Front Burner - WHO under fire as U.S. halts funding

Episode Date: April 15, 2020

U.S. President Donald Trump has put the World Health Organization in the crosshairs, announcing Tuesday the U.S. would halt funding and accusing the agency of mismanaging the coronavirus crisis by being too deferential to China. Today on Front Burner, we take a closer look at the UN body, the organization’s track record and its limitations, with Guardian science writer Stephen Buranyi.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson. The world depends on the WHO to work with countries to ensure that accurate information about international health threats is shared in a timely manner. The WHO failed in this basic duty and must be held accountable. It's time after all of these decades. So that was Donald Trump yesterday evening, promising to halt funding to the World Health Organization, the UN agency that's been handling the global response to the COVID-19

pandemic. The move comes amid criticism, not just from the U.S. president, who we all know is no fan of big international organizations, but also from the likes of Japan's deputy prime minister. The deputy prime minister said the WHO should change its name to the CHO, or China Health Organization. and also yesterday, from more than 100 China experts and senior political figures. In an open letter, they accused the WHO of being under the influence of China, saying the WHO initially downplayed the pandemic. Today, how much responsibility does the WHO have in all of this? And what is the future of the organization? We spoke with Stephen Baranyi before President Trump's announcement. Baranyi writes for The Guardian, and he's written at length about criticism leveled at the WHO and the challenges the organization faces today. This is From Berger.

Stephen, thank you so much for joining me today. Thanks for having me. So let's start today with this relationship between the WHO and China. As I mentioned, there is this growing international criticism over outsized Chinese influence in the WHO's response to COVID-19. And can you tell me more about that criticism? Yeah, I mean, I think you sort of have to separate it into several bits. I mean, there's a lot of questions about the influence of China on the WHO sort of before the crisis started. And here, I don't think there's sort of a big critical leg to stand on. I mean, China is not a very big donor to the WHO. And before this crisis,

the WHO was sort of seen as a place that the Chinese government, Chinese state could sort of project power, project influence that wasn't very controversial. I mean, I think one thing that's important to remember when talking with the WHO is that before this crisis, most people didn't think about it very much. Right. This isn't an organization with a ton of authority right like we're not talking about nato here no i mean and and to zoom in on that like yeah it unlike nato unlike sort of the wto things like that it doesn't have a lot of uh i mean you could say authority but i would even say power doesn't really have any power to control its members um so yeah like i said it was a place

that china uh as with many other sort of international organizations, was just trying to present a very good face. And then basically the criticism is that in the at least first two to three weeks of the crisis, this is what we know, possibly earlier, China was basically obfuscating the situation, either at the local or higher level, not clear, basically not reporting all of the information it had about the outbreak that it was dealing with. It was back in late December when Dr. Li Wenliang first warned friends on WeChat about a SARS-like disease going around. Li sent a group message saying that a test result showed a patient had a coronavirus. Chinese police then accused him of making false statements,

of severely disturbing the social order. He was then forced to sign a document. And so then that's the criticism of China. And then the criticism that goes on to the WHO is basically to what degree they were allowing this to happen in order to sort of keep China in line in the hopes that they would respond better in the future. And do you think that that criticism is valid? You know, it has recently come out that Taiwanese officials say that they warned the WHO on December 31st, as early as December 31st, that there was human-to-human transmission. And then on January 14th, the WHO announces that Chinese authorities have seen no clear evidence of human to human transmission. Do you think there's merit to that criticism that, you know, they the WHO essentially believe China over Taiwan?

I mean, to a certain extent, I mean, this is getting into a very complex situation because China has essentially blocked Taiwan from being part of the WHO. And that's not specific to the WHO. They've been blocking Taiwan from from officially joining the United Nations and all United Nations bodies of which the WHO has won since 1971. Senior WHO official Bruce Aylward, a Canadian epidemiologist, has raised hackles in Taiwan by appearing to dodge questions. The WHO considered Taiwan's membership? Hello? I couldn't hear your question. Okay, yeah, let me repeat the question.

No, that's okay. Let's move to another one then. Right, because I'm actually curious on talking about Taiwan as well, on Taiwan's case. And so there's a clash there. I mean, I think that there is definitely something to look into with Taiwan's warning. However, I mean, I think it's worth noting that the largest outbreak was in China. And early on, very early on, there was no reason to suspect that China wasn't reporting properly. And so I think the WHO is very much focused there. I mean, and what you're getting with this sort of not reporting properly is sort of two things. The human-to-human contact is the really big one. And so it's very clear that at least at the local level, Chinese officials

basically suppressed or muzzled doctors from speaking out about their suspicions about the severity suspicions of human to human contact. Bold blowing whistles to remember a whistleblower. Dr. Li Wenliang worked and died at this Wuhan hospital. A victim of the virus he dared to warn about before the government would. And then there's some there's sort of a very muddy area in any outbreak very early on where you are receiving confirmations of what it might be, but there's just not enough scientific information to call it.

