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Covid-19, global accountability and the role of the WHO

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Jordan Griffiths is the acting chief of staff in the mayor’s office in Tshwane; he writes in his personal capacity.

As Donald Trump suspends funding to the World Health Organisation, the challenge facing the WHO as it responds to its critics is that the information it puts out is only as good as the information it receives from its member states.

As the world grapples with the spread of the coronavirus, the politics of global health and accountability have come to the fore. Questions are being asked pertaining to who should be held accountable for the state in which the world finds itself. Could the spread of the virus have been better prevented if the right information was shared earlier on, and how could this have better been prevented?

Take a step back and reflect on how countries and the world respond to events that are caused by failings in the private sector. In South Africa in 2018 the country found itself caught in the wake of a listeriosis crisis after hundreds of people became sick due to eating contaminated meat products that were tracked to meat processing plants belonging to Tiger Brands. This resulted in the deaths of more than 200 people. The backlash was swift, the company soon had to close multiple plants, major retailers also withdrew the sale of particular products and a class-action lawsuit was filed against the company.

In 2010 the Deepwater Horizon oil spill resulted in the discharge of 4.9 million barrels of oil into the Gulf of Mexico in what is considered one of the biggest environmental disasters in American history. In November 2012 BP pleaded guilty to 11 counts of manslaughter and allowed the government to monitor its activities for the next four years. They were also liable for $4.5-billion in fines and other payments. As of 2018 the cleanup costs and total charges for the cleanup had come to $65-billion.

In 2008 the Sanlu Group in China was caught up in a massive scandal after milk powder they produced was found to be contaminated by the compound melamine. By November 2008, 300,000 babies were sick from contaminated milk and kidney damage had led to six fatalities. It is considered one of the largest food scandals in history and laid bare China’s inability to build an effective oversight tool on key products within the food industry. It led to the introduction of a Food Safety Law in 2009, resulted in the jailing of 19 Sanlu executives, including the chairwoman who was given a life sentence, and the executions of a dairy farmer and a milk salesman. Sanlu went bankrupt.

The above examples illustrate how society and government work together to hold companies that cause public or environmental health crises to account. When such matters occur, the backlash is usually swift and severe, resulting in companies feeling the full wrath of their governments and the consumers whose trust they have violated.

Now, as the world grapples with the coronavirus pandemic that has spread across borders, globally we are not only engaging with a public health crisis but also a matter that is inherently political. It is also exposing how countries with different political systems respond to such matters and how as a result of those systems they can compromise the responsiveness of the rest of the world.

One must go back to where this started, namely in Wuhan, China and examine how the Chinese political system may have helped and hindered the spread of the virus. It is becoming increasingly clear that China’s command and control system of government prioritised secrecy over public health as officials delayed crucial decisions in the interest of saving face, particularly as there were a series of annual congresses scheduled in January 2020.

In fact, on 7 January the city of Wuhan held its People’s Congress and even had a banquet while still ignoring the concerns being raised by the country’s medical professionals. This need to keep everything under control and try to placate residents cost the Chinese valuable time which is why by the time they responded in late January, the disease had already grown exponentially through the population.

Further to that, the government actively suppressed the views of doctors who were trying to raise the alarm. The most well-known example is that of Li Wenliang who attempted to go public through a social messaging app and was reprimanded by the police. Wenliang had contracted the virus while he was treating a patient and by the time of his death he had become a national hero, stirring significant criticism against the Chinese government for its management of information while the virus was spreading.

However, that same political system which repressed important information about the spread of the virus has proved very adept at managing and containing its spread. Once the severity of the virus was established, the Chinese government was able to radically deploy its authoritarian systems to control the flow of people and enforce social distancing. Wuhan, the epicentre of the outbreak, a city of more than 11 million people, was locked down for months. The Chinese very quickly stepped up their international media campaign in an attempt to change the narrative on their management of the crisis, donating medical equipment to affected countries and flying in medical personnel and consultants where they could.

Now it is worth mentioning the role of the World Health Organisation (WHO). The WHO Director-General Tedros Adhanom Ghebreyesus is facing mounting criticism for his leadership of the WHO during those critical few weeks when the outbreak began. President Donald Trump has been vocal about this and in the US it has gone as far as Florida Senator Rick Scott calling for a Congressional investigation into the agency’s role in acting as an accomplice to China. Trump has now suspended funding to the organisation pending a review.

The challenge facing the World Health Organisation as it responds to its critics is that the agency is confronting the reality that the information it puts out is only as good as the information it receives from its member states. If those states are failing to adequately respond to the virus and providing incorrect information about its scale, then this is the information that the WHO will put out publicly. As such the WHO essentially compromises the rest of the world in sharing this information.

If you have a global agency that is built around trusting its member states to provide it with the right information and one of those states fails to do that, you won’t know unless you have the capability to truly interrogate the facts, and with a country like China this is very difficult. US intelligence agencies have also now filed reports indicating that China misled the world about the outbreak.

As the virus will likely be the biggest story of 2020, there will at some level be a global reckoning. One where countries which will be severely affected by the virus will begin questioning the role of the WHO and its directive to ensure that its member states take their responsibility to the rest of the world seriously when it comes to matters such as global health. When we see management failings in companies we are quick to act and hold people to account. The same must happen with the spread of this global outbreak.

Donald Trump has now acted on this by suspending the US’s payments to the WHO, citing what he believes is the organisation’s failure to adequately share information and manage the coronavirus spread. While there is definitely politics at play as Trump has poorly handled the US’s response to the pandemic, he has pointed out legitimate flaws in the way the WHO managed the initial stages of information flow on the virus in its engagements with China. As the US is the biggest funder of the organisation, Trump’s suspension of payments could force a total realignment in how the organisation conducts itself.

South Africa should also emerge as a leader in this space. The country is one of the worst affected in Africa and with a significantly high level of the population being immune-compromised, the spread of this virus could severely affect our society. This has an inherent cost both on a deeply personal level and on a grand economic scale.

We should expect that diseases such as this will occur again in the future, however, we cannot tolerate a space where countries fail to do their global duty in adequately briefing the world on these matters should they occur within their borders. The South African government needs to confront this reality and begin actively ensuring it is able to hold its own on the international stage when engaging on ensuring better global accountability and management in the WHO. DM

 

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