The crisis in the United States cannot end if the covid-19 pandemic rages elsewhere in the world. It’s that simple: In our interconnected world, Americans are vulnerable to infection. The World Health Organization urgently needs U.S. funding to scale up the response in low- and middle-income countries where epidemics are growing. The pandemic could kill millions in Africa, where test kits are scarce and only small numbers of ventilators are available to help more than 1 billion people. The WHO has urgent work to do.
Instead of leading with global cooperation, however, the discourse in Washington is becoming dangerous and disingenuous. There are valid critiques of the WHO. But many criticisms recently lobbed by the president and political allies are simply wrong.
Critics have accused the WHO of being too close to Beijing and too “political.” This rings hollow. The WHO is a political institution, overseen by 194 governments. Its director-general is elected by a vote of member states. Every director-general has to balance the WHO’s political mission of building global cooperation with its mandate to support science-based health efforts. Dr. Tedros Adhanom Ghebreyesus has been remarkably effective.
It is fair to debate whether the WHO struck the right balance in early messaging on covid-19 in China. We would have preferred to hear more about China’s muzzling of independent scientists, lack of transparency and human rights violations. But WHO leaders have long walked a fine line to keep communication open while coaxing international cooperation. U.S. personnel got key early epidemiological data from China only because the WHO brokered access. In late January, President Trump was thanking President Xi Jinping on Twitter. “China has been working very hard to contain the Coronavirus,” he wrote. “It will all work out well.”
Critics have decried the WHO’s advice in January not to impose restrictions on travel from China, which the organization said is not effective in stopping transmission. The Trump administration focused much of its policy response in February on travel bans of foreign nationals who had visited China. As we all know, border restrictions did not keep the virus out of the United States. Research suggests that the coronavirus circulated in New York since mid-February, brought mainly from Europe. Preliminary data suggests that travel bans have not been helpful; Canada, which did not enact a ban, has fared better so far than the United States and Italy.
The WHO urged in January that “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread.” Yet U.S. politicians focused on keeping the virus out rather than rapidly scaling up core public health defenses when there was time to do so.
Some criticize the WHO for not declaring a global health emergency sooner. China reported the novel coronavirus to the WHO on Dec. 31, describing a cluster of pneumonia cases and no deaths. In retrospect, the virus probably circulated in Wuhan weeks before China’s report. Still, the WHO has been transparent, issuing regular updates and warning governments of likely perils. It was hobbled by inadequate data from China, whose leadership, like the U.S. administration, urged that a global alarm was not necessary.
When Tedros declared a global emergency Jan. 30, there were still relatively few reported cases outside China. World leaders, including Trump, had ample opportunity to act as the virus swept across China and East Asia, then to Europe. Some countries responded. South Korea, for example, blended aggressive testing and contact tracing with social-distancing efforts. It conducted health checks and followed up on arriving travelers. As of Sunday, South Korea had just 214 deaths from its outbreak; the share works out to about 20 cases per 100,000 South Koreans, compared with 162 per 100,000 people in the United States.
The White House, meanwhile, was aware of the threat. Reporting has shown that the National Security Council received intelligence reports predicting spread to the United States by at least early January, and presidential adviser Peter Navarro wrote an urgent memo on Jan. 29. Social distancing guidelines were not established until mid-March. The WHO cannot credibly be blamed for the slow U.S. response.
Meanwhile, China is exercising more power at the WHO and across the international community, partly because U.S. leadership has been largely absent. The United States led global aid efforts in response to earthquakes, tsunamis, and the AIDS and Ebola crises. No such leadership emerged for covid-19, however, and China has sought to fill the breach.
The U.S. failure to lead a coordinated response is sure to lengthen the duration of this pandemic. Weakening and defunding the WHO will undermine the global response — worsening the health and economic devastation to come in poorer countries. None of this will be good for Americans’ health, the U.S. economy or the political survival of U.S. leaders.