And so this is stuff like, when is the proper time to say this is a coronavirus outbreak? Now, I know from talking to scientists, this is now sort of publicly available information, that earlier than the 31st, some scientists had done tests and shown that this was a coronavirus outbreak. Okay, earlier than the 31st of December. Yeah, but the threshold for when a government needs to announce that, you know, this is for sure coronavirus is a little bit fuzzier than that.

And so I think you can definitely criticize China for not confirming it was coronavirus earlier. But you have to remember that outbreaks spring up that you've never heard of because they turn out to be nothing, if that makes sense. You know, it's not like a lack of transparency around an outbreak is something new for China, right? Like, we saw this in SARS. And as Times reporter Donald McNeil explained, dead silence had deadly consequences. Well, I mean, if China had admitted what was going on, then presumably that doctor would not have left southern China and he never would have infected those 12 people in the Metropole Hotel in Hong Kong. So the disease would never have gone to Canada. It never would have gone to Vietnam. It never would have gone to Singapore.

And so why didn't the WHO do its own due diligence here? Like, for example, why did they not send a team out as soon as they got word that this was happening? So there's sort of two things going on there. The WHO does do its own due diligence on the outside. So basically, since just before SARS, they do their own monitoring. So they don't rely entirely on nations to report outbreaks to them. So they monitor doctors just through social contacts. They monitor the media. They monitor sort of these news groups and Internet boards that scientists and doctors post on.

So they did have a fair bit of information coming from within China. And then the second part of that, you know, why didn't they send a team? Well, I mean, that one's easy. And this is this is, I think, the easiest thing to criticize China for. And I think they deserve to be criticized for. They refused to allow a WHO led scientific team to go into Wuhan at that time and didn't actually let them in until until February. Right. And so this is something that I had been wondering at the end of January. The director general was allowed to visit China, even though he didn't get a team into Wuhan. Right. But he praised China's leadership for setting a new standard for outbreak response. with which China detected the outbreak, isolated the virus, sequenced the genome, and shared it with WHO and the world are very impressive and beyond words.

So is China's commitment to transparency and to supporting other countries. And I know that this surprised many health experts. They were surprised at sort of the level of praise, particularly because the WHO wasn't allowed to send a team into Wuhan. Was there pressure put on this organization to say those sorts of things? Almost all member states were praising China for what it did. And so what was the motivation behind this praise? Like, why were we hearing this at the end of January? I mean, you're seeing Tedros praise Xi Jinping's

leadership specifically, because I think that they didn't think there was any other way to get into the country. I mean, basically, at one time, as you mentioned, you know, that this happens in China once before during SARS. The doctor general at that time was a very different person. And she very publicly and very directly criticized China and Canada, for that matter, for their handling of the outbreak. If we look at China, there still is a considerable number of cases every day. So certainly we have not seen a peak in China yet. The WHO has changed a lot since then. And I think that it would be safe to say that they feel much more subservient to member states. They feel much more like they act at their behest rather than

acting slightly on the sort of on the same level. And so to answer it quickly, I mean, Tedros thought that was the only way to get the team in was to say, look, you guys are doing a great job. So let's talk about that a little bit, how the role of the WHO has changed over the years. You talked about the former director. This is like the former prime minister of Norway. She was very tough on Canada in 2003. I remember this on Mel Lastman in particular. Headlines around the world echoing the warning of the World Health Organization.

Don't travel to Toronto unless it's absolutely necessary. That sense of outrage was echoed by Toronto's mayor. Who did they talk to? Did they go to our hospitals? Did they go to our clinics? Did they go anywhere? You made a mistake in labelling Toronto in that way, or were you right? We must take the precautionary measures now. It is now we have a chance to contain it. And you have to use public health tools to do so. But tell me a little bit more

about the role of the WHO in SARS. Sure. So the WHO has been around for about 70 years. But in its modern incarnation, in terms of its outbreak response, in terms of us seeing it as sort of this, you know, organization that coordinates the entire world's response to an outbreak, that comes from the SARS crisis. And so Gro Harlem Brundtland, the former prime minister of Norway, was the director general at that time. And without there being sort of a template for doing so, she basically took charge of the situation. She told China that they were not cooperating. They weren't sharing data, basically.

