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The coronavirus lays bare the limits of WHO's health diplomacy with China | Global development


On social media this week the insults were flying thick and fast, some tinged with racism, but all with a common theme: how the World Health Organization, and its head, Dr Tedros Adhanom Ghebreyesus, was effectively doing the bidding of the Chinese government in the midst of the Wuhan coronavirus outbreak.

It is a charge that has also been expressed in less offensive terms elsewhere in columns and articles, some of which have focused on whether, in praising China’s response to the deadly Wuhan coronavirus outbreak during a visit to Beijing, Tedros allowed himself to become complicit in China’s flawed handling of the outbreak in its early days?

In some respects, it is a hoary old paradox, familiar to many international bodies and NGOs. How – when dealing with a health crisis or a humanitarian disaster – you are limited in the choice and nature of your partners in the place where it is occurring, and the limitations they impose.

But if the politics of such accommodations is always uncomfortable, the Wuhan coronavirus outbreak encapsulates in a stark fashion a number of difficult issues.

Above all, it asks how the UN’s international health diplomacy, confronted with a potential pandemic where a timely and accurate flow of information is crucial, should interact with one of the world’s most powerful, and controlling, states.

Looming above all else is the fact that China is a country whose trajectory under Xi Jinping has been to become more, not less, authoritarian, marked by mass internment camps for Uighurs, a growing internet crackdown and its harsh response to street protests in Hong Kong.

There seems little doubt either that China’s bureaucratic culture of control and secrecy, including the local government’s efforts to clamp down on the information emerging about the disease in the first weeks of the epidemic, contributed to its initial spread in December and the first weeks of January.

It is also true that after admitting the scale of the problem, China has shared much information internationally, in line with its commitments, about the nature and spread of the virus, and deployed unprecedented and costly national efforts in a bid to contain the outbreak, even as it has employed what many would see as draconian restrictions.

Tâi Siáu-káu (台痟狗) ㄊㄇㄉ 🇳🇫 Taiwan 🌏 😷
(@TimMaddog)

😷 TaCo editorial cartoon: World Health Organization’a (@WHO) words vs. the truth about China (dead people in the streets).https://t.co/miZ5oq59WL#2019nCoV#WuhanCoronavirus#武漢肺炎 pic.twitter.com/yiX8FT99d5


February 3, 2020

Interposed into the midst of all this has been the WHO – and Tedros – a relationship complicated by the fact that China is a major donor to the world health body. The mix of health and international politics has been underlined by the exclusion of Taiwan from discussions even after the coronavirus spread there.

The argument about how the WHO has negotiated the complexities boils down to several key questions.

The first is whether the organisation should have pushed harder for Beijing to be more forthcoming when evidence of a new form of coronavirus first emerged, but before the scale of the outbreak was fully acknowledged. And whether the head of the UN body should have been so warm in praising the response of a country that unsettles so many for its secrecy and rights violations.

In particular, the fraught politics of the WHO declaring the outbreak a public health emergency of international concern (PHEIC) has once again come under the spotlight in the same way it did during the Ebola crisis in the Democratic Republic of the Congo.

Some of those most critical have parsed Xi’s meeting with Tedros – and Xi’s declared hope that the UN body would assess the “epidemic situation in an objective, just, calm and reasonable way” – as pressure from Beijing to ensure WHO would refrain from designating the epidemic a global health emergency to protect China’s economy.

Although that didn’t happen, the WHO’s advice – contrary to that of many governments – is that it still “advises against the application of any restrictions of international traffic based on the information currently available on this event”.

And on this front some are pointing to a startling contradiction: how the UN body has praised the extreme internal travel restrictions in China while criticising other countries for implementing their own travel measures.

Sources familiar with the politics at the top of the organisation, and the decision over declaring the outbreak a PHEIC, insist that WHO have had to balance very difficult issues.

With China’s well-known history of extreme sensitivity to criticism, the argument goes, a conscious decision was made to prioritise diplomacy that would encourage China to be as open as possible in sharing information with international researchers and health bodies even at the risk of drawing inevitable criticism.

“China was very quick to let the WHO know what was happening on 31 December,” said one close observer. “The organisation’s goal was to get as much information about what was happening in China to inform what the rest of the world would need to do.

“It’s clear there were two options: to keep pressing behind the scenes, or to go public and say at a press conference we didn’t get such and such at this time and for the Chinese to lose face and slam the door. So it seems like a deliberate decision to keep the flow of data coming, to encourage the Chinese to keep focused on the epicentre, even at the risk of being seen in public as kissing up to Beijing.”

And while insiders point to China’s preparedness to come clean and admit mistakes once its central government had realised the scale of the threat, critics counter that greater pressure from WHO might have made that moment come days earlier, potentially helping contain the epidemic at an earlier stage.

In the end, whether the current diplomacy was the right approach in balancing the demands of human rights and global risk and the threat to China’s (and the world’s) economy and prestige, only the course of the outbreak will confirm.



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