GENEVA (AP) – As the coronavirus explodes again, the World Health Organization finds itself both under intense pressure to reform and hoping that US President-elect Joe Biden will overturn a decision by Washington to quit the health agency.
With its annual meeting underway this week, WHO has come under heavy criticism for not playing a stronger and more vocal role in managing the pandemic. For example, in private internal meetings at the start of the virus, top scientists described some countries’ approaches as “an unhappy lab to study the virus” and a “macabre” opportunity to see what worked, the records obtained by the virus. ‘Associated Press show. Yet in public, the United Nations health agency praised governments for their responses.
Biden has vowed to reverse President Donald Trump’s decision in June to cut funds to the WHO and withdraw the U.S. The WHO has also bowed to member countries’ demands for an independent group to review its handling of response to the pandemic, and WHO Director-General Tedros Adhanom Ghebreyesus said on Monday that the agency welcomed “all attempts” to strengthen it “for the benefit of the people we serve”.
One of the main dilemmas that the WHO faces is that it lacks enforcement powers or authority to independently investigate in countries. Instead, the health agency relies on behind-the-scenes discussions and cooperation from member states.
Critics say the WHO’s traditional aversion to confronting its member countries has come at a high price. As COVID-19 spread, the WHO often avoided calling countries, as large donors such as Japan, France and Britain made repeated mistakes, dozens of records show internal WHO meetings and documents from January to April obtained by the Associated Press.
Some public health experts say the WHO’s inability to exert its influence has given credit to countries adopting risky outbreak policies, possibly undermining efforts to stop the virus.
“We need the WHO to be bold and use its political power to denounce and shame, because the consequences are so devastating,” said Sophie Harman, professor of international politics at Queen Mary University in London. “This is their Spanish flu moment … By not speaking out when countries do questionable things, the WHO is undermining its own authority as the planet burns.”
Others said it would be politically unwise for the WHO to speak too openly unless countries give the agency more power and the ability to censor countries – an option that Germany and the France have recently proposed.
“If Tedros were to take a very aggressive stance towards member countries, there would be repercussions,” said Suerie Moon, co-director of the Center for Global Health at the University Institute of Geneva, referring to the director-general of WHO.
WHO spokesperson Farah Dakhlallah said that since the onset of the coronavirus epidemic, “WHO officials have had and continue to have frank and open discussions with their government counterparts… We pride ourselves on an organizational culture that fosters frank discussion with the goal of achieving life. saving solutions. “
One of the scientists present at the meetings, Emergency Chief Dr Michael Ryan, also outlined the WHO’s approach in response to a question from the media on March 11 about whether the agency was ready. to say which countries were not doing enough.
“The answer to that question is, you know who you are,” Ryan said. “WHO does not interact in public debate and does not criticize our Member States in public. What we are trying to do is work constructively with our Member States. “
However, it is not without precedent for the WHO to publicly question its Member States. He threatened to shut down his office in China as the country hid cases during the SARS outbreak, urged Nigeria to end its 2003 boycott of polio vaccine and accused Tanzania of not sharing enough money. information on an Ebola outbreak last year.
The review of the WHO’s role in the pandemic comes at a critical time as the agency is now tasked with helping to purchase and distribute coronavirus vaccines around the world once they are proven to be effective, especially in the poorest countries. Some countries, including the United States and Russia, have refused to join the effort, but on Sunday WHO chief scientist Dr Soumya Swaminathan said she hoped the election of Biden would “open the door” to American inclusion.
The WHO’s reluctance to call countries started with China, as the PA previously reported. Despite a meeting in January between Tedros and Chinese President Xi Jinping, information about the epidemic was still scarce in February. Maria Van Kerkhove, WHO technical officer for COVID-19, noted that the agency lacked “enough detail to say what worked and what didn’t”.
Yet at a press conference soon after, Tedros said, “China is doing a lot of good things that are slowing the virus and the facts speak for themselves.
