The World Health Organization has been lambasted by some for its handling of the Covid-19 pandemic. It has been blamed for, among other things, allegedly helping China to cover up the initial Wuhan outbreak and for offering wrong or confusing advice on everything from masks to travel restrictions.
For some, Tedros Adhanom Ghebreyesus, the Ethiopian director-general of the WHO, has become a figure of hate, not to say xenophobia. Like Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, he has been made a scapegoat for politicians, not least US President Donald Trump, for their own flailing response to the pandemic.
The WHO is an easy punching bag. But the attacks serve little purpose other than to undermine the fight against Covid-19. They are part of a swelling backlash against multilateralism, underlined by the US withdrawal from the WHO in the midst of the pandemic itself.
If the WHO has made some mistakes, these result from genuine dilemmas about how to respond to health emergencies. More fundamentally, they reflect the difficulties of dealing with sovereign states, and the breakdown of a postwar order that is struggling to accommodate the rise of China.
This is not to say the WHO has made no errors. It has. It unnecessarily praised China in the early stages of the pandemic, undermining its own neutrality. Its default position against travel bans now looks suspect, especially in the context of a highly infectious virus like Covid-19.
Yet the WHO’s advice is the result of 150 years of grappling with how best to balance an emergency health response with a duty to protect economies and livelihoods. It is part of the 2005 International Health Regulations, a legally binding instrument of international law. When 192 nations signed up to the planetary manual on how to deal with a pandemic, it was a high watermark for global health co-operation.
Partly in response to the threat of emerging diseases, including Ebola, Aids and Sars, nations were prepared to cede more authority to the WHO. They agreed it could collect data independently, rather than rely on countries to admit to outbreaks themselves. The WHO was also given authority to declare a public health emergency even over the objection of individual nations.
Such powers are tricky to use. Governments don’t like small bureaucracies in Geneva gathering information that could wreck their reputations and economies. When there was an outbreak of Ebola in west Africa in 2014, Margaret Chan, then director-general of the WHO, was reluctant to embarrass African governments by declaring a health emergency. Yet no one has accused the WHO of being in the pocket of Guinea or Liberia.
In the case of China, Mr Tedros did lavish too much praise. “They should be thanked for hammering the epicentre. They are actually protecting the rest of the world,” he told the FT. In his rush to commend Beijing’s effective containment policies, he skated over the early obfuscations of President Xi Jinping’s secretive and prickly regime.
Yet accusations that the WHO colluded in a cover-up do not stack up. On December 31 2019, the WHO invoked powers granted under the International Health Regulations to ask China what was going on in Wuhan after picking up chatter about mysterious cases of pneumonia. On January 5, the WHO warned its members that something unusual was happening, and to be on alert.
It is true that on January 14 the WHO issued confusing statements about whether the virus could be transmitted between humans. But by January 22, it was clearly warning about human-to-human transmission.
The week-long delay was not helpful, but it was hardly decisive. Countries like the UK, the US and Brazil had weeks, if not months, to prepare their pandemic response while they watched what was unfolding in China and Italy. A sharper warning from the WHO a few days earlier in January is unlikely to have woken them from their slumber.
Mr Trump has made much of the fact that, in late January, he signed an executive order blocking entry to the US of any non-US citizen who had been in China in the past 14 days. His claim that this saved many lives would be more credible if it had been fortified by other measures including rigorous test-and-tracing. In the event, many US infections came from Europe.
“The WHO may have been soft on the Chinese in early stages, but it has also tiptoed around the fact that the US has had one of the worst policy responses in the world,” says Mark Malloch Brown, former UN deputy secretary-general.
There was a fleeting moment, after the financial crisis of 2008, when people talked about the G2 — the idea that the US and China could co-operate to solve global problems from climate change to financial meltdowns. It quickly yielded to what Ian Bremmer, president of the Eurasia Group, calls a G-Zero world in which international diplomacy is a zero-sum game.
Caught in the crossfire, there is only so much a relatively small bureaucracy can do. Unless China and the US can come to some sort of “global health detente”, says David Fidler, a public health expert at the Council on Foreign Relations, then the WHO is in for what he calls “a world of trouble”.