The WHO and the Viral Politics of Nationalism

Part II of “Who’s Responsible:  The WHO, Internationalism, and the Coronavirus Pandemic

The WHO’s record in helping contain the transmission of viruses, many of zoonotic origins, that have created global public emergencies over the last two decades and that are quite likely poised to become even more critical in the decades ahead is rather more mixed.  It may be that the organization was created with the intention of liberating the world from those diseases that had long been the scourge of humankind and whose very name evoked dread:  typhoid, malaria, yellow fever, and especially cholera and smallpox.  No one by the second half of the 20th century was quite thinking of the “plague”, even if the outbreak of pneumonic plague in Surat in 1994 (with bubonic plague discovered in three villages in Maharashtra), was a grimly reminder that this ancient pestilence had by no means disappeared.  The incidence of death from the plague in Surat was only 56, and it was soon relegated to the background as an anomaly, as something that was merely an unpleasant reminder of “medieval times” in a modern age that had purportedly moved beyond such calamities.

Surat1994Plague

Surat, 1994, during the plague. Source: Getty Images.

India_Plague_Laurie-Garrett

The Indian Military enforcing quarantine at a hospital in Surat, 1994. Photo: Laurie Garrett. Source: https://www.pri.org/stories/2016-03-12/us-ready-next-big-pandemic

The point here is that the WHO may have been somewhat ill-prepared for the 21st century and for the kind of viruses that appear to proliferate partly in consequence of the relentless pressure placed upon the land by large-scale mechanized farming, the substantial decrease and often decimation of the habitats for wildlife, the enormous increase in greenhouse gases, and the increasing incidence in zoonotic diseases.  Nevertheless, the WHO was still able to profit, at least into the early years of the 21st century, by the fact that most countries had not yet succumbed to extreme forms of nationalism and that international organizations still commanded considerable respect.  The case of SARS, Severe Acute Respiratory Syndrome, is illustrative of the influence, largely unthinkable today, that the WHO was able to exercise less than 20 years ago.  In mid-November 2002, the Chinese government first became aware of cases of SARS, but it failed to report them to WHO.  Three months later, the Guangzhou city government was still putting on a bold face in declaring that it had the disease comprehensively under control.  But the WHO was in any case on to the fact that something was amiss:  the organization’s then Director-General, Gro Harlem Brundtland, had in place a system of rigorous monitoring and the WHO’s staff surmised that an atypical pneumonia outbreak had taken place in China.  Brundtland, whose stern and disciplined leadership of the WHO won her some admirers even as it raised a few eyebrows, chastised China for keeping the outbreak a secret, arguing that it could have been contained if the WHO had been brought into the picture and allowed to share its medical expertise.  On February 7th, China responded by sending the WHO the first detailed report on the outbreak; thereafter, as the disease spread, China and other countries regularly shared their data with the WHO.  Though SARS spread to 29 countries, worldwide fatalities numbered around 800, with China and Hongkong alone accounting for 75% of the deaths.

The WHO had played its part in containing SARS, but its role in subsequent crises, according to some critics, is far more questionable.  It declared the H1N1 “swine flu” of 2009 a “pandemic”—the first time it did so under revised international protocols—and was heavily criticized by many countries for having over-reacted.  Perhaps, chastened by this experience, it may have taken too long to send an international health warning to other countries after the Ebola outbreak in West Africa in 2014.  But these controversies may pale into insignificance in comparison with the storm that has been brewing over the WHO’s role in the present coronavirus pandemic. In early April, President Trump let loose a volley of highly critical remarks blaming the WHO for having withheld information about COVID-19 from the US (and the rest of the world, though it need not be said that Trump cares not an iota for other countries), and thereby holding it just as responsible as China for the rapid spread of the disease around the world.  In subsequent remarks, Trump threatened to withhold US funding from the WHO: no small matter this, considering both that the WHO has to call upon all its resources to fight the pandemic and that the US makes the largest contribution among member states to the organization.  Sentiment against the WHO runs very high among many Republican lawmakers, who have long complained that China gets a free hand in bullying other nations and international organizations alike, and the feeling is widespread among them, and other critics of the UN and its agencies, that WHO was far too willing to pander to China.  That the United States is not wholly singular in taking this view is clear from the fact that the Japanese Deputy Prime Minister and Finance Minister, Taro Aso, noted scathingly that many people were referring to the World Health Organization as the “Chinese Health Organization”.

If Beijing sought to keep knowledge of SARS from the rest of the world, its credibility in the present pandemic is obviously questionable.  The supposition, on the part of the United States, is that the WHO abetted China in disguising some known facts about SARS-coV-2, more particularly the question of whether human-to-human transmission of the virus was possible.  The WHO continued to deny publicly that such transmission was possible as late as 14 January 2020, as its tweet of that day made clear, but by January 24 the Chinese government had sealed off the entire province of Hubei, which has a population of 50 million, and thereby signaled to the world that SARS-coV-2 does indeed transmit from one person to another.  The WHO now had to make a call:  should it declare COVID-19 a “public health emergency of international concern” (PHEIC)? Its emergency committee met on January 22 but the committee was split down the middle:  though the United States has declared the WHO complicit with China, it was represented on the 15-member committee along with representatives of many of its allies, including New Zealand, Australia, Sweden, France, Canada, The Netherlands, Japan, South Korea, Singapore, and Saudi Arabia.  Indeed, only Russia among the committee’s members can be counted as hostile to the US:  evidently, then, at least some of the US’s friends were against the decision to designate COVID-19 an international public health emergency (PHEIC).  However, in an attempt to forge a unanimous opinion, Director-General Ghebreyesus did not go public with the committee’s decision and ordered it to reconvene the following day, with similar results.  It wouldn’t be until January 29 that the WHO would declare the coronavirus a PHEIC—a far more critical decision than its decision, six weeks later, to designate it a “pandemic”.

