275 views | Dr. Binoy Kampmark | April 17, 2020
The US president is in a warring mood. Having declared himself a president at war, a meaningless gesture given that the US is always, somewhere in the world, at war, finding necessary enemies in distraction was always going to be a priority. Donald Trump already had the “China virus” in his artillery, attaching nationality to the pathogen. Now, and it took some time in coming by his standards, is the World Health Organization, a body which has, as its utopia, an idea of health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”
The US tends to contribute a large slice of funding to the WHO – some $400 million a year and ten times, say, what China does. It has been foot-dragging lately: $200 million is still to be paid for the last round. (As a point of interest, the Bill & Melinda Gates Foundation is the second-largest donor, with a touch over $200 million based on 2018-9 figures.) In a flourish of indignation, Trump has decided to freeze the revenue stream. On Tuesday, he claimed that the WHO had “failed in its basic duty” in responding to COVID-19. “I am directing my administration to halt funding while a review is conducted to assess the World Health Organization’s role in severely mismanaging and covering up the spread of the coronavirus.”
The White House has been eager to disgorge any material to press outlets keen to understand the nature of WHO villainy and corruption. Accusations read like mirror portraits, and the headline of one of the factsheets is hysterical: “Delaying world mobilization in the fight against COVID-19: Working with China to cover up the deadly spread of COVID-19, who hindered critical efforts that could have saved lives.”
The charge list on the White House fact sheet is the usual muddle of slung mud and mild accuracy: the role played by brave Taiwan; the WHO deference to “Chinese propaganda that covered up the virus’ spread and fatalities, praising Beijing for its false efforts and promoting the use of Chinese traditional medicine to treat the disease.”
Nor can we deny the obvious remark that the US was “not alone in its well-founded criticism. WHO has faced constant critique over its poor coordination, lack of transparency, and finances from multiple parties.” This would sound like a superb summary of the Trump administration, but the president lacks humour in such matters.
The organisation’s director-general Tedros Adhanom Ghebreyesus, who had previously praised Trump as showing “leadership” in this crisis (we are all entitled to slips), was regretful. The US had been “a long-standing and generous friend… and we hope it will continue to be so.”
The WHO is the convenient whipping boy of pandemic and epidemic; of premature assessment or over-eager commitment. Uncertainty is its curse, leaving it vulnerable in such instances as the swine flu epidemic when it was accused of being too quick off the mark in declaring it to be a pandemic; or too foot slow in declaring the West African Ebola outbreak a pressing health emergency. And forgotten in its current shade of demonization by Washington is the fact that the WHO, for decades, was belittled for being an auxiliary of US foreign policy. “Like other United Nations (UN) agencies,” comes a sombre assessment in the American Journal of Public Health in 2016, “the WHO quietly abandoned its dreams of a collaborative community of nations and instead began to come to terms with international political realities. The agency moved closer to US foreign policy and became partially captive to US resources and priorities.”
By no means should the WHO be seen as angelic. No international organisation is, marked as they tend to by the gravy train effect, the flabby end of upper management more interested in first-class travel than fighting health problems. At the same time, it has also operated with one hand tied behind its back, reliant, as it were, on the initial drips and drabs coming from the source country where an infectious outbreak has taken place. Its chief has, it is true, shown an unsettling tendency to praise the Chinese effort, which has veered between harsh and muscular concealment to harsh and muscular quarantine. But it is worth casting an eye to the more workmanlike nature of the process of how the WHO formed a picture of what was happening.
China’s first smidgens of information on COVID-19 reached the WHO on December 31, describing it as “a pneumonia of an unknown cause”. On January 5, the organisation, based on what was provided by Chinese sources, stated that the material showed “no evidence of significant human-to-human transmission.” No causal agent had been as yet identified or confirmed, and the WHO admitted to having “limited information to determine the overall risk of this reported cluster of pneumonia of unknown aetiology.” The advice given in that note now seem like the haunted warnings of premature assessment: no recommended specific measures for travellers; no application of travel or trade restrictions on China. Again, the caveat, weighty as ever, was always on what was in the hands of WHO functionaries, who, it should be said, are not entirely shock horrors in the epidemiology department.
In time, the picture became more muddled as information started to clot the canvas. The Wuhan Health Commission refused to rule out the possibility of human-to-human transmission. The WHO, as January progressed, started drawing parallels, basing its assessments on other coronaviruses. What this chaotic swirl of information does not seem to show, as Trump alleges, is that Taiwan in its exchanges with WHO went heavy on the idea of human-to-human transmission.
Then came Trump’s own glorious words of praise, lost in consciousness but retrievable in cyberspace. “China has been working very hard to contain the Coronavirus,” he tweeted with boyish enthusiasm on January 25. “The United States greatly appreciates their efforts and transparency. It will work out well. In particular, on behalf of the American people, I want to thank President Xi!” Not exactly hostile.
Trump’s change of heart revolves upon supposed tardiness in sending in that class of individuals he tends to despise: the experts. “Had the WHO done its job to get medical experts into China to objectively assess the situation on the ground and to call out China’s lack of transparency, the outbreak could have been contained at its source with very little death.” Lacking in this resentful assessment is the point that plagues all international bodies: their need to respect the sovereignty of member states.
The immediate consequences of such funding will have the effect, as has been threatened before, of driving the WHO to bankruptcy. The front organisation responsible for marshalling the medical side of combating disease and infection will be hobbled. Trump can at least have one historical comfort: in pulling US funding, he joins the defunct Soviet Union in refusing to pay membership fees for several years after it had “deactivated” its membership. Grievances with international governance, be it over health, security, even sport, never age.
Dr. Binoy Kampmark was a Commonwealth Scholar at Selwyn College, Cambridge. He lectures at RMIT University, Melbourne. Email: firstname.lastname@example.org