Has WHO mismanaged the global coronavirus pandemic?

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The World Health Organization has been criticized for its response to the global coronavirus pandemic, with threats of budget cuts and investigations into its conduct.

But experts say that even if WHO may have made mistakes in its handling of the crisis, the organization is only as powerful as its weakest link.

The United Nations agency was founded in 1948 with a mandate act as an international health authority.

Its 194 member states fund the agency and shape its policies, and it is accountable to them. Conversely, it has the discretion to investigate the management of public health crises by members, but it depends on their cooperation and the exchange of information.

“An organization like the World Health Organization cannot be as strong and as effective as its member states want,” said Steven Hoffman, director of the Global Strategy Lab and professor of global health law at York University. in Toronto.

“One of the challenges that the World Health Organization has faced in recent decades is therefore that it continues to assume new responsibilities and no new resources. “

In 2005, its responsibilities increased with the adoption of the International health regulations (RSI), a legal agreement signed by all members that requires countries to report outbreaks of emerging diseases that are likely to spread worldwide.

WATCH | WHO defends COVID-19 record

The World Health Organization defended its management of the coronavirus epidemic after President Donald Trump ordered the withdrawal of US funding for the organization. 2:55

In doing so, experts say that WHO has played a more political role in juggling the national interests of its individual members and those of the rest of the world.

“They never behaved well in this job – not once,” said Amir Attaran, professor at the Faculties of Law and the University of Ottawa’s School of Epidemiology and Public Health, who Explain CBC’s Sunday edition WHO should never again preside over a pandemic.

“They give in to diplomatic pressure. Or even if there is no diplomatic pressure, they self-censor. “

Attaran said that an agency charged with enforcing an agreement like the RSI cannot also operate with “the attitude of a diplomat.”

Tedros shakes hands with Chinese President Xi Jinping before a meeting in Beijing on January 28. Amir Attaran said that WHO would constantly “give in to diplomatic pressure”. (Naohiko Hatta / Reuters)

“At the same time, it cannot constantly implore countries to cooperate in certain areas where they are expected to attack the next moment and perhaps blame them for hiding an epidemic. “

Hoffman says the agency is “dedicated to its institutional design.”

“The criticisms that WHO has faced are not fair in the sense that WHO is not an independent entity, it acts primarily on behalf of its member states, which control it,” he said. .

“So the criticism is really a criticism of the inability of these national governments to create the kind of strong public health agency that the world needs in the age of globalization. “

Early response to the criticized pandemic

On December 31, China alerted WHO to a mysterious epidemic of pneumonia in the city of Wuhan, in the central Chinese province of Hubei.

But it will be weeks before WHO declares the situation Public health emergency of international concern on January 30, a key designation that determines whether a country’s response to an epidemic has been effective and whether more resources are needed.

The timing of this declaration of emergency is critical at the start of an epidemic and can have knock-on effects on the speed with which countries in the world respond.

“I think it probably happened a week too late,” said Hoffman, adding that the organization was “on hold” to find out if the epidemic was an emergency.

While WHO reviewed the emergency declaration, Chinese authorities acted quickly to silence early informal press releases of health workers ringing the alarm bell in Wuhan, opting instead to carefully manage the dissemination of information within weeks before WHO is authorized on the ground.

Former Canadian Ambassador to China David Mulroney said the news had been put through a “political lens” in China and delayed, as local authorities determined how to put the best face on the crisis before sending it in Beijing.

“You never want to give bad news to your boss in China,” he said.

On February 6, healthcare workers care for COVID-19 patients in the intensive care unit of a designated hospital in Wuhan, China. WHO was quick to praise China for its efforts to contain the coronavirus epidemic, but was criticized for not declaring a public health emergency of international concern quickly enough. (China Daily / Reuters)

Mulroney said this problem highlights an inherent problem with WHO: it can be “blocked” by a member country when information is released – posing a “significant risk” at a critical time in an epidemic.

Lynette Ong, associate professor of political science at the University of Toronto and expert on China, said that WHO should maintain a diplomatic relationship with China in order to encourage investigation and the sharing of key data.

When Chinese health officials quickly genetically sequenced the virus from an infected patient, WHO welcomed the effort, calling it a “notable achievement” that “demonstrates China’s increased ability to manage new epidemics.”

“But you don’t want to do too much, be too deferential and too friendly as you can’t step back and question the things they share with you,” she said.

“WHO is rightly criticized, and much of the criticism is justified in my view because it has probably gone a little too far on the other side of deference. “

Ong said that if the WHO “praised China outwardly” for its ability to build hospitals and put in place a strict foreclosure for millions of its citizens, which helped smooth their epidemic curve, the country has done by setting aside privacy and human rights with draconian restrictions. on the citizens.

Health workers drive a patient to a hospital in Wuhan on January 27. Former interim Liberal leader and Canadian special envoy for humanitarian and refugee issues Bob Rae says there is no evidence that WHO has actively suppressed the release of any information on the pandemic. (STR / AFP / Getty Images)

“The other side of the criticism, which also seems to me to be justified, is the cover-up at the start, which I don’t think WHO has really addressed,” she said, adding that the world had lost two to three weeks. at a “very crucial time” to fight the epidemic.

“If there had been no cover-up, I think the world probably would have been in a different position. “

Should WHO be held accountable?

There are increasing calls for WHO to be held accountable for its response to the global coronavirus. Australia says this will require an international investigation on the origin of the pandemic at next month’s annual meeting of the World Health Assembly, WHO’s decision-making body. And American President Donald Trump has already cut funding for the organizationsaying that he “failed” in his duty.

Yet the United States works with the agency. The Centers for Disease Control and Prevention have, since the end of January, a member within the emergency committee, which also includes Canada’s Chief Public Health Officer, Dr. Theresa Tam, as an advisor.

Tam said that although she would welcome a review of the advice on the pandemic provided by WHO, she doesn’t blame him for her initial response because health experts around the world “underestimated where it could go.”

WATCH | Dr. Theresa Tam says it would be “worth looking into” the WHO response to COVID-19

In an exclusive interview, Dr. Theresa Tam, Chief Public Health Officer of Canada, told Rosemary Barton, CBC chief political correspondent, that health experts have underestimated the global spread of COVID -19 and that it would be “interesting to examine” the response of the World Health Organization. 1:29

Prime Minister Justin Trudeau said Canada will continue to work with WHO because the virus “Demands a global and coordinated response. “

He added that there will be “a lot of time to think about the challenges” in the future.

Former Interim Liberal Leader Bob Rae and Canada’s Special Envoy for Humanitarian and Refugee Affairs said that although WHO acts as a source of information, alert and referral for the countries affected by a pandemic does not take away the responsibility of governments to take the steps they deem necessary.

“You could never say,” Well, you know, [the WHO] didn’t tell us how serious it was. Sure they did, “said Rae. The question of how each country should respond to the information is entirely up to each country. It’s not at WHO. ”

The WHO does not give instructions “to say that you have to lock, you have to limit transportation, you have to cut all flights. “

Rae said that while it may be difficult for WHO to overcome the challenges of the Chinese political system, there is no evidence that the organization has actively suppressed the publication of any information on the pandemic.

He says criticism of WHO is “completely wrong” and that cutting funding for the organization at a critical time is a strategic “mistake”.

“I think every crisis like this will inspire every government agency, national and international, to reflect on what happened and see how it can be improved,” he said.

“This is a question that is going to be legitimately placed at the gates of WHO. “

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