By Rya Jetha (PO ’23)
Back in 2018, when going to school, grocery shopping, and itching our noses was normal, the World Health Organization (WHO) put out a plan for accelerated research of diseases like Ebola, SARS and Zika. The plan, known as the 2018 Research & Development Blueprint, included Disease “X” on the list of priority diseases. “X,” stands for “unexpected”, explained Dr. Anthony Fauci of the United States National Institute of Allergy and Infectious Diseases (yes, the same Dr. Fauci who is now immortalized on socks and donuts and may be this year’s People Magazine’s “Sexiest Man Alive”). The Blueprint described Disease “X” in detail: it would likely be a virus that emerges in a place where economic development brings people and wildlife together. The virus would migrate from animals to humans, spread rapidly and inconspicuously to multiple countries, and cripple financial markets before receiving the “pandemic” label.
Disease “X” is COVID-19. The “unexpected” is here. And although the WHO foresaw the possibility of such a disease, it has thus far acted ineffectively and irresponsibly despite its promise of reform after their “egregious failure” in dealing with Ebola in West Africa. This time around, the WHO’s actions can be told through two stories: one of disregard, and one of collusion. Both stories illustrate an organization putting politics above public health.
Let’s begin with the story of disregard.
Taiwan and China have a troubled relationship. Taiwan, an island off the southern coast of China, has rejected the “one country, two systems” framework enforced by China, while China and much of the international community continue to deny Taiwan the right to statehood and subsequent membership of international bodies. Despite its international isolation and its vulnerable geographic position (dozens of flights were arriving in Taipei from Wuhan up until this January), Taiwan has become the poster nation for COVID-19 containment.
Unlike most other countries, Taiwan was proactive when early news of the “Wuhan pneumonia” emerged in December. Taiwan’s strategy to combat the virus was a combination of border control, travel restrictions, information sharing with the public, and online platforms to ration masks and pharmaceutical supplies. In stark contrast to the draconian measures enforced in China to contain the virus, Taiwan has lauded itself on its transparency. Daily televised media briefings from the Health Minister Chen Shih-Chung were part of the government’s open communication strategy to relay accurate information to the public and maintain their confidence.
Three months after reporting its first confirmed cases of COVID-19, Taiwan has had 373 cases and only 5 deaths. It was one of the earliest countries to be hit by the virus, and has one of the lowest infection rates. If you get your COVID-19 updates from the WHO, however, you would not know anything about Taiwan’s success — despite Taiwan sharing all their information about cases and prevention with the WHO, this information is not included in the WHO’s daily updated situation report. The spokesperson for the Taiwan Foreign Ministry Joanne Ou told Reuters that “the health bodies of various countries cannot understand the current situation of Taiwan’s epidemic situation, preventive policies and border quarantine measures from the information provided by the WHO.” Ou’s statement is rather generous to the WHO. The organization allowed China to report on Taiwan’s COVID-19 cases, causing countries to enact a travel ban to Taiwan despite its low number of cases. However, the costs of denying Taiwan direct channels of communication to the WHO have been more than economic.
When health officials in Wuhan announced on December 31st that they had discovered a virus with “no clear evidence of human-to-human transmission,” Taiwan requested more information about the virus from the WHO. The WHO acknowledged the receipt of Taiwan’s request, but did not reply. Taiwan took matters into their own hands. Two weeks later, they sent health officials to Hubei province, who concluded that there was a high chance that the virus could be transmitted between humans. At the same time, WHO and Chinese officials assured the world that the virus was nothing to worry about. Four days later, the Chinese government announced that human-to-human transmission of COVID-19 was happening.
Let’s turn now to the story of collusion.
The WHO did not have access to China until Director-General Tedros Adhanom visited President Xi Jinping in late January. Until then, the WHO reported information coming out of China uncritically, parroting the propaganda machine of the Communist state. Steve Tsang, director of the China Institute at the School of Oriental and African Studies said “I thought the greatest success of the Chinese party-state was in getting the WHO to focus on the positive sides of China’s responses and ignore the negative sides of the responses. With the WHO presenting China’s responses in a positive light, the Chinese government is able to make its propaganda campaign to ignore its earlier mistakes appear credible and to ignore the human, societal, and economic costs of its responses.”
Defenders of the WHO have emphasized that the organization has a measly $2 billion operating budget (which is smaller than most university hospitals) spread across a vast number of public health works and research. Stephen Buranyi of The Guardian wrote a few days ago that “the WHO is less like a military general or elected leader with a strong mandate, and more like an underpaid sports coach wary of “losing the dressing room,” who can only get their way by charming, groveling, cajoling and occasionally pleading with the players to do as they say.” Despite being drained of power and resources, the WHO has not used the little power it has to be an objective, accountable international body.
After Tedros’ visit to Beijing, the WHO put out a statement saying they appreciated “especially the commitment from top leadership, and the transparency they have demonstrated.” Transparency? We’re talking about a country that is forcing people to quickly and quietly bury their dead and actively suppressing the true COVID-19 death toll in China. We’re talking about a country that reprimanded Dr. Li Wenliang for “rumour-mongering” on the medical school alumna WeChat group about seven cases of pneumonia in his hospital that resembled SARS. We’re talking about a country that has been anything but transparent.
Shortly after the Beijing meeting, on January 30th, the WHO declared a public health emergency of international concern. They also praised China’s “extraordinary” efforts to combat the epidemic and asked other countries not to restrict travel. Instead of consulting Taiwanese public health officials, the WHO presented China as a model country for COVID-19 containment, saying China’s “uncompromising and rigorous use of non-pharmaceutical measures” is a lesson for the international community and that Beijing’s strategy has “demonstrated that containment can be adapted and successfully operationalized in a wide range of settings.” The WHO ignored the side-effects of prescribing such measures to the international community — the effect on non-coronavirus patients, the psychological effects on the population, the human rights costs, and the economic collapse that would ensue. Lawrence O. Gostin, director of the WHO Collaborating Center on National and Global Health Law at Georgetown University, suggested that lockdown techniques pioneered in China and now being adapted to other countries are not “scientifically justified,” and countries should instead adopt practices like testing, treatment, contact tracing, isolation, and quarantine. Practices that Taiwan adopted. Practices that WHO ignored as they were bullied by China and then put them on a pedestal.
In late March, Radio Television Hong Kong journalist Yvonne Tong interviewed Dr. Bruce Aylward, a Canadian physician, epidemiologist and senior advisor at the WHO. Tong asked Aylward if the WHO would reconsider Taiwan’s membership, Aylward said he could not hear the question. When Tong offered to repeat it, he said, “no, that’s OK, let’s move to another one then.” “I’m actually curious to talk about Taiwan as well,” said Tong. Aylward then hung up (or perhaps was disconnected).
The WHO’s suppression of Taiwan and its complicity with China is disturbing and unforgivable. As I write this, I am staying with relatives in the Bay Area, unable to return to my family in Mumbai because of travel restrictions. We are living just like everyone else, wondering if our next trip to the grocery store will prove fatal, worrying for our elderly parents and grandparents, and still feeling thankful that we have the luxury of self-isolation.
It shouldn’t be like this. Maybe if the WHO was not so quick to hang up on Taiwan, it wouldn’t be.
Thank you to Izzy Davis for editing the piece!