Simply Put: WHO response, under review

World Health Assembly has resolved to review WHO response to Covid, and for failing to question China. What is it that WHO could have done, and where do various countries including India stand on this?

On Friday, India became the chair of the World Health Organization Executive Board at its 147th session. Health Minister Dr Harsh Vardhan succeeded Dr Hiroki Nakatani of Japan as Chairman of the 34-member Board. India takes charge at a pivotal moment, when the world is grappling with the Covid-19 pandemic. “When India decides, it performs,” Dr Harsh Vardhan said, while assuming the leadership position.

It is also a time when the WHO itself has become a battleground of global politics. Earlier this week, the WHO was at the centre of the world’s attention as it convened and over 60 countries, including India, asked for an “impartial, independent and comprehensive evaluation” of the WHO’s response to Covid-19.

Why has WHO’s response come under question?

The final resolution in the World Health Assembly, co-sponsored by 122 countries including India, was adopted by consensus without a vote. The resolution has asked for a “systematic review”, also calling for “a stepwise process of impartial, independent and comprehensive evaluation to review experience gained and lessons learned from the WHO-coordinated international health response to Covid-19” at the earliest and appropriate time in consultation with member states.

WHO Director-General Tedros Adhanom Ghebreyesus — a former foreign minister of Ethiopia and earlier its health minister — has been under criticism for not acting on time. With the WHO having been accused by US President Donald Trump of being a “puppet of China”, the WHO head has said he would initiate the evaluation at the “earliest appropriate time”. The WHO, a specialised agency of the United Nations, could have questioned China’s handling of the outbreak in Wuhan so that the WHO could better prepare the world for the dangerous disease, but has been criticised for failing to act decisively.

Who has raised this criticism?

This criticism stems from the International Health Regulations (IHR), the leading international agreement on infectious diseases and other serious disease events adopted by WHO member states in 2005.

The IHR empowers WHO to take actions that can challenge how governments exercise sovereignty. The IHR authorises WHO to collect disease-event information from non-governmental sources, seek verification from governments about such information, and, if necessary, share the information with other states. Also, the IHR grants the WHO Director-General the power to declare a public health emergency of international concern, even if the country experiencing the outbreak objects.

How effectively has WHO responded to earlier global outbreaks?

During the SARS outbreak in 2003, then WHO Director-General Gro Brundtland had taken on China over the outbreak and, without the nod of the countries concerned, had issued warnings against travel to SARS-affected regions. Brundtland had acted without authority to take these steps.

“In adopting the IHR in the aftermath of SARS, WHO member states gave WHO unprecedented authority vis-à-vis state sovereignty and expanded the need for WHO’s scientific, medical, and public health capabilities,” David P. Fidler, who is an Adjunct Senior Fellow for Cybersecurity and Global Health at the Council on Foreign Relations, wrote in an article on the ‘WHO and the Pandemic Politics’.

After the IHR guidelines came into play in 2007, the H1N1 influenza spread around the world in 2009, and WHO Director-General Margaret Chan declared the world’s first public health emergency of international concern and issued recommendations that, among other things, advised against trade and travel measures. This was seen as a success of the IHR.

“Then came the Ebola outbreak in West Africa in 2014, which was a disaster for WHO and the IHR. WHO’s response was so bad that UN Secretary-General Ban Ki-moon created an ad hoc emergency response effort. WHO Director-General Chan failed to act on information that WHO had received from non-governmental sources, did not challenge governments that wanted to keep the outbreak quiet, and only declared a public health emergency of international concern after the epidemic was already a crisis,” Fiddler wrote.

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“The next major crisis was an Ebola outbreak in the Democratic Republic of the Congo that started in late 2018. WHO’s response to this outbreak demonstrated that it had re-invigorated its functional capacities,” he wrote.

What is the significance of the resolution in international politics?

Apart from WHO’s approach in not confronting the Chinese leadership over Covid-19, Beijing’s general resistance to any external criticism and action has been at the centre of the debate.

To add to that, the US administration under President Trump has seized the opportunity to blame China for the pandemic, as it faces an election year.

Beijing, which views itself as a natural successor to the global leadership role, has been riled at the international community’s calls for “transparency and accountability”.

What has happened in the current churning is that an unprecedented coalition of those asking for accountability have emerged. From Australia to Europe, India to Japan & South Korea — many of these countries who have high stakes in their bilateral relations with China, have all come out to question Beijing. So, what a global initiative like Belt and Road Initiative could not do — get more and more countries question China’s ambitious initiative — the pandemic has done.

How important is India in this debate?

India has been advocating for reforms of the WHO along with other international organisations, and this demand has been articulated by Prime Minister Narendra Modi during the virtual G-20 summit in March this year.

“To quote Churchill, why waste a crisis? India must use this opportunity to further it’s place in the global high table. The country has an unique opportunity to play a role in the WHO,” Manjeev Singh Puri, former Deputy Permanent Representative at the UN, told a webinar organised by the Indian Council of World Affairs in April on ‘Re-Imagining the Global Health Agenda: What Role Can India Play?’ Last month , the WHO Director-General had said, “Please don’t politicize this virus,” and later urged political leaders to “please quarantine politicizing Covid”; Puri says the world needs to get rid of this idea of “de-politicising the health agenda”.

As India takes the leadership role, much will depend on how it is able to navigate the global politics over the next three years, when it remains on the Executive Board. And, on how it handles its own disease trajectory in a transparent manner.

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