Coronavirus Outbreak: Donald Trump's case against the WHO relies on half-truths and misrepresentations
President Donald Trump's decision, this week, to cut off funding to the WHO, has come on the back of his weeks-long campaign blaming the global heath body for the catastrophic mismanagement of the coronavirus pandemic
Ebola, malaria, HIV, hypertension, road safety, the threat of global warming: Ensconced in the World Health Organisation's plush Geneva headquarters, director-general Tedros Adhanom Ghebreyesus led its executive board on a journey through the world's front-lines in the war against disease and death. Then, well past halfway into his 3 February speech, he arrived at the new coronavirus that had by then claimed at least 161 lives in China, and spread to no fewer than 23 other countries.
"The number of cases we have now, 151, it's actually small, and it's coming only slow," Tedros said, responding to fears the novel coronavirus could spark off a global crisis. There was, he went on, "no reason for measures that unnecessarily interfere with international travel and trade".
"It can be managed."
President Donald Trump's decision, this week, to cut off funding to the WHO, has come on the back of his weeks-long campaign blaming the global heath body for the catastrophic mismanagement of the coronavirus pandemic. Tedros' ideologically-driven deference to Beijing, the story has it, led the WHO to defer action until it was too late. The WHO director-general's speech is the star exhibit of Trump's case.
For many in India, the opportunity to sock one to superpower-bully China has proved too good to resist — but there's somewhat more to this story than the crusade against the WHO lets on. True, the WHO did dither and delay. Every major nation-state, though, fearing the economic and social consequences of pandemic containment measures, did just the same thing.
This ought be a time to reflect and learn lessons on how global health crisis ought be managed. Trump has chosen, instead, to respond like a playground bully — picking on the weakest kid in the playground, while at once carrying gifts to the school bully.
Full accounting for China's actions in the weeks after the first cases of COVID-19 broke out in December lies in the future. But there's no doubt authorities made strenuous efforts to cover up the scale and intensity of the crisis. Li Wenliang and seven other doctors in Hubei were punished for posting a warning on social media about the lethal new disease. The argument was that there was no scientific evidence to back their claims, but China didn't raise the alarm even after the virologist Shi Zhengli conclusively identified the new pathogen on 7 January.
As patients poured into hospitals across the country from 2 to 17 January, China's Centre for Disease Control simply did not record the data — allowing it to pretend to its own people and the world that the epidemic was a local problem.
The Associated Press has revealed that, in a 14 January memo, Ma Xiaowei, the head of China's National Health Commission, warned officials that the situation was "the most severe challenge since SARS in 2003, and is likely to develop into a major public health event". For a week after, authorities did not warn the public: Wuhan itself hosted a banquet for thousands, and millions began travelling for their Lunar New Year holiday.
Little hard evidence exists for why China's leadership acted as it did — but little imagination is needed to guess, either. Already faced with a spluttering economy and slowing growth, Beijing just didn't want industrial supply chains and production centres shutting down.
Trump, and other WHO critics contend that Tedros and the WHO bureaucracy colluded in this cover-up. Even as late as 14 January, Trump noted that the WHO insisted there was no evidence the virus was being transmitted from human to human. That meant the threat was only to those directly exposed to China's live-animal markets, not from business travellers and their contacts. "They did. They did give us some pretty bad play calling," Trump claimed, "They really called, I would say, every aspect of it wrong."
Like China's own politically-driven story-telling, though, the Trump version of what happened elides over some important parts of the truth.
As early as 10 January, Peter Beaumont and Julian Borger revealed in The Guardian, the WHO warned world health leaders through briefings and in notes "of potential human-to-human transmission and made clear that there was a threat of catching the disease through water droplets and contaminated surfaces". This was, it may be recalled, just three days after virologist Shi identified the novel coronavirus as a close relative of the one that caused Severe Acute Respiratory Syndrome (SARS) — and thus likely to behave in the same ways.
In a briefing for the media at WHO headquarters on 14 January — the same day as the organisation publicly tweeted there was no evidence of human-to-human transmission of the new coronavirus — its technical lead, Maria Van Kerkhove offered a more nuanced explanation than was possible in a tweet. Wider human-to-human transmission should not be regarded as "surprising", she noted, given the similarity to earlier SARS outbreaks.
Following permission being granted by China to send a field team on 20 and 21 January, the WHO confirmed that human-to-human transmission of the virus was indeed taking place. An Emergency Committee was assembled at the WHO the same day, which led on to the declaration of a public-health emergency a week later.
Even thought the week-long delay is controversial, few experts believe it was catastrophic. Lawrence Gostin, among the experts who wanted a public health emergency declared earlier, told the BBC that "it was only a short delay and I don't think the timing had any impact on the trajectory of COVID-19 ".
Even as the WHO's finger wavered over the alarm button, experts in the United States who did shout out warnings found these weren't welcome. Early in January, the head of the United States' Centres for Disease Control, Robert Redfield, spoke to his Chinese counterpart about the new disease. What Redfield was told alarmed him enough to set up an incident management structure for the new coronavirus on 7 January, and to activate the CDC's emergency response structure two weeks later.
