk at a time when global co-operation was crucial.
Meanwhile Tedros Adhanom Ghebreyesus, the WHO director-general and Aylward’s boss, has gone out of his way to praise China’s “extraordinary” efforts to curb the deadly virus. “China is actually setting a new standard for outbreak response,” he said at one point. He also insisted the country deserved to be “congratulated” for protecting its people, along with “the people of the world”.
Just days later, the views of those citizens in China were glimpsed: the death of a doctor who was arrested for trying to warn about the outbreak sparked a rare outburst of open anger against the system.
Perhaps it is not surprising that Tedros endorsed this autocratic regime. He was, after all, health minister for seven years under Meles Zenawi in Ethiopia, who ran one of Africa’s most brutal one-party states, which jailed journalists, tortured dissidents and shot pro-democracy protesters. He was accused of covering up cholera outbreaks. Then shortly after defeating his British rival to win WHO’s top job, he tried to honour Zimbabwean president Robert Mugabe by naming him a “goodwill ambassador”. Mugabe, bear in mind, so devastated his nation that life expectancy plunged by 26 years at one point; meanwhile, the elderly dictator flew abroad for treatment as his health deteriorated, before dying in Singapore last year aged 95.
This ridiculous idea was cancelled after a storm of protest. Human rights groups noted that Mugabe, an ally of China, was head of the African Union when it helped manoeuvre Tedros into the post. The Washington Post also pointed out that China “worked tirelessly behind the scenes” to help his cause, saying his success would be “a victory for Beijing” and for Xi’s desire to demonstrate his nation’s growing strength.
Does this explain why WHO echoed China’s opposition to travel restrictions in the early days of this crisis and now promotes the flawed idea that this nation is a role model for fighting the virus?
It gets worse. WHO was told about the disease on the last day of 2019. There are allegations China already knew about human-to-human transmission even as it was detaining doctors who were trying to protect the public over following days. Yet on January 14 WHO’s twitter account claimed that “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China.” Just three days later, one of its officials publicly intimated the new virus was being transmitted among humans, a critical revelation that highlighted the epidemic’s dangers — then this was confirmed by China after another three days.
Taipei officials said in late December they tipped off WHO — through a warning system designed for exchange of such facts — that medical staff in China were becoming ill: a clear indication of human-to-human transmission. But this critical information was not shared, since Taiwan was excluded from a key WHO platform; indeed, the body did not even bother to reply. “An opportunity to raise the alert level both in China and the wider world was lost,” Chen Chien-jen, Taiwan’s vice-president and an epidemiologist, told The Financial Times.
It took until the end of January before Tedros finally proclaimed coronavirus to be a public health emergency of international concern — by which time it had spread to 19 nations on four continents. Some experts defend his pragmatic need to work with China to contain the outbreak, despite scepticism over data. And despite WHO’s sluggishness to declare a pandemic, the body has been hailed for subsequent work to marshall global efforts to contain the virus. Yet when this crisis is concluded, there needs to be accountability for actions that have again damaged its credibility.
WHO was guilty of disastrous inaction over the deadly ebola outbreak six years ago, when its slack approach was accused of fuelling death and suffering. The terrible epidemic killed more than 11,000 people in three west African nations, provoking fear and paralysing these countries, as I saw for myself in Liberia.
Yet when Médecins Sans Frontières begged the world for help and warned the disease was out of control, it was rebuked by a WHO spokesman on social media. Only after four more months did this body, which is supposed to show global leadership, concede that there was an international health emergency. A devastating inquiry by British and US experts accused it of “the most egregious failure” for failing to sound the alarm.
Reach back further in time and there are other examples of this body’s flaws, not least the inept way it coped with the Aids crisis that led the UN to set up a separate body for the disease. Possibly it was restrained in this new crisis by fear of seeming alarmist, having been criticised for calling the 2009 swine flu outbreak a pandemic when it turned out milder than expected. This could explain why, at the end of last month Tedros, still downplayed the disease. “Using the word pandemic carelessly has no tangible benefit, but it does have significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralysing systems,” he said.
Like other UN bodies, this organisation has a tough job balancing a big leadership role with systemic flaws and competing national interests. Set up in 1948 to help the world attain “highest possible level of health”, its strategic scope ranges from curbing smoking and tackling child obesity through to antibiotic resistance and preparing for emergencies. Unfortunately, again like some other UN bodies, it is bloated, bureaucratic, struggles for funds, suffers from organisational dysfunction and is stuffed with political stooges.
When we emerge from this dark cloud, the world may look very different. Yet one thing is certain: this cruel pandemic has exposed with the most terrible clarity that we need a global health body free of politics, unfettered by diplomatic restraints and fearless about telling the truth.