During a recent interview with Hong Kong news outlet RTHK, Bruce Aylward, a physician and senior adviser to the World Health Organization’s director general, refused to answer a question about Taiwan’s handling of the COVID-19 pandemic. A clip of the exchange has been viewed thousands of times on Twitter, and there are growing calls for Aylward to explain himself.
Don’t expect him to. Aylward’s behavior is just the latest in a long line of instances of the WHO putting politics ahead of good policy.
The WHO is coming under criticism for its politicized handling of the Wuhan coronavirus. Early in the pandemic, WHO’s Director General Tedros Adhanom Ghebreyesus, widely known simply as Tedros, praised the Chinese response to the emerging pandemic.
The WHO praised and supported China in spite of the fact that Chinese authorities had been consistently attempting to cover up the pandemic and lied about it publicly. Not only that, as National Review has documented, the Chinese punished those brave physicians who attempted to raise the alarm. As a result, what could have been a local or perhaps regional health problem became a global pandemic, the likes of which we have not experienced for 100 years.
For years, Taiwan has sought membership in the WHO, but China has blocked it, claiming the independent and democratic nation as a province. To date, the WHO has kowtowed to China, even though Taiwan has a better record on public health than the communist dictatorship.
Taiwan’s handling of the COVID-19 pandemic has been so effective that, to date, the island has recorded only five deaths. Long before the Wuhan coronavirus, Taiwan had a better record in dealing with the SARS and swine flu outbreaks. The WHO and its members should be learning from Taiwan, not denying it a seat at the table.
The World Health Organization Shifts Its Focus
The WHO certainly has a proud record in the fight against numerous diseases. Early in the organization’s history, when it was allowed to take a more paternalistic approach to disease control in poor countries, it recorded considerable progress against diseases such as river blindness, yaws, leprosy, polio, and malaria. The WHO ran these programs in a top-down manner, directing specific interventions, measuring progress, and changing course as necessary.
By the 1970s, however, there was a general move away from disease-specific programs and toward more holistic health programs. Additionally, the global population-control movement rose in power and influence, along with a push to limit the number of births.
As my colleagues and I explain in our 2010 book, “The Excellent Powder,” this change of focus had disastrous consequences for malaria control. The population-control movement and environmental activists campaigned against using insecticides to combat malaria, which is problematic for combatting insect-borne diseases.
The WHO’s global malaria eradication program, which it began in the 1950s and was largely based on the use of public health insecticides, never actually achieved eradication. However, the WHO estimates the program saved about 1 billion lives, which is a remarkable achievement by anyone’s standards.
The move against insecticides and the focus on family planning meant the disease slowly started to reemerge. By the early 2000s, about 1 million people were dying of malaria every year. The WHO finally reversed that counterproductive policy in 2006, but only after a protracted effort by malaria scientists and some malarial countries.
World Health Assembly meetings minutes show that during the 1970s, many malarial countries complained about their inability to source sufficient stocks of public health insecticides. These same minutes show wealthy donor countries, such as Sweden and Canada, kept pressure on the WHO to stop the use of these life-saving chemicals.
Follow the Money
The WHO has a considerable problem in its funding structure. Over the years, donor nations, which provide the bulk of WHO’s finances, have been reluctant to provide general support to the WHO. The donors prefer to fund specific programs, in which they have some particular interest.
The mismatch between donors’ desires and recipient countries’ needs has resulted in many situations similar to the WHO’s prioritization of programs that limited the use of insecticides against malaria. The old adage “follow the money” has seldom been as true as when applied to the WHO.
Several years ago, while visiting Geneva during the WHO’s annual World Health Assembly, I had a fascinating discussion with two long-term WHO staffers, whom I had gotten to know fairly well.
The two, who shall remain nameless, had worked for the organization for many years in various locations around the world and knew the WHO well. In our conversations, I thought I would be criticizing the WHO and they would be defending it. Far from it. They described the backstabbing and the politics, both internal and external, which had frustrated their work and probably cost lives.
“But surely we need something like the WHO to control things like global pandemics and other emergencies,” I said.
“No,” they both responded. These long-standing public health professionals argued the world didn’t need the WHO, even when dealing with a pandemic. They believed it should be shut down.
The Wuhan virus has shown that even during pandemics, the WHO will put politics ahead of public health. It has prioritized China, a country unmatched as a human rights abuser in recent decades, ahead of global health.
Should the World Health Organization be shut down? I’m not sure, but when the pandemic is over, there should be a rigorous investigation of the WHO’s handling of COVID-19, as well as a robust public debate about China’s malign influence over the organization. If the WHO is not shuttered, the process of inquiry will hopefully result in a much-needed and radical restructuring of the organization.