They weren't sharing patient data about the outbreak. She told them to get it together. They issued travel recommendations. So, you know, you shouldn't go to this area. You shouldn't fly to this area. Despite having no power to sort of ground planes, everybody listened. Flights to affected areas dropped. She criticized the city of Toronto very specifically for not tracking and tracing its cases properly. And that's why the World Health Organization is reclassifying

Toronto's transmission category as a level C. Essentially a slap on the wrist for the health officials who are responsible for containing it. And more bad news for a city reeling from SARS. And sort of just by taking charge like that, people listen to her. And it's one of the most successful responses to an outbreak ever. And it's definitely the most successful in WHO's history. Due to an unprecedented global collaboration in public health, unprecedented global collaboration in public health, the World Health Organization can say that the SARS outbreaks have been contained worldwide. So how does she compare to the WHO's current director? So Tedros Adhanom Ghebreyesus?

Is it their leadership styles that are very different? Or is Tedros sort of handcuffed by different systemic issues that Gro Harlem, Brundtland didn't have to contend with? Yeah, I mean, the first thing is that the WHO in general and Tedros specifically are in a much more fractured international situation. Basically, you're seeing countries the size of the United States withdrawing from sort of their place of leadership, whether you think that's a good or a bad thing in the international system. So they're basically dealing with a much more fractious situation than she was. But also, they're very different people. And I think it's fair to say that

Gerhardt and Brundt was a much better leader than not just Tedros, but perhaps any director general after her. But she was also quite an anomaly. I mean, it's a rarity that a former prime minister or president of a country would lead something like the WHO. It happened that she was a doctor. I think she thought it was interesting. I mean, obviously, she was a stronger leader and was able to exert more authority than anybody after her. Tedros is a lot more like other WHO director generals. He's not a doctor, which is quite unique, but he was a minister of health. And I think he's more comfortable with organizational politics

and the sort of slow administration of public health around the world than sort of this jousting on the world stage like she was. No need to use COVID to score political punches. You have many other ways to prove yourselves. punch. You have many other ways to prove yourselves. This is not the one to use for politics. And you mentioned after SARS. Tell me about what happened to the WHO after this, I don't know, high point in leadership in 2003. Sure.

So some people sort of characterize it as almost a lost decade after that. So they basically formalized some of their approaches to SARS in terms of what countries were supposed to do, listen to them, listen to their advice, tell them if they weren't listening to their advice, report certain things. But again, no legal power behind any of those things. And then they sort of deal with these two big crises, both when Margaret Chan, who was a Chinese-Canadian physician, was the director general. So the H1N1 flu outbreak and then Ebola in 2014. And so during H1N1, although they did contain the outbreak, they were widely seen, especially in the media, to have basically overplayed it and made it out to be more dangerous than it was. I mean, there's a lot of argument about that. But I think it's

definitely fair to say that that was the perception. And then many people think that that made them quite tentative. And then with Ebola, they basically let that outbreak go on far too long. They were condemned by Médecins Sans Frontières. Dr. Joanne Liu, the international president of Doctors Without Borders, remembers lobbying Chan to sound the alarm last July. Dr. Chan, the Ebola epidemic in West Africa is out of control. And then she looked at me and she said, Dr. Liu, I'm not that pessimistic. And the United Nations actually had to create basically a special council to take over response to the situation from them. And so you basically see, I think, I guess like an unwillingness to return to that position of authority that they had during SARS.

And do you think that these two experiences, H1N1, where they were criticized for calling a pandemic too early, and Ebola, where they were criticized for waiting too long, have informed how they've reacted to COVID-19, particularly around calling in a pandemic. Devi Sridhar, a professor of global health, has said that this pandemic declaration was long overdue, that the outbreak had met all the definitions of a pandemic that we had well before the WHO declared it one, although the director general repeatedly said

that unless we're convinced it's uncontrollable, why would we call it a pandemic? This is though an emergency in China, but it has not yet become a global health emergency. Yeah, I mean, how much does the history inform it? I think a fair bit. I think in terms of the institutional timidness, I think you still see it there.

I mean, I'm not qualified to say whether they called it too early or too late. I mean, I talked to Debra Sridhar for this piece and I'll go with what she says. I mean, she's brilliant. But I think the sort of more important thing, because in some ways calling it a pandemic or not, when they did in March, is more of a rhetorical move than anything else. It technically gets you to take it more seriously, but it doesn't hold any legal weight.

But I think more so what you're seeing is this institutional tibbiness around criticizing countries. And we can move on from China here because, I mean, there certainly should be an investigation of, you know, how much China knew and when. But the real problem now is that the WHO is completely unable to get countries that traditionally back it, like the UK or the US, to follow its advice. And this is where you get this sort of institutional timidness, where they're not willing to call up by name these countries, even though they should have a very good relationship with them. I remember when they did declare this a pandemic, they talked about how sort of shocked they were. Both by the alarming levels of spread and severity and by the alarming levels of inaction. You know, a lot of people thought that they were talking about the U.S. and the U.K.,

