Key Points 1
WHO has very limited direct access on the ground until a mission on February 12. It does not question, then or now, China’s official assertions . 2
WHO has only recognized human-to-human transmission of the coronavirus on January 24, delaying declaration of an emergency. 3
WHO has only announced a global pandemic on March 11. 4
WHO does not depend for its budget on China, which gives a very small voluntary contribution, and implements its international health assistance policy (during the Ebola crisis or presently) outside WHO channels 5
Tedros Adhanom Ghebreyesus, initially trained as an epidemiologist, is the first WHO Director-General from Africa and avoids all criticism of China (as opposed to other member states).
From January 23, when China’s turnaround and policies changed radically, the WHO has been a constant stream of useful information, coordination and recommendations to governments. 7
This is made easier by a near consensus on the usefulness of China’s strict containment measures, which DG Tedros calls a “window of opportunity” for the rest of the world. 8
WHO has taken in the South Korean set of policies, although it steadfastly ignores Taiwan’s. 9
The issue is now largely about the capacity of member states – even the most developed – to follow its recommendations, notably on testing, protective equipment, tracing and isolating.
The WHO’s Director-General Tedros Adhanom Ghebreyesus has shown an evident bias to accept Chinese declarations and denials at face value – this has created a delay in international responses.. This in spite of a very limited Chinese contribution to WHO, but it matches the weakness of other UN organizations in the face of China’s powerful campaigning. As China itself has reversed course on the epidemic, the WHO becomes once more an irreplaceable tool in health emergencies.
Timeline of WHO actions
January 14, 2020 – Endorses the preliminary investigation conclusion by the Chinese authorities that there is no clear evidence of human-to-human transmission
January 23, 2020 – Recognises human-to-human transmission of COVID-19 and recommends airport exit screening. WHO’s Emergency Committee meets for the first time
February 4, 2020 – Pledges to share information with governments
February 7, 2020 – Highlights the global shortage of Personal Protective Equipment (PPE)
February 12, 2020 – Publishes Operational planning guidelines for countries
February 20, 2020 – Warns that the window of opportunity “may close”
February 24, 2020 – Recognises potential of a pandemic
February 27, 2020 – Lists “vital questions” for health ministers
February 28, 2020 – Releases “Report of the WHO-China Joint Mission on Coronavirus Disease 2019”
March 5, 2020 – Recommends wide testing
March 11, 2020 – Announces a pandemic
Can the World Health Organization (WHO) be better than the member states of the United Nations that ultimately have a considerable say on its operations? This is a question that has peaked with the coincidence of rising Chinese influence inside the UN system, and the appearance of a pandemic that by all reasonable accounts has started in China. These questions have been made more acute by the lavish praise of China’s behavior from WHO Director-General Tedros Adhanom Ghebreyesus.
WHO is a key UN organization – with a projected base budget (excluding polio and some other special programs) of 3,8 billion $ in 2020 and a major role in recommending, coordinating and assisting both the prevention and the treatment of major health issues. It is also a frequent subject of potential controversy at times of epidemics, because its role, success and failures will then be scrutinized and occasionally scapegoated. It was accused of being very late in declaring an epidemic over the Ebola outbreak in Africa, and earlier of being slow to recognize SARS as well.
DG Tedros’ permanent and forceful endorsement of Chinese actions throughout the crisis has, of course, created a counter-reaction: the organization itself is now accused of having missed the opportunity to forestall a global pandemic. This is the result of two decisions. First, WHO’s failure to recognize proven human-to-human contamination until January 23 (and going along on January 14 with China’s refusal to admit human to human contamination), despite strong and persistent indications to the contrary, and alerts by Taiwanese health officials directly conveyed to the WHO. Second, the organization’s refusal to declare a pandemic until March 11, when 114 countries had already reported 118,000 cases. These decisions have had global consequences, as WHO guidelines are for better or for worse followed by countries and even by private actors who can base – and later justify – their actions from these guidelines. Such was the case for example in France, where public authorities were still saying there was no proof of human to human contamination on January 20. Beyond the issue of what WHO can do at times of epidemics, there is a ripple effect from its statements.
In the present case of the coronavirus, any quick search for information from unofficial sources in China, including but of course not limited to the courageous doctors in Wuhan who raised the alarm from the last week of December 2019, would have established China’s failure to recognize human-to-human transmission and declare an epidemic. Ironically, Taiwan’s status as a “Chinese province” means its own information was officially ignored. We therefore have to search for explanations on the reasons why a 3,8 billion $ UN agency with large regional offices and some of the world’s most extensive experience of epidemics and emergency responses fell into this trap.