Also in February, WHO scientists were concerned about Japan. On February 1, a passenger who disembarked from the Diamond Princess cruise ship in Hong Kong tested positive for the coronavirus. During the ship’s next stopover in Yokohama, 10 more cases were discovered and authorities locked the 3,711 people on board.
Ryan told reporters at the time, “Let’s be careful here not to overreact. But on February 10, the number of cases almost doubled overnight.
“(This) is not surprising given the nature of the response to the investigation,” Ryan said in an internal meeting, saying only a small number of epidemiologists have been affected with the outbreak. “If you double the number of cases in a ship in a day, something is wrong. “
Dr Thomas Grein, head of WHO’s acute event management team, reported to colleagues that WHO had discussed the outbreak with their Japanese counterparts, but had failed to glean much. useful information.
“This is a very, very sensitive issue and we have to be careful,” he warned.
While the WHO is fully aware that the situation is deteriorating, scientists have said the outbreak could help understand the patterns of COVID-19 transmission.
“(It’s) unfortunate, but it’s a useful opportunity to study the natural history of the virus,” Ryan said.
Several days later, Japanese epidemic specialist Dr Kentaro Iwata boarded the Diamond Princess and called the response “completely chaotic”. Shortly after, the WHO announced that more than half of the known COVID-19 cases worldwide outside of China were on board the Diamond Princess.
“It was very obvious on this cruise ship that things were wrong and the WHO should have said something,” said Lawrence Gostin, director of the WHO Collaborating Center on Public Health Law and Human Rights. of man at Georgetown University. “When what countries are doing is completely wrong, we need the WHO to say it.”
Although the WHO was not specific, Tedros said on February 26: “One of the biggest challenges we face is that too many affected countries are still not sharing data with the WHO. “
In February and March, COVID-19 sparked outbreaks in South Korea, Singapore, Iran and elsewhere. The virus has also gained a foothold in Italy, making Europe the epicenter of the pandemic.
At the WHO, officials expressed concern during internal meetings about the lack of information from European member states. Grein said WHO’s efforts to get more details on the spiral outbreaks had “failed dramatically”.
Yet on March 8, Tedros tweeted that “the Italian government and people are taking bold and courageous action to slow the spread of coronavirus and protect their country and the world.” Three days later, Tedros declared COVID-19 a pandemic, saying the announcement was made in part due to “alarming levels of inaction” from countries he did not name.
Georgetown University’s Gostin said the WHO should be forced to report publicly when countries don’t share enough data.
“If a country does not provide vital epidemiological or biological information, then the WHO and the world are blindly flying in an epidemic and we cannot have that,” he said.
The WHO has also complained privately that Western countries are hoarding scarce supplies against the pandemic.
“We had the terrible situation yesterday with (personal protective equipment) where all the supplies were requisitioned in France and we lost access,” Ryan told his colleagues. He said the WHO must put pressure on countries and companies to avoid similar situations.
As countries across Europe adopted social distancing measures and called off mass gatherings in early March, Ryan noticed that one country hadn’t done so: Britain.
“There is not a single sporting event in Europe and yet all Premier League matches in the UK have to run smoothly,” he said. Ryan called Britain’s pandemic strategy “problematic” after hearing the UK’s scientific director publicly say the country was targeting herd immunity.
“For that to happen, hundreds of thousands and millions of old people are going to be infected and there are going to be so many deaths,” Ryan said. Still, he said, the different approaches to tackling COVID-19 around the world could turn out to be “one massive ecological study” that would allow the WHO to document what works best.
“It’s macabre in some ways, but it’s the reality,” he said.
Going forward, the role of WHO in the continued development of the pandemic will depend in part on the group’s review. Harman, the expert from Queen Mary University, acknowledged that the WHO had a huge responsibility in the early months of COVID-19, but said even bigger challenges were now looming.
“It is not an experiment for WHO to learn lessons for the future, the stakes are too high for that,” she said. “With the next wave of the pandemic, I think the time for quiet diplomacy is over.”
Jamey Keaten in Geneva and Dake Kang in Beijing contributed to this report.