The Thankless Work of the WHO

Despite having one-fourth the budget of the American CDC—and a host of structural problems owed to being governed by nearly 200 countries—the WHO does quite a lot of good work, most of it behind the scenes and thus unappreciated—hence most Americans being indifferent, if not supportive, of our recent withdrawal.

➡️ It helped eradicate smallpox, a scourge of humanity throughout history that used to kill millions annually, even into the mid 20th century. This was accomplished partly by getting Cold War rivals the U.S. and Russia to consolidate their scientific and technological resources. In 1975, less than a decade after launching this effort, smallpox was vanquished.

➡️ It is close to eradicating polio, another horrific infectious disease that was once widespread, but now lingers in only two or three countries. Rates of polio infection dropped 99% since the global campaign was launched in 1988.

➡️ HIV/AIDS is no longer the death sentence it used to be, thanks in large part to the WHO, which reduced the cost of HIV medication by literally 95.5%. Over 80% of people with HIV/AIDS use drugs backed by the WHO; consequently, AIDS-related deaths have declined by over half since their peak in 2004.

➡️ The WHO is currently working on reducing the cost of insulin as well, as nearly half the world’s 80 million diabetics cannot afford it (including in the U.S.). It hopes to achieve the same results as with HIV/AIDS, through the same process known as “prequalification” (in which cheaper drugs, mostly from developing countries, are approved for safety and efficacy, allowing them to enter the global market).

➡️ In 2017 alone, it helped stem a yellow fever outbreak in Brazil (by providing 3.5 million vaccine doses), provided vaccines to nearly five million children in Yemen in the midst of its civil war; expanded mental health support to Syrians affected by their civil war; and provided new healthcare support (such as ambulances) in places like Iraq and South Sudan).

➡️ With respect to COVID-19, the WHO has shipped literally millions of items of personal protective equipment to 133 countries. It has launched a global trial involving the world’s top medical experts to find the most promising treatments and vaccine. As of now, 5,500 patients have been recruited in 21 countries, with over 100 countries joining or expressing interest in joining the trial.

➡️ Early on, 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 published the first genetic profile of the virus for the world to use. Against initial resistance, the WHO succeeded in making China allow observers into the country; in early February, an international team led by the agency visited Wuhan, including those from the CDC and NIH.

➡️In 2018, the WHO warned the world that it was not ready for a pandemic and needed to do more. It declared COVID-19 an emergency on January 30, when there were still relatively few reported cases outside China. World leaders still had the info and time to act, and some countries responded immediately; South Korea, New Zealand, and others implemented an effective blend of policies that made them one of the top success stories. The WHO cannot be blamed for our slow response.

➡️ Even Trump himself seemed to acknowledge the WHO’s work 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…” In the weeks leading up to its withdrawal, the U.S. was still leaning on WHO experts for assistance, with even Secretary of State Pompeo trying to get the administration to soften its break up with the organization.

As always, I welcome any fact checking on these claims.

The Pandemic Success Story No One Has Heard Of

Senegal is the pandemic success story no one has heard of—which actually tells you how successful it has been! The much-maligned WHO, as well as the CDC and UNICEF, played a key role in that.

In this country of 16 million known for its peaceful democracy and sense of community, Senegal’s response to the coronavirus is notable not only for its humanity but for its thoroughness. For example, each newly diagnosed individual – no matter how mild or severe the case – is provided a hospital or health center bed where he or she stays isolated and observed– a key element to Senegal’s strategy to contain the virus.

“Senegal is doing quite well, and we were impressed at the beginning at the full engagement and commitment by the head of state,” says Michel Yao, program manager for emergency response for the World Health Organization Africa.

Officials from both Senegal’s ministry of health and WHO stress that the wheels of the response team were set in motion five years ago in response to the Ebola outbreak in West Africa. Yao explains: “What we advised countries to have in place following Ebola in West Africa was to have an operations center, to have in one place the required information for effective decision making. It’s quite an important tool to control the crisis, and this was a good plan from Senegal to have this structure.”

Senegal set up its Health Emergency Operation Center (also known by its French acronym, COUS), in December 2014, in response to the Ebola outbreak spreading in nearby countries. At the start of this year, the center had some 23 staff members – five of them doctors.

Over the past five years, that center, working with the ministry of health and the support of international partners such as the World Health Organization, the U.S. Centers for Disease Control and Prevention and UNICEF, have run simulations of mock outbreaks and crafted emergency measures to activate in case of an epidemic.

Along with Vietnam and the Indian state of Kerala, Senegal proves that wealth alone is not a predictor for a successful pandemic response. It also shows the importance of working with international partners to get as many different perspectives, resources, and knowledge as possible.

The First Global Event

The novel coronavirus outbreak may be the first time in our species’s 250,000 year history that virtually everyone is being affected by the same event simultaneously. As Joshua Keating of Slate notes:

“Global event,” in this case, means a distinct occurrence that will be a significant life event for nearly every person on the planet. This is not to say that we’re all experiencing it the same way. Some become ill or lose loved ones; others lose jobs or livelihoods; for others, it’s merely a source of inconvenience or anxiety. And different countries and local governments are responding to the crisis in very different fashions, leading to wildly divergent outcomes for their citizens. But as the writer Anna Badkhen puts it, not since human beings first began spreading across the globe has a single event “affected everyone, on every continent, as instantly and intimately and acutely as the spread of coronavirus, uniting us as we fear and think and hope about the same thing.” It’s the truly global nature of the crisis that French President Emmanuel Macron was referring to when he called the coronavirus an “anthropological” shock.