The evidence on whether the WHO acted decisively, and early enough, in sounding a warning to the world about the origins, modes of transmission, and advance of SARS-coV-2 remains inconclusive.  But, whatever position one might adopt, what is incontrovertibly true is that the United States, and similarly countries such as the UK and Brazil, did not take the threat seriously for weeks after the WHO had declared that there was a public health emergency of international concern.  Consequently, the debate over the WHO should be recognized for what it is, namely a form of scapegoating.  A pure narcissist such as Trump has no other interest at the moment besides trying to ensure his electoral triumph this November, and it is imperative that one recognize the much larger considerations that are raised by the present controversy over the WHO.  The real question revolves around the future of international organizations considering that nations are increasingly veering towards authoritarian populism, mindful only of some of their constituents at home, and that disdain for international opinion in many countries is all too visible.  Even as these remarks are being penned the news has come in that the United States is thinking of placing sanctions on the International Court of Criminal Justice (ICCJ) for daring to launch an investigation into possible war crimes by the armed forces of several nations, including the United States, in Afghanistan. The United States has long acted on the supposition that its own sovereignty is supreme and that it owes no responsibility to any supra-national organization.  Can new forms of “internationalism” emerge in the wake of COVID-19 that take the place of organizations such as the WHO that superficially appear to be supra-national but are, in actuality, entirely built upon the notion of the nation-state as the ultimate expression of human community?  The speculations that one might entertain about such possibilities are, however, the subject for another essay.

(concluded)

See also Part I:  “The World Health Organization (WHO): Testing Times for Medical Internationalism”

The two parts together were published in a slightly shorter and different version under the title of “Who’s Responsible: The WHO, Internationalism, and the Coronavirus Pandemic” at ABP Live, here.

7 thoughts on “The WHO and the Viral Politics of Nationalism

  1. I’d begin with thanks for this important article, Professor Lal.
    The pandemics of COVID-19 is a turning point which will undoubtedly be written in the future history books for scholars, along with WWI and WWII. Human mind is designed so, that it seeks explanation of everything, with an attempt to scapegoat someone or something. Last year the former President Trump criticized the WHO for the global spread of SARS. One of the main mistakes of the WHO, according to the American authorities, was that it prevented the introduction of restrictions on exit from the PRC and other countries at the beginning of the pandemic. Trump added that the WHO believed the data of the Chinese authorities that the virus is not transmitted from person to person, which caused the outbreak of the disease. Recommendations of WHO have also caused a sharp increase in the incidence in Europe. The decision of other large countries not to close their borders was one of the most serious tragedies and missed opportunities in the early stages. In attacking movement restrictions, WHO prioritized political correctness over saving lives, believing that this is a regional outbreak.
    Furthermore, WHO denied that the infection is contagious and can be transmitted across humans until January 20th, when the epidemics already transformed into pandemics.
    However, I’d assert that such accusations are the consequence of misunderstanding of the role and powers of this intergovernmental organization, which, first of all, is an agency, and not a rescue service. WHO is a joint project of the Member States of the United Nations and, therefore, primarily depends on their will, capabilities and resources to implement projects around the world. I consider that such international organizations should show diplomacy and caution in relations with their member states. They can hardly be expected to sharply publicly criticize the information policies of individual countries or their health policies. In my opinion, this approach would only yield in dispassionate prejudice. In the case of China, I think that their Healthcare Authorities should be responsible for falsification of data they provided to the WHO.
    Criticizing is the task of independent humanitarian organizations, lobbyists and, of course, the media. In accordance with its doctrine, WHO should be guided by the health authorities of those states that make it up, and not by capricious public opinion in democratic societies. This principle, of course, makes it somewhat passive, but it is embedded in the UN system. And the WHO cannot be blamed for this. When it comes to the fundamental calamities of humanity, which, in fact, are quite easy to overcome, WHO can achieve impressive results. Just one example is the measles vaccination, which last year alone affected 20 million people and killed 140,000. Or campaigns to combat malaria and reduce child mortality.
    Of course, WHO must also monitor outbreaks of epidemics, such as the COVID-19 epidemics. The World Health Organization is an important global focal point for the exchange of information between governments, academics at universities, government institutions and pharmaceutical companies. But WHO is not omnipotent. The real work of tackling emerging diseases can and should only be done by national health systems, research institutes and industry and stay dispassionate from harassment of «narcissist Trump».