In the days from 13 January, when the first COVID-19 case outside China was detected and all the way to the WHO's declaration of an emergency on 30 January, South Korea, Taiwan and Singapore all imposed swift measures to slow the outbreak.
"During this time," scholars Jeremy Wallace and Jessica Weiss have noted, "Political leaders in the United States were dithering and minimising the severity of the crisis." The same was true of Europe, where leaders from the United Kingdom's Boris Johnson to Italian president Sergio Mattarella sought to avoid the crippling costs of the lockdowns necessary to contain the infection.
Indeed, in a tweet his supporters don't now care to remember, Trump heaped glowing praise on the WHO. "CDC & World Health have been working hard and very smart," Trump announced a full month after the declaration of an international public health emergency. At that stage, the WHO's less-than-aggressive response clearly did not appear to him to be a problem.
Following the early phase of delay, French scholar François Godement has argued, Tedros and the WHO acted much as they ought to have. Although Tedros lauded China's containment in cringe-inducing language, Godement notes, "It is clear that this time around he was right."
The WHO highlighted global shortages of Personal Protective Equipment on 7 February. Five days later, operational planning guidelines for countries were published. Even as governments across the world dragged their feet. the WHO warned on 20 February that the window of opportunity for containment "may close", and recognised "pandemic potential" on 24 February.
Like those of all bureaucracies, the WHO's actions were shaped by experience. In 2009, the WHO declared the H1N1 flu a global pandemic based on guidelines devised by experts, which centred around how many countries the disease had spread to — not its severity. But the disease was contained far more easily than expected. Governments that had built up stockpiles of vaccines and medical equipment in response to the WHO declaration were less than amused.
Fourteen members of the Council of Europe's parliamentary assembly even charged the WHO with corruption, alleging that pharmaceutical companies had influenced its scientists and official agencies "to alarm governments" in order to "promote their patented drugs and vaccines". The WHO responded by dropping its pandemic guidelines altogether.
In hindsight, there's no doubt the WHO ought have reached for the panic button earlier — and pushed it harder. And perhaps Tedros ought to have called out China for hiding information on the scale and seriousness of the problem, instead of seeking to flatter its leadership.
For pop-Right commentators, the answer is simple: In their telling, Tedros is a closet Marxist, beholden to Beijing. Ethiopia's foreign minister from 2012 to 2016 and health minister from 2005 to 2012, Tedros was indeed part of the Ethiopian People's Revolutionary Democratic Front. The problem with the story is that the EPRDF reinvented itself after the collapse of the Soviet Union, and led Ethiopia into a strategic partnership with the United States' Global War on Terrorism.
As a member of then-prime ministers Meles Zenawi and Hailemariam Desalegn's Cabinets, Tedros collaborated with the provision of military bases to the United States to combat jihadists in the Horn of Africa, and even allowed the Central Intelligence Agency to run secret prisons.
The truth doesn't need a conspiracy theory: For a cash-strapped WHO, which elects its leadership on the basis of the geopolitical considerations of its member-states, sucking up to superpowers is the key to getting things done. Tedros was elected director-general on the basis of a developing-world coalition, including India, against his West-backed rival.
Flattering a key player in that coalition was good politics — even if meant eroding the WHO's credibility as an independent institution.
Trump's supporters ought to, of course, understand this. Even as he assails the WHO, Trump — his antennae tuned to the realities of economic power and geopolitics — has been flattering China in terms just as effusive as those of Tedros. "China has been working very hard to contain the coronavirus ," he tweeted recently, "It will all work out well. In particular, on behalf of the American People, I want to thank President Xi [Jinping]!"
In a sensible world, leaders would be asking themselves why it is the WHO finds it so hard to be independent. Experts know the answer. "The WHO's budget for the biennium 2018–2019," scholars Srikanth Reddy, Sumaira Mazhar and Raphael Lencucha have recorded, "hovered around $4.421 billion, while the annual healthcare and social services budget of Quebec, a Canadian province in which we live is approximately $33 billion." Indeed, the WHO had less funding "than the budget of many major hospitals in the United States".
This year, the WHO's budget is around $4.5 billion; the United Kingdom’s National Health Service alone has budgeted to spend some $133 billion. Increasingly, the funding for WHO programmes comes from private-sector donors, with their own agendas.
Trump has long seen global institutions as a waste of time: In February,, he sought to halve United States funding for global health programmes. Now, Trump's found the pretext to do it.
This is the worst of all possible lines of actions. Poor countries across the world are entirely dependent on the WHO to deal with crisis. The shrinkage of the WHO will end up leaving the West more vulnerable to epidemics — and give Beijing even more power in the international system.
Finding someone to blame for disasters — countries, belief-systems, our neighbours — is, profoundly human. For political leaders to accept their own mistakes had something to do with engendering a crisis has political costs. Scapegoating a powerless bureaucratic actor wins easy applause. In this case, though, the urge to play catch-the-witch will have hideous consequences for us all.
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