25 November 2021

The Guardian: “The WHO v coronavirus: why it can’t handle the pandemic”

There is a simple reason for this. For all the responsibility vested in the WHO, it has little power. Unlike international bodies such as the World Trade Organization, the WHO, which is a specialised body of the UN, has no ability to bind or sanction its members. Its annual operating budget, about $2bn in 2019, is smaller than that of many university hospitals, and split among a dizzying array of public health and research projects. The WHO is less like a military general or elected leader with a strong mandate, and more like an underpaid sports coach wary of “losing the dressing room”, who can only get their way by charming, grovelling, cajoling and occasionally pleading with the players to do as they say.

The WHO’s response to Sars was considered a huge success. Fewer than 1,000 people worldwide died of the disease, despite it reaching a total of 26 countries. The pandemic was defeated not with vaccines or medicines, but with NPIs, or “non-pharmaceutical interventions” in WHO parlance: travel warnings, tracking, testing and isolating cases, and a huge information-gathering operation across multiple countries, all made possible by the WHO’s willingness to wield authority that it had, in a sense, created simply by speaking it into existence. Brundtland did things the WHO had no authority doing. She just did them, said Fidler. She sort of used Sars as a way to test drive some very radical changes.

Despite mounting frustrations – in mid-January, China also refused the WHO’s request to send a team of scientific observers to Hubei province, the centre of the outbreak – Tedros has never come close to doing what Brundtland did and calling China out. Instead, on 28 January, he had a closed-door meeting with Xi Jinping in Beijing, and two days later, he praised Chinese efforts to contain the disease, declaring that China is setting a new standard for outbreak control. That same day, 30 January, the WHO declared a Pheic, and began issuing prescriptions to countries around the world. On 8 February, China finally allowed WHO observers into the country. For Tedros’s supporters, this was vindication of his strategy of keeping China onside. For his critics, it was too little, too late.

Stephen Buranyi

This article was published during the early days of the pandemic, but the information and conclusions remain valid. The comparison with the earlier SARS pandemic and other similar emergencies was particularly informative: as I remarked before, a key factor for success is the willingness to act quickly and decisively, before the situation spirals out of control. Dr. Brundtland displayed that initiative and leadership during the SARS outbreak; current WHO chief Tedros Adhanom not so much… His initial deference to China may have signaled to other countries that it’s fine to disregard the WHO – after all, it has no concrete power to impose them. And if the WHO can’t – or won’t – criticize China for its role in letting the virus loose, it can’t expect other countries to fall in line with its recommendations.

WHO director-general Gro Harlem Brundtland gives polio immunisation to a young boy in New Delhi
WHO director-general Gro Harlem Brundtland (centre) gives polio immunisation to a young boy in New Delhi in January 2000. Photograph: John Mcconnico/AP

WHO leadership aside, the parallel to SARS highlights many aspects that are different this time around, and have surely contributed to amplifying the crisis. China had another leader back then, and the country was more willing to engage and follow the global community than under Xi Jinping. The geopolitical tensions between the US and China have polarized international institutions, their guidelines are now regarded through a political lens, as benefitting either US or China – as Tedros was perceived as soft on China, other countries distanced themselves from the WHO as a whole. Having Donald Trump as US President has certainly not improved international collaboration, nor US’ internal response. The WHO should have more authority to intervene in emergent crisis – but under the current situation it is very unlikely that countries will grant it these additional powers.

The new coronavirus itself behaves differently; more infectious and less deadly, it spreads silently before medical authorities can become alerted of its presence. This renders containment through non-pharmaceutical interventions less effective. International travel has also increased significantly in the almost two decades since SARS, and most countries have been slow or unwilling to limit the flow of travelers, who normally generate good tourism incomes.

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