Image: Marcus Winkler (Unsplash)
“The W.H.O. really blew it,” President Donald Trump tweeted on 7 April 2020, referring to the World Health Organization. “For some reason, funded largely by the United States, yet very China centric. We will be giving that a good look.” In the global spotlight, the World Health Organisation (WHO) has been criticised for its lack of responsiveness, especially in the beginning in managing the COVID-19 pandemic. This has been the case with every major health crisis. The WHO was founded in 1948 by the United Nations (UN) and has 194 members. It plays an important recommendation, coordination and assistance role in preventing and managing global health crises. The organisation is facing criticism for being slow to act and counter the spread of the COVID-19 pandemic. Justifiably so, it was on January 24th 2020 that the WHO recognised this new virus as being readily transmittable, from one person to another, although this was already evident from cases in Wuhan, China, in December 2019. Which is worrying, as this spread was not declared an international public health emergency until January 31st 2020. At some point, it took Taiwan and other international organisations to issue direct warnings to the WHO about the urgency of the situation. It was not until March 2020 that the WHO declared COVID-19 a pandemic.
This is déjà vu all over again, in 2014, the organisation (then headed by Margaret Chan) was strongly criticised for its tardiness in issuing an alert about the spread of the Ebola virus in countries such as Sierra Leone, Liberia and Guinea, which were ravaged by the virus and experienced unnecessary fatalities. In this instance, an epidemic was declared in March 2014 by the ministry of health in Guinea. Yet it took until August 2014 for the WHO to announce a global public health emergency. Surely there are institutional deficiencies here. In response, a UN mandated Report of the Ebola Interim Assessment Panel pointed to ‘serious shortcomings in contacts with local communities during the first months of the epidemic’ and how the ‘Ebola crisis not only exposed the organisational failings in the functioning of the WHO, but it also demonstrated shortcomings in the International Health Regulations. If the world is to successfully manage health threats, especially infectious diseases that affect us all, then the regulations need to be strengthened.’ The report concludes that ‘there is a strong consensus that the World Health Organisation does not have a strong enough capacity and culture to lead emergency operations.’
Furthermore, what has been evident in the past few months, is that regardless of mainstream media praising Dr Tedros Adhanom Ghebreyesus, the WHO in fact, has been weak in dealing with the COVID-19 pandemic and has failed in putting pressure on China to investigate the origins of the virus. The WHO failed to act decisively and exercise its global health leadership and instead became a tool for Chinese politics and propaganda. Strategic experts such as Anne Senequier of the Institute of International Relations (IIR) would argue that this is simply because of the strong ties between China and Ethiopia. That although ‘in late 2016, he faced attacks from several Ethiopian doctors who accused him of having concealed three cholera epidemics that occurred in his country while he was Minister of Health between 2006 and 2011, which allegedly deprived his country of international aid, an allegation he denied.’ He still managed to campaign successfully and capture the votes of most African Union (AU) countries and other WHO member states. Many argue that this is because he was China’s preferred candidate. This raises two questions, not only the competency of his leadership and some of the institutional deficiencies which we have seen since the pandemic, but also the institutional powers of the WHO with regards to holding countries accountable for sharing of information. Especially with countries such as China with limited public freedoms (in a liberal sense) of information dissemination.
It is without a doubt that the blame game has and remains a serious distraction from the essential work needed to control and flatten the curve, thus coordinated efforts could be a starting point for the United States and China to not only depoliticise the pandemic, but also control the virus.
Given the aforementioned, there are three options in going about to fix the WHO. The first would be, what President Trump wants to do, and that is retiring the WHO, in this case it cannot be fixed, therefore, throw it away. The second option would be, which I am cynical about, projecting new programs and phasing out of the old ones and eventually hope that it works, and is restructured. Lastly, because of the nature of globalism, there needs to be a recognition that states are not primary and sole authority actors in global politics, which liberals and realists might argue otherwise. Nonetheless, there needs to be shared authority through different institutional networks which recognise that the world is changing, and only then, we can move towards a radical restructuring of global health governance.
Nkosana Sithole is a Mellon Mays Research Fellow (MMUF). He is a graduate student working towards a Master of Management in Governance, specialising in Public Policy, at the University of the Witwatersrand’s School of Governance.