16 April 2020

How China Deceived the WHO

KATHY GILSINAN
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Back in January, when the pandemic now consuming the world was still gathering force, a Berkeley research scientist named Xiao Qiang was monitoring China’s official statements about a new coronavirus then spreading through Wuhan and noticed something disturbing. Statements made by the World Health Organization, the international body that advises the world on handling health crises, often echoed China’s messages. “Particularly at the beginning, it was shocking when I again and again saw WHO’s [director-general], when he spoke to the press … almost directly quoting what I read on the Chinese government’s statements,” he told me.

The most notorious example came in the form of a single tweet from the WHO account on January 14: “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus.” That same day, the Wuhan Health Commission’s public bulletin declared, “We have not found proof for human-to-human transmission.” But by that point even the Chinese government was offering caveats not included in the WHO tweet. “The possibility of limited human-to-human transmission cannot be excluded,” the bulletin said, “but the risk of sustained transmission is low.”


This, we now know, was catastrophically untrue, and in the months since, the global pandemic has put much of the world under an unprecedented lockdown and killed more than 100,000 people.

The U.S. was also slow to recognize the seriousness of this new coronavirus, which caught the entire country unprepared. President Donald Trump has blamed the catastrophe on any number of different actors, most recently, singling out the WHO. “They missed the call,” Trump said about the body at a briefing this week. “They could have called it months earlier.” 

Trump may well be looking to deflect blame for his own missed calls, but inherent structural problems at the WHO do make the organization vulnerable to misinformation and political influence, especially at a moment when China has invested considerable resources cultivating influence in international organizations whose value the Trump administration has questioned. (Trump just in March announced he would nominate someone to fill the U.S. seat on the WHO’s Executive Board, which has been vacant since 2018.)

Even in January, when Chinese authorities were downplaying the extent of the virus, doctors at the epicenter of the outbreak in Wuhan reportedly observed human-to-human transmission, not least by contracting the disease themselves. In the most famous example, Dr. Li Wenliang was censured for “spreading rumors” after trying to alert other doctors of the new respiratory ailment; he later died of the virus himself at age 33. China now claims him as a martyr. Asked about Li’s case at a press conference, the executive director of the WHO’s Health Emergencies Programme, Michael Ryan, said, “We all mourn the loss of a fellow physician and colleague” but stopped short of condemning China for accusing him. “There is an understandable confusion that occurs at the beginning of an epidemic,” Ryan added. “So we need to be careful to label misunderstanding versus misinformation; there's a difference. People can misunderstand and they can overreact.”

Those lost early weeks also coincided with the Chinese New Year, for which millions of people travel to visit family and friends. “That’s when millions of Wuhan people were misinformed,” Xiao said. “Then they traveled all over China, all over the world.”

The WHO, meanwhile, was getting its information from the same Chinese authorities who were misinforming their own public, and then offering it to the world with its own imprimatur. On January 20, a Chinese official confirmed publicly for the first time that the virus could indeed spread among humans, and within days locked down Wuhan. But by then it was too late.

It took another week for the WHO to declare the spread of the virus a global health emergency—during which time Dr. Tedros Adhanom Ghebreyesus, the WHO’s director-general, visited China and praised the country’s leadership for “setting a new standard for outbreak response.” Another month and a half went by before the WHO called COVID-19 a pandemic, at which point the virus had killed more than 4,000 people, and had infected 118,000 people across nearly every continent.

The organization’s detractors are now seizing on these missteps and delays to condemn the WHO (for which the U.S. is the largest donor), call for cutting the organization’s funding, or demand Tedros’s resignation. At the White House, Trump’s trade adviser Peter Navarro has been a sharp critic.

“Even as the WHO under Tedros refused to brand the outbreak as a pandemic for precious weeks and WHO officials repeatedly praised the [Chinese Communist Party] for what we now know was China’s coordinated effort to hide the dangers of the Wuhan virus from the world, the virus spread like wildfire, in no small part because thousands of Chinese citizens continued to travel around the world,” Navarro wrote to me in an email. Secretary of State Mike Pompeo recently said the administration was “reevaluating our funding with respect to the World Health Organization;” Trump has said an announcement on the matter will come next week. On the Hill, Republican Senators Martha McSally of Arizona and Rick Scott of Florida are both seeking an investigation of the WHO’s performance in the crisis and whether China somehow manipulated the organization. “Anybody who’s clear-eyed about it understands that Communist China has been covering up the realities of the coronavirus from Day 1,” McSally, who has called for Tedros to resign, told me. “We don’t expect the WHO to parrot that kind of propaganda.” Scott told me he wants to know whether the WHO followed their own procedures for handling a pandemic and why the organization hasn’t been forceful in condemning China’s missteps.

Asked for comment, a representative from the WHO pointed to a press conference Tedros gave this week. “Please quarantine politicizing COVID,” Tedros said then. “We will have many body bags in front of us if we don’t behave … The United States and China should come together and fight this dangerous enemy.” Even in early January, when it was still describing the disease as a mysterious new pneumonia, the WHO was publishing regular guidance for countries and health-care workers on how to mitigate its spread. And the organization says it has now shipped millions of pieces of protective gear to 75 countries, sent tests to more than 126, and offered training materials for health-care workers.

In any case, it’s not the WHO’s fault if China obscured the problem early on, says Charles Clift, a senior consulting fellow at Chatham House’s Center for Universal Health who worked at the WHO from 2004 to 2006. “We’d like more transparency, that’s true, but if countries find reasons to not be transparent, it’s difficult to know what we can do about it.” The organization’s major structural weakness is that it relies on information from its member countries—and the WHO team that visited China in February to evaluate the response did so jointly with China’s representatives. The resulting report did not mention delays in information-sharing, but did say that “China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic.” The mission came back telling reporters they were largely satisfied with the information China was giving them.

If this is something short of complicity in a Chinese cover-up—which is what former National Security Adviser John Bolton has alleged of the WHO—it does point to a big vulnerability: The group’s membership includes transparent democracies and authoritarian states and systems in between, which means the information the WHO puts out is only as good as what it’s getting from the likes of Xi Jinping and Russian President Vladimir Putin. North Korea, for instance, has reported absolutely no coronavirus cases, and the WHO isn’t really in a position to say otherwise.

The structure also gives WHO leaders like Tedros an incentive not to anger member states, and this is as true of China as it is of countries with significantly less financial clout. During the Ebola epidemic in 2014, Clift said, WHO took months to declare a public-health emergency. “That’s three very small West African countries, and WHO didn’t want to upset them,” Clift said. “WHO didn’t cover itself in glory in that one.” The response this time has been much faster and better, in Clift’s observation. “It doesn’t mean it shouldn’t be examined afterwards to see what they could have done better,” he said. “And one should really investigate the origins of what happened in China.”

The WHO has also shown, however, that it can walk the line between the need for cooperation and information-sharing from member states and the need to hold them accountable for mistakes. During the SARS outbreak in 2003, a WHO spokesman criticized China for its lack of transparency and preparation, which had allowed the virus to spread unchecked. China even later admitted to mistakes in handling the outbreak.

No such critique has been forthcoming this time. One study found that China could have limited its own infections by up to 95 percent had the government acted in that early period when doctors were first raising the alarm and the Chinese Communist Party was still denying the extent of the problem. “The WHO at that time didn’t do their job,” Xiao said. “The opposite: They actually compounded Chinese authorities’ misinformation for a few weeks. That is, to me, unforgivable.”

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