This truth says as much about the era in which COVID-19 emerged as it does about the virus itself. It was only in the past 500 years that people in all regions of the Earth even became fully aware of one another and in the last 200 that they’ve been able to communicate more or less instantaneously. And it’s this very interconnectedness that allowed the virus to spread so rapidly across the globe. (The Black Death felt like the end of the world to many who experienced it, but more than a century before Columbus, entire continents of people were unaware of it.)

Previous events have had global impact in the past. Billions of lives have been affected by, say, the French Revolution, or 9/11. Contemporaneous writers have made cases for various events as the “shot heard round the world” or Ten Days That Shook the WorldBut these events were not experienced by the entire world at the same time—not even close.

Even the world wars, contrary to their description, did not impact the day to day lives of most people in Latin America, Africa, and parts of Asia. By contrast, COVID-19 has forced virtually every country in the world to either implement life-changing lock-downs or to endure the impact of the subsequent economic slowdown. Previous pandemics, including the deadly 1918 “Spanish”, were either limited in their geographic spread or occured when the world lacked an international forum for coordination or communications. These things still felt very much localized.

This matters because our species has only recently reached a level of consciousness and moral awareness that extends beyond the interrelated bands and tribes that were the norm for most of our quarter-of-a-million-year existence. Suddenly, we’re feeling for victims across the world, in places most of us have never been; learning from countries we otherwise never give much thought to (or in some cases can’t even find on a map); and enduring the same sorts of shocks to our routine as billions of other humans we pretty much forget exist. (Of course we know there are billions of other humans out there, but how often do we stop at any moment to consider how their lives our playing out at the same time as ours?)

As Keating notes, those of us with an internationalist bend are largely disappointed with the fractured and even divisive response by the world community. The notion that a bigger threat might finally unite humankind in a productive and cohesive response has yet to be proven. (Will it really take an alien invasion or robot uprising!?) I’m a tad bit more optimistic though: Though beleaguered and under siege, international institutions like the World Health Organization are still doing their thing; many countries and international organizations are coming together to pool their funds, resources, and knowledge to tackle this threat. As always, progress is never neat and linear.

However this global even hashes out, one thing is probably certain: Most people will pay more attention to what goes outside their respective countries.

Perhaps a more realistic expectations is that people may change how they view far away events—events like a mysterious virus cluster in Wuhan. Those of us who write about world news are used to making the case that people should care about events that happen in other countries and continents because it could eventually affect them—that political developments in Russia or a drought in Central America can very quickly become a major event in American life. Perhaps after the common experience we’ve all just shared, it will be a little easier to grasp the importance of faraway wars, revolutions, famines, and even “massively distributed” problems like climate change, feel a little more empathy for those directly affected by them, and have a little better sense of how they might soon affect us. For the first time ever, it feels like it’s literally true to say that international news is just news that hasn’t become local yet

While there have been no shortage of wars or diplomatic crises that should have roused us from our parochialism and insularity, maybe the first truly global even should do the trick.

The Perils and Promise of Globalization

I know my bias for internationalism and globalization are obvious. But I genuinely believe this pandemic has made clear that however we feel about global interconnectedness, there is simply no other way to fight something like a pandemic without the world working together.

Global threats like viruses, terrorism, environmental degradation, and the like don’t adhere to borders. They’re too big, spread out, and complicated for even the most powerful countries to handle them on their own. At the very least, countries need to coordinate and keep each other informed, but they also need to pool their resources, know-how, and ideas, too.

Consider this pandemic: On the one hand, globalization did make it easier for it to spread, given the unprecedented amount of travel, migration, and business that occurs across the world. But there’s really no preventing that: Even seven hundred years ago, the world was connected enough for the Black Death to sweep through much of Asia and Europe, wiping out a quarter to half of the societies it struck. Good luck going back to pre-Medieval levels of international engagement.

Plus, on the other hand, globalization is helping us tackle this virus and prevent another Spanish Flu, which claimed 50-100 million lives beginning during World War I, when most nations weren’t working together. (Heck, it’s called Spanish Flu precisely because Spain was the only country to report openly about it; the U.S. and the rest of Europe kept it under wraps so as not to appear weak in the war.)

Notwithstanding its poor initial response, China quickly acted to contain the virus and assist the world (whether for charitable reasons, to save face, or both, is irrelevant). As early as January, Chinese scientists figured out the genetic code of the virus and shared it with the world. Australian researchers quickly found a potential treatment, followed by scientists in Canada, Israel, Germany, the U.S., and elsewhere.

The west African nation of Senegal—all too familiar with pandemics given Ebola’s impact on the region—worked with the U.K. to develop one of the fastest testing rates and a possible treatment.

Thailand, Vietnam, and China have found novel drug combinations that may be effective; the Vietnamese have done well enough that they’re aiding their poorer neighbors and even the West with supplies.

Taiwan has become recognized as a global leader in pandemic response, aiding other countries with both medical supplies and its highly effective strategy (which have been emulated to great success by other countries, such as New Zealand).

Italy found a way to 3-D print lifesaving respiratory valves, while an Irish-based research group is making similar techniques openly available to the world.

For all its flaws, the U.N. World Health Organization has proven beneficial on balance. It’s brought together dozens of top researchers across the world to discuss solutions; has provided supplies to countries around the world (including the U.S.); and is leading a “Solidarity Trial” involving labs across the wold to test the four most promising treatments. (Recall that the W.H.O. led the effort to eradicate smallpox, which has killed hundreds of millions, and helped discover an Ebola vaccine.)

Speaking of global efforts: the Coalition for Epidemic Preparedness Innovations (CEPI) is also leading the charge for a COVID-19 vaccine. Based in Norway, it brings together governments and organizations all over the world to tackle the worst infectious diseases bedeviling humanity.