but they wouldn't actually say the United States or the U, one of the WHO's sort of higher ups, I remember him saying, the answer to that question is, you know who you are? What are they concerned about what could happen if they start sort of naming and shaming countries or people? I think that it's just almost a law of the institution at this point that they don't call out. So in some cases, I don't even think they're thinking about what the consequences would be. It's more that there's just an institutional aversion to calling out countries. But then I think if they're thinking it through, they would simply be worried that they would lose

what little authority they have. Because if you really zoom out, I mean, there are some egregious examples of countries in Europe and America, North America, not following the WHO's recommendations. But by and large, countries are. It's sort of a fractious line. It's kind of a ragged line, but it seems to be holding. And I think that they believe that if they were to get more confrontational with their member states, they might lose what little hold they have. Because you do see, I mean, I'm more familiar with the context in the UK, but it's very clear that what they've relied on is criticizing in vague terms and then relying on their surrogates within the UK to criticise the government for them. And in the UK, it worked. I mean, there was basically a revolt amongst the scientific community

about the UK's response, amongst the public health community, you know, what the hell are you doing? And that got them back on the track. This is a huge and unexpected step change in the government's response to the coronavirus crisis. You should not be going shopping except for essentials like food and medicine. If you don't follow the rules, the police will have the powers to enforce them, including through fines and dispersing gatherings.

And so in that case, it seems to have worked. But of course, I'm not sure if that was the right calculus all love. on CBC Gem, brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. Stephen, I know you've talked to so many experts about this specific issue. And when we come out of this, what do you think that the WHO's legacy on this question will be? Because I should say, you know, there has been a lot of criticism directed at this organization. But you know, there are experts who are also saying that the WHO has done exactly what it was designed to do no more, no less. And that,

you know, perhaps there's larger questions here about how much authority this body should have, and the resources that it should have. Yeah, and I mean, I think what's going to happen is you're going to see it go to two ways. I mean, we've basically seen the edge of the power or authority or whatever you want to call it of the WHO, what they can do, you know, give this advice, most countries follow it, but they can't keep certain countries in line. And I think what you're going to see at the end of this is one side calling for the WHO to basically be binned, to say, what's the point? Nobody's listening. They can give advice, but what's the point of us all agreeing to this legal framework that they have? And then I think on the other side,

you're going to see people saying things would have been different if it had more power. And I think where you fall on this has a lot to do with how you feel about international organizations, transnational organizations and power in general. But yeah, I think where you fall on this has a lot to do with how you feel about international organizations, transnational organizations and power in general. But, yeah, I think you're going to see it dividing into two camps, which is, you know, in the WHO or basically beef it up. Stephen, before we go today, you mentioned that there are people who believe that had the WHO acted differently here, the outcome of this global pandemic would have been very different. And so what do they think could have been prevented here? I mean, I think they think that we would all have been Germany or we would all have been South Korea,

for the most part, to listen to everything the WHO said as soon as they said it. You know, track and trace and then shut down if that doesn't work. And I mean, I think they're right. I mean, we've seen the evidence in those two countries that that works. South Korea and the US both confirmed their first cases of COVID-19 on the same day in January. Last week, Seoul announced the daily number of new infections had fallen into the 20s. They've seen 10,000 cases and 214 deaths. Still very sad, of course, but nothing on the scale seen here. And how much of that is the responsibility of the WHO? And how much of

that is the responsibility of countries like Germany and South Korea and countries that just didn't do that. Well, I mean, I think you've sort of led on to the great problem of international organizations. They work as well as countries listen to them. And so, you know, when you're talking about beefing up the WHO, in some ways, you know, nobody wants them to become the world police. All of this stuff is going to be very fuzzy. It's going to be some sort of recommitment to countries holding maybe each other accountable to actually listening to it in a future situation. Donald Trump is talking about withholding funds to the WHO. Because you know what, they called it wrong. And if you look back over the years, even, everything seems to be very biased toward China.

What would it mean to defund the WHO? I mean, for the U.S., it would mean a lot. They're the largest donor. I mean, interestingly, Trump has been talking about that since February, about cutting their budget as part of his larger cuts. I mean, I think that if that does happen, it still remains to be seen. If that does happen, I think you probably will see other countries stepping up. Because I think something to remember is that WHO is being criticized. I've criticized it in some cases, but lots of countries are still very happy with what

it's doing. I'm still happy with a lot of things that it's doing. So I think you're going to still see lots of lots of countries stepping up and saying, no, we want this. We want this organization. Stephen, thank you so much for this conversation today. Thanks for having me as well. All right. So as I mentioned at the start of the episode, we talked to Stephen shortly before Donald Trump announced he was indeed going to halt funding to the WHO. Whether other countries will step up to fill the void,

as Stephen suggested there, well, that remains to be seen. But we will keep you posted. That's all for today. Thanks so much for listening to FrontBurner, and we'll talk to you soon. For more CBC Podcasts, go to cbc.ca slash podcasts.