The Flawed But Indispensable World Health Organization

Withholding funding (even temporarily) from the World Health Organization—in the midst of a pandemic and while it has been providing supplies and training to vulnerable nations, including our own—is foolhardy and utterly without merit.

The W.H.O. is accused of having been too deferential to China at the start of the outbreak. But around the same time, on January 24, the president praised the Chinese response on Twitter, stating that “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency.”

When confronted about this tweet yesterday, Trump stated he “would love to have a good relationship with China”—which is ironically why the W.H.O. handled China the way it did.

The organization is run by 194 countries (including the U.S. and China), which also elect its Director-General. In order to facilitate global cooperation and knowledge sharing, it has to strike a delicate balance between providing science-based health information and making sure countries aren’t antagonized or allowed to squabble with each other; otherwise the world might lose out on key information and research.

In fact, the U.S. received vital early epidemiological data from China only because the WHO used its good relations to broker access. That’s the same reason the otherwise secretive Chinese eventually opened up and even published the first genetic profile of the virus for the world to use.

Trump himself seemed to acknowledge this with gratitude. In late February, he tweeted “Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart…”

Furthermore, against initial resistance, the W.H.O. managed to pressure China to allow observers into the country; in early February, an international team led by the agency visited Wuhan, including two Americans, (one from the C.D.C. and the other from the N.I.H.).

Of course, it’s totally fair to debate whether the W.H.O. struck the right balance with China. It could have said more about China’s suppression of independent scientists, lack of transparency and human rights violations. It certainly could have been more open to Taiwan and the crucial information it provided. But again, it’s a hard balance to strike given the need to keep China on board (and recall that most of the world, including the U.S., also avoid official relations with Taiwan out of deference to China, too).

From the beginning, the W.H.O. issued urgent advisories throughout January about the potential dangers from the virus and announced that it constituted a “public health emergency of international concern” a day before the U.S. made a similar declaration. The W.H.O. repeatedly said “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread.”

From January 22, Director General Tedros Adhanom Ghebreyesus held almost daily news briefings to warn the world that the virus was spreading and that countries should do everything they could to stop it. Every day he repeated: “We have a window of opportunity to stop this virus. But that window is rapidly closing.”

The W.H.O. has also been criticized for its decision in January not to impose restrictions on travel from China, which the organization warned would be ineffective— and they were right. We imposed travel bans in February on all foreign nationals who had visited China, but as we know, this did not stop the virus from spreading; we now have more reported cases than anywhere in the world. Meanwhile, countries that did not enact a ban, such as Canada, South Korea, and Taiwan, have fared better those that did.

Finally, the W.H.O. has been taken to task for not declaring a global emergency sooner. But when it made this declaration on January 30, there were still relatively few reported cases outside China. World leaders still had the info and updates to act, and some countries responded immediately; South Korea implemented an effective blend of policies that has made it one of the top success stories. The W.H.O. cannot be blamed for our slow response.

There is no denying that the World Health Organization is a flawed institution. But that’s to be expected of an organization made up of 194 countries, each bringing their own baggage, rivalries, and self interest. For all its problems and missteps, on balance it has done a good job in the face of a very complex and difficult pandemic—one that even the world’s richest country has had a hard time handling.

Perhaps the biggest irony in our abandoning the institution (albeit allegedly temporarily) is that it will give ample opportunity for China to fill the void, as it has been doing throughout the last few years. We bail out of global leadership time and again and then wring our hands at the Chinese for doing the obvious geopolitical thing of stepping in.

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