Unfortunately, while both the WHO and Trump have been hasty, irresponsible and wrong with their health advice, only Trump will be accountable in November – the WHO, it appears, will never be held accountable, writes Quentin Wray.
The World Health Organisation has had its already shaky reputation shattered by its mishandling of the coronavirus pandemic.
Though its myriad weaknesses were never that well hidden, the Covid-19 crisis has shown the WHO, and its Director-General, Tedros Adhanom Ghebreyesus, to be incompetent, misguided, and uncomfortably cosy bedfellows with China.
It is not just the general public that have lost faith in the WHO. US President Donald Trump has halted funding to the organisation, citing their severe mismanagement.
Despite the fact that it was a blatant move by Trump to hide his own shortcomings, there was no real global outpouring of support for the WHO.
The reality is that the fact that there was a definite political driver of Trump’s decision does not invalidate his reasoning: the recent history of the WHO is a litany of failures.
It is generally accepted that the coronavirus spread from the wet markets in the Hubei province of China.
That a highly communicable virus could emerge from these conditions should come as no surprise - as far back as 2006, a study confirmed that Chinese wet markets (marketplaces selling fresh meat and other perishables) are fertile breeding grounds for “severe respiratory viral infections”.
Did the WHO respond to these findings with the kind of cautious and critical inquiry one would expect from an independent, non-state organisation? It did not.
Rather, last year, it gave its endorsement to traditional Chinese medicine (TCM). This is a move that has been decried by conservationists and scientists alike.
It puts pressure on endangered species like rhinos and pangolins, and is seen, medically, as “an egregious lapse in evidence-based thinking and practice”, according to the Editors of the Scientific American.
The history of the WHO is fraught with such incompetence, and it has regularly shown itself to be unable to respond to epidemics.
It faced criticism last year for failing to declare the Ebola outbreak in the Democratic Republic of Congo a Public Health Emergency of International Concern (PHEIC).
These declarations are meant to be ordered when there is sufficient risk that a public health crisis could spread across borders.
The failure to do so echoes the WHO’s appalling response to the Ebola crisis of 2014.
The declaration came far too late, and this delay had dire consequences. Its response was so catastrophic that leading health experts called for it to be stripped of its authority to decide what is and isn’t a PHEIC.
More than 11 000 people died in that outbreak.
What then, kept the WHO so busy that it couldn’t respond in a timelier manner, potentially saving thousands of lives?
The WHO focused rather on pushing the prohibition of alcohol, tobacco and, ridiculously, on vaping which, unlike cigarettes, doesn’t release tar and carcinogens.
Yet in the latest turn of events, nicotine patches are getting tested on coronavirus patients. Some initial studies suggest that smokers are far less likely to catch the disease.
Now, obviously, this isn’t meant to advocate for smoking, but rather to remind us that not so long ago governments and NGOs suggested that smokers were far more likely to catch the disease.
It seems, sometimes, that the culture of ideologically driven and punitive interventions continue to triumph over evidence-based policy.
In fact, in terms of positive health outcomes, vaping and the availability of reduced-risk nicotine products in the UK, and their promotion by public health, likely contributed to the reduction of smoking rates from 20.4% in 2012 (around the time vaping became mainstream) to 16.1% in 2016.
Uncertainty about the long-term effects of things should be a reason for caution but never for paralysis or disproportionate regulation.
But uncertainty is the norm in the Covid-19 crisis; we know so little about the virus that, naturally, speculation fills the space when the facts are missing.
When such speculation is based on “alternative facts”, which is more often than not, we have a problem. This impacts global health, so it’s only reasonable to expect the WHO to take some responsibility in addressing it.
But we shouldn’t hold our breath.
Take, for example, the now infamous 1998 Lancet paper which argued that there were links between the MMR (measles, mumps and rubella) vaccine and autism.
This was only retracted in 2010 and described as fraudulent.
In the same year, Andrew Wakefield, the author of the paper, was struck off the UK medical register for “serious professional misconduct”.
Surely it falls at the feet of the WHO to play this role, to provide clarity and firmly dismiss dangerous pseudoscience. So, what role did they play in one of the biggest contemporary battles against hysteria and fake news?
Well, nothing, really.
It took nine years after the retraction of the research for the WHO to recognise anti-vaxxers as a “Top Threat to Global Health”. The snail-paced under-reaction is predictably inadequate.
Scientific studies that are misleading, and even fraudulent like Wakefield’s, are shared and reported worldwide, often with fatal consequences.
We rely on global authorities to set the record straight and provide clear answers for a confused and non-expert public.
There is another reason for the WHO’s inability to act: the ever-present political dimension.
It has been implied that Ghebheyesus' appointment to Director-General, the first non- (medical) doctor to get the job, has much to do with Chinese lobbying, which used economic aid for developing countries as a means to drum up support for his campaign.
If that is the case, the investment certainly paid off.
Ghebheyesus has shown a public reverence for China’s response to the crisis and has shied away from voicing criticism about its lack of transparency.
This is not all, though.
It has been suggested that Chinese pressure from within the organisation has led to the WHO’s exclusion of Taiwan from the World Health Assembly (WHA) for the third year in a row.
The WHA is the forum through which the World Health Organisation (WHO) is governed by its 194 member states.
China is intent on excluding Taiwan from world organisations, including the WHA, despite Taiwan having one of the world’s most advanced healthcare systems.
Taiwan’s exclusion from the WHA is detrimental to both the health of the Taiwanese people, whose government now does not have access to international information networks, and the rest of the world, as Taiwan’s response to the coronavirus crisis has been one of the most efficient.
It is clearly absurd that an organisation tasked with protecting international public health is willing to take an action so antagonistic to that goal.
It is equally clear that while we need a world health organisation, we deserve more than the World Health Organisation that we have.
Unfortunately, while both the WHO and Trump have been hasty, irresponsible and wrong with their health advice, only Trump will be accountable in November - the WHO, it appears, will never be held accountable.
- Quentin Wray is a UK-based South African freelance writer and journalist focusing on politics and economics. He is the former editor of Business Report.