With the upcoming World Health Assembly at the end of May, and indications that the World Health Organization (WHO) director-general plans to seek a second term in office, AIDS Healthcare Foundation (AHF), the world’s largest provider of HIV/AIDS care globally, calls on the United Nations Member States to consider and address the many ways in which the WHO did not measure up to the task of protecting the world from COVID-19.
“It is now fourteen months since the WHO declared COVID-19 a pandemic, and the world was thrown into chaos. Vaccinations are ramping up, but much too slowly in many parts of the world – and countries like India are on ‘fire’,” said AHF President Michael Weinstein. “Coordinated international efforts to control COVID-19 have been virtually non-existent, raising the question—why was the world so unprepared for this pandemic? And more importantly, why did the institution with the primary responsibility of protecting global public health, the World Health Organization, fail so catastrophically?”
As the 10 points below will detail, missteps at the highest levels of the WHO led to delays and confusion with dire consequences across the world. WHO Director-General Tedros Adhanom Ghebreyesus ultimately bears responsibility for WHO’s actions, or lack thereof, from the start of the COVID-19 pandemic. In light of these facts, it is clear that Dr. Tedros should not be re-elected as director-general for a second five-year term at the WHO.
As evidenced by SARS, Ebola, Zika, and COVID-19, every new infectious disease outbreak carries a unique set of properties that poses unexpected challenges and requires a specialized response. There is no ready-made solution for all outbreaks, but in terms of evidence-based public health best practices, there are basic universal principles, such as transparency, accountability, and coordination. WHO, under Tedros’s guidance, has largely failed to implement and maintain these principles while responding to COVID-19 in the following ways:
- While it is still unclear exactly when and where COVID-19 first erupted, we do know that it was earlier than first reported by the WHO. A recent study in Italy puts their first case before the first identified case in China. Additionally, eight scientists in China raised the alarm about a novel virus in December 2019 and were detained and interrogated by authorities. A Harvard University analysis showed increased traffic at Wuhan health facilities going back to August 2019. WHO either did not have an effective early warning system, knew about this virus and didn’t report it, or was prevented from knowing about it by the Chinese government. The result is that COVID-19 spread for months under the radar, thereby preventing effective containment and paving the way for a disastrous pandemic.
- Once WHO acknowledged the emergence of the virus in early January 2020, it resisted pressure from key stakeholders, including AHF, and did not declare a Public Health Emergency of International Concern until January 30, 2020. By the end of January, there were already over 8,000 officially reported cases of COVID-19. This contributed to complacency on the part of countries in preparing and responding effectively.
- Despite the spread of COVID-19 to multiple countries, the WHO waited an additional 40 days until March 11, 2020, to declare a pandemic.
- The WHO director-general repeatedly praised China’s response to COVID-19 despite knowing that its authorities failed to act quickly and transparently, wasting precious time for the world to respond. In addition, WHO knew that China was withholding vital data about the virus and was blocking independent scientists from coming in to investigate the origins of the virus. The WHO delegation only recently went to China and was denied access to source data and was carefully managed by Chinese authorities.
- The WHO panel, which was sent to China to investigate the origins of COVID-19, was not entirely independent. It was selected in coordination with the Chinese government and included people who had clear conflicts of interest due to prior work with the Wuhan Institute of Virology. Even in a situation where impartiality was essential, WHO did not have sufficient leadership or power to hold countries accountable.
- Throughout this pandemic, WHO failed to provide authoritative scientific information, data, and pragmatic operational guidance that could inform global efforts to control the virus. As a result, almost every country acted on its own with respect to case reporting, travel restrictions, and guidance, causing chaos and contributing to the spread of the disease.
- WHO lacked a coherent communications strategy. They spoke authoritatively on matters they didn’t understand but equivocated on things that were quite clear. Some examples include initial inconsistencies in whether there was ongoing human-to-human transmission, the effectiveness of face masks, and the efficacy and safety of Ibuprofen or dexamethasone use among COVID-19 patients.
- WHO did not develop an effective vaccine strategy. Working with COVAX, they failed to garner the resources necessary to guarantee vaccine access for the developing world, failed to advocate for essential patent waivers, and failed to provide effective guidance on minimum standards or side effects. At present, COVAX expects to provide enough vaccines to protect 20% of people in 92 lower-income nations, but WHO says that to stop COVID-19, at least 70% of people need to be vaccinated.
- WHO failed to approach and incentivize mobilization of civil society to help educate and convince communities to cooperate with prevention measures.
- WHO failed to provide or even establish timely workable standards for basic protective equipment.
For these and many other reasons, the world needs a new public health security architecture. It is the very nature of WHO, which answers to 194 health ministers, is highly politicized, and is luxuriously ensconced in Geneva – far from the battlefield – which makes it ineffective in fighting this and any future pandemics.
This press release is Part 1 of a two-part statement on the urgent need for fundamental reforms of the global public health system. Part 2 will highlight how the structure for a new and improved Global Public Health Convention should be designed.