The TLDR: The World Health Organisation is increasingly under fire for its handling of the pandemic. From the very outset, a number of its policy recommendations have been wildly off the mark—some made more questionable due its perceived ‘soft on China’ approach. Now, the US has withdrawn its funding, and many countries are ignoring its advice. We look at why and how WHO lost the plot—just when we needed it most.
The United Nations agency was founded in 1948. It is broadly in charge of global public health and was created with a lofty goal: “the attainment by all people of the highest possible levels of health.” Its biggest success story: the coordination of a worldwide campaign to eliminate smallpox.
But until 2003, WHO enabled policy coordination and cooperation among different countries. It took on a more aggressive role—of telling governments what to do—during the SARS outbreak. And that role has remained controversial ever since. It has been accused of both over-reacting and under-reacting to potential threats. That resentment has now boiled over thanks to the pandemic.
The organisation misread the coronavirus from the very beginning, and its performance has gone downhill from there.
Travel bans: The WHO issued a February 29 advisory on strongly opposing travel bans or trade restrictions claiming that “restricting the movement of people and goods during public health emergencies is ineffective in most situations.” This was widely seen as giving into pressure from Beijing—which was furious about other countries suspending flights to China. In early February, Director-General Tedros slammed US and Australia for inciting "fear and stigma.”
Declaring a pandemic: The WHO finally took the big step in March but only because its advice—which now emphasised testing and tracing—was being roundly ignored by most countries. At this time, there were 120,000 confirmed cases across 114 countries and nearly 4,400 deaths.
Face masks: The same February advisory also strongly advised against the use of face masks “as there is no evidence that wearing a mask—of any type—protects non-sick persons.” The WHO finally changed its advice on face masks in June, saying they could provide "a barrier for potentially infectious droplets."
How the disease spreads: The WHO has made its biggest—and most critical mistakes—in its claims about the virus itself:
Last but not least, earlier this week, the WHO was forced to admit that the coronavirus may spread further and more widely by particles that float in the air. And it only did so after 239 scientists from 32 countries called it out in an open letter urging it to rethink its guidance.
Why this matters: Until now, the organisation insisted that the virus spread only via droplets of saliva or mucus expelled when someone coughs or sneezes or yells—and in close proximity. Hence, the emphasis on hand-washing, keeping a 2 metre distance etc.
But a slew of studies now show that the virus may travel longer distances indoors—via lighter particles (called aerosols) that float in the air, and accumulate over time. This could exponentially increase the risk of catching the disease if people share indoor spaces. For example, a choir practice in Washington state. According to one of the scientists who signed the letter:
“Inadequate ventilation, the long exposure time and the singing were sufficient to explain the number of people who became infected. And no amount of ventilation could have reduced the risk to an acceptable level for the two-and-a-half-hour rehearsal.”
This in turn has implications for best practices to prevent the spread. Governments may require masks indoors, a minimum standard of ventilation in all indoor spaces, and ban any kind of large gathering in closed spaces. None of which is music to a world leader’s ears.
Point to note: These studies are not entirely conclusive, and further research is necessary to definitively establish the level of airborne transmission.
Why this matters right now: Mumbai doctors warn that there is a high risk of Covid transmission during the rainy season:
"This is where Mumbai is right now. Whenever there is a mixture of air and water, like now in monsoon, the likelihood of airborne transmission is high. The humid environment of Mumbai right now is nothing but an aerosol mixture of water and air and would aid transmission."
The US—which is WHO’s largest funder, accounting for 20% of its budget—has just formally withdrawn from the organisation. The official statement claimed that the organisation “needs to get its act together” and demonstrate “significant progress and the ability to prevent, detect, and respond to infectious disease outbreaks with transparency and accountability.”
The US pullout—which takes a year to kick in—may never happen if Joe Biden becomes president in November. But the damage to the WHO may be irreversible. The pandemic has shown it to be nearly powerless and therefore ineffective, as The Guardian notes:
“The WHO is less like a military general or elected leader with a strong mandate, and more like an underpaid sports coach wary of ‘losing the dressing room,’ who can only get their way by charming, grovelling, cajoling and occasionally pleading with the players to do as they say.
The WHO ‘has been drained of power and resources,’ said Richard Horton, editor of the influential medical journal the Lancet. ‘Its coordinating authority and capacity are weak. Its ability to direct an international response to a life-threatening epidemic is non-existent.’”
And this—more than any pro-China tilt—explains why Beijing has been able to lead WHO by the nose.
There are three pieces worth your time. One, The Guardian’s excellent long read titled ‘The WHO v coronavirus: why it can't handle the pandemic’. Two, Nature magazine’s deep dive into mounting evidence of airborne transmission. Three, NBC News on how China has consistently blindsided and blocked the WHO.
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