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  2. Hello Professor Lal! Considering how the WHO and other international organizations operate, it seems as if the U.S. will not stop at nothing to criticize them on any matter they see fit in order to further their own agenda. For instance, when Trump was president, he made it clear that he was the one that was going to fix the pandemic and that he was the one that was going to create the “miracle vaccine”. In order to portray himself as a leader of his people, he isolated himself from the WHO and other allies and continued to blame China. Trump’s supporters were able to immediately accept Trump’s version of events and Trump used this to his advantage in the upcoming election. By creating false narratives, he was able to convince his supporters that the fantasy was the reality and Trump and his supporters continued to become more radical in their ideas. Since Trump’s narcissism continued to feed into his ego, this evidently contributed to his call to raid the capital.

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  3. The WHO’s role in how COVID-19 escalated definitely showed an issue within international organizations. For example, a criticism of the UN’s Security Council I’ve seen was that requiring an unanimous decision from the five permanent nations, half of whom are ideologically divided and enemies with one another, makes progress towards resolving problems difficult. Leaving the discussion of how effective the council is aside, it shows a fundamental aspect of international organizations that’s hard to overcome: Every country needs to agree with what’s happening. The issue arises when countries have different, opposite goals, which threatens the power and structure of the organizations itself. Most obviously, the US’s actions of delegitimizing and blocking funding to the WHO and potentially sanctioning the ICCJ indicate an unwillingness to follow international norms, which was supported by their claim that the WHO was just pandering to China, and how they (along with other countries) didn’t heed the WHO’s advice even after the official designation of COVID-19 as an international public health emergency. Given the WHO’s effectiveness on treating SARS only a few decades ago, it is troubling that an individual nation’s nationalism can potentially ruin the entire organization. The nationalism that makes the US (especially with Trump) push away international agreements and organizations could potentially serve as one that causes an end to international cooperation.

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  4. It has been roughly one year since this article was released and many individuals continue to be distrustful of the WHO, despite the fact that there are not near as many unanswered questions regarding COVID-19 as there were last year. It is not difficult to see why this is the case when the topic of the coronavirus has become ridiculously politicized. More often than not, the information provided by right-wing news sources directly contradicts the information provided by left-wing sources. Considering that the WHO did not express how COVID-19 was transmitted between people until the middle of January last year, many individuals, especially conservative Americans, believe that the WHO is still hiding crucial information from the general public. However, these beliefs are preposterous in the middle of 2021. As stated before, there are not near as many unknowns about COVID-19 nowadays and it does not appear that there is much information the WHO can disclose. Unfortunately, a common belief is the idea that masks are ineffective and the health experts of the world have information that supports this rhetoric. It has been proven multiple times that masking reduces the spread of the coronavirus and even if that was not the case, wearing a mask is obviously not much of a hassle. It is arguable that a lot of these beliefs were born out of Trump’s words about the pandemic and his dissatisfaction with the WHO. While the WHO is far from a perfect international organization, the distrust many people hold towards it seems to be based off of blatant fallacies nowadays.

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  5. I found this analysis incredibly interesting professor. Primarily, I agree with your commentary on using the WHO as a scapegoat. So many world leaders, specifically Trump in our case, didn’t take the Coronavirus seriously, even after many health organizations clarified the extent of its threat. The outrage against the WHO simply served to divert the blame to a larger power, and remove responsibility from actual policy makers. I noticed a similar trend on the home front, when republicans blamed the CDC for their frequently changing guidelines. I found this ironic, as nobody followed any original guidelines in the first place (mask wearing, lockdown, etc), which created the continuously changing numbers, therefore changing the most effective way of dealing with it.

    Additionally, your comments on the larger implications of this controversy were very thought-provoking. The inability to be cooperative even in a world threat of this magnitude certainly cannot be a positive beacon for international unity in the future. I agree that at the core of the argument, it’s less important whether or not the WHO acted quickly enough, but what the controversy and refusal to consider other nations as a whole represents for international politics. I feel this was reflected all throughout America during Trump’s presidency. He used division and nationalism to gain political traction, riling up white republicans with his policy of “America First”. I believe Trump may have been a turning point for this country, as we turn away from creating a global community, and embrace a sense of American entitlement.

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  6. Before reading this essay, I did not realize that international organizations have no official authority, only that from the nations recognizing its legitimacy. The WHO was relatively successful in containing potential pandemics during the period that the US was the undisputable super power, but with China’s rise to the world stage, the legitimacy of the WHO and other world organizations are at risk, as seen with America’s slow response to WHO guidelines. China is the role model for authoritarian governments and China’s success is a challenge to democracy, and all world organizations directly, or indirectly, led by the United States. China’s lack of regard for the international community and human rights is also an issue. At least the United States makes an effort to disguise their intervention around the world with promises of freedom and democracy. China is quite clear about their internal censorship and lack of regard for human rights. China’s inevitable movement to center stage of the world will result in widespread destabilization of world organizations. For example, China ignores the jurisdictions outlined by the United Nations Convention of the Law of the Sea and claims the entire 9-dash line. Further, Trump blamed China for the pandemic and villainized China during his entire presidency, fueling the contention in US-China relations.

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