WHO and Covid-19: Some pertinent issues of global interest

By Dharam Gokhool

On 18-19 May 2020, a very important international meeting will be held in Geneva Switzerland – the 73rd World Health Assembly (#WHA73), in virtual mode with an adjusted agenda because of the Covid-19 pandemic. WHA brings together 194 member states and their role is to review the work undertaken by WHO, set new goals and tasks.

“In view of the exceptional circumstances and Taiwan’s exceptionally successful response to Covid-19, if anything, the global community would stand to benefit from its experience and the strategy it deployed in containing the pandemic. The Taiwan response to Covid-19 is an interesting, informative and eye-opening case study…”

Membership and meetings of the annual World Health Assembly

WHO was established in 1948 to promote health and ease the burden of disease worldwide. According to its constitution, all countries which are Members of the United Nations may become members of WHO by accepting its Constitution. Other countries may be admitted as members when their application has been approved by a simple majority vote of the World Health Assembly.

At the annual Assembly, two main types of meetings are held, each with a different purpose:

  • Committees
  • Plenary sessions where all delegates to the World Health Assembly meet to listen to reports and adopt the resolutions transmitted by the committees. The Director-General and Member States also address the delegates at the plenary.

 In addition to the above, technical briefings are organized separately on specific public health topics to present new developments in the area, provide a forum for debate and to allow for information sharing.

The agenda for the #WHA73 includes the following items:

  • Address by the Director-General (on Covid-19 pandemic response)
  • Statements by Heads of delegation on Covid-19 pandemic

There is also an item where “Invited Speakers” address the Plenary Session.

#WHA73 – A historic moment

#WHA73 comes at a time when the world is engaged in a relentless struggle to tackle the Covid-19 pandemic. There is no doubt that this year’s assembly will be of historic importance not only because of its timing but also in view of the dramatic, unprecedented global public health challenge posed by Covid-19 – a pandemic which, as at 14 May 2020, had claimed 297,000 victims, with some 4,350,000 confirmed cases.

With a second wave, and with the improbability of an effective vaccine being developed in the near future, the statistics are likely to indicate a heavier burden – economic, social, psychological and emotional — on the global community.

The situation will become more complex and complicated with:

  • any mutation of Covid-19 i.e. genetic changes in the make-up of the virus, making it easier to infect more people and more difficult to develop effective vaccines and treatments;
  • the appearance other diseases linked to Covid-19 like the Kawasaki syndrome, affecting children;
  • the devastating social, human and psychological impact of fear, anxiety, stress, loneliness and depression and the effects of lockdown, quarantine and curfew measures on the people’s liberty, social routines and livelihoods.

#WHA73 will have to address a number of issues of global public health interest, namely:

  • The Chinese enigma

The origin of the virus remains shrouded in a thick veil of opacity. Since it is deemed to have spread from China, thereafter engulfing the whole planet, the Chinese authorities are duty-bound not only to enlighten the global community about the genesis of this virus but also to assume its share of responsibility in tackling this unprecedented human tragedy. Was it from a human source or the result of a lab accident? How will WHO ensure greater transparency and accountability in the reporting of global health hazards in future?

  • Re-emergence, Surveillance and Preparedness

In the aftermath of the Severe Acute Respiratory Syndrome (SARS) which became a global health threat in mid-March 2003, both possibilities – human source and lab accident origin – of a post SARS virus were examined by the scientific community under the aegis of WHO.

“The future is likely to bring far greater challenges. Will SARS re-emerge, and with greater virulence? Can we contain a more widely disseminated epidemic? Will we have preventive or therapeutic countermeasures? Can the necessary global cooperation and resources for containment be sustained? If not SARS, are we prepared for the next emerging infection? Are our public health and research investments (human, technical, and financial) flexible enough to respond to the ever-changing profile of microbial threats?”

Furthermore, it was recognised that:

“The experience of the SARS outbreak and the history of its control hold clues to the origin and spread of the disease — knowledge that will help to prevent or curtail its resurgence. In assessing the public health response to SARS at both the global and local levels, workshop participants focused on the roles of surveillance and containment in limiting the spread of SARS and anticipated the use of these tools against future microbial threats.” (1)

The outbreak of Covid-19 and its rapid spread and the unprecedented casualties and its short- and long-term consequences for humanity beg the question as to the role and responsibilities of the authorities concerned – international, regional and local – in putting in place effective measures of surveillance and preparedness.

In the case of Covid-19, since advance warning and knowledge were available, what were the weaknesses in the system of surveillance and preparedness and why?

  • Leadership and Management

How the Covid-19 pandemic is being managed in different parts of the world provides clear indications of why some countries’ response is more effective than that of others. Asian countries like Japan, South Korea, Singapore, Hong Kong and Taiwan, learning from their experience in tackling SARS (2003) and H1N1(2009), were able to put in place outbreak management plans. They were better prepared so they are managing better.

In Nordic countries like Finland and Iceland, as well as in Germany, New Zealand, and a few others in the Pacific, women leaders have focused on the public health priority, and through their clear and credible messages combined with decisive and timely actions have earned public trust and have stood out in sharp contrast to “many countries led by incompetent, science-denialist men” like US President Donald Trump, who “accused the Democratic party of politicizing the virus as a “hoax” and of ignoring multiple warnings from top scientists for months”.

In most of the cases where management and leadership have failed or are failing, narrow political considerations are driving public health priorities. Obviously, this is a politically sensitive issue but can #WHA73 push it under the carpet when the lives and livelihoods as well as the future of our planet are concerned?

  • The Case of Taiwan

Taiwan, a democracy of almost 24 million people (and a territory claimed by China) and led by a woman President, Tsai Ing-wen, is among the few countries which have provided an effective response to the Covid-19 pandemic. It has also been very active in extending its help to a number of countries battling with Covid-19. In view of its political differences with China, since 2009, it was granted an “Observer” status only at the WHO Annual Assembly and was invited as such until #WHA73. This is certainly a highly politically sensitive issue and whether Taiwan will be present, and in what status, is still undecided.

However, in view of the exceptional circumstances and Taiwan’s exceptionally successful response to Covid-19, if anything, the global community would stand to benefit from its experience and the strategy it deployed in containing the pandemic. The Taiwan response to Covid-19 is an interesting, informative and eye-opening case study. Will WHO be able to untangle this Gordian knot and let the whole world take cognisance of the experience and strategy deployed by Taiwan to tackle Covid-19?

These are but a few issues of global public health interest that #WHA73 could address and chart a more coherent, comprehensive and cohesive strategy for post Covid-19 challenges. And help avoid another human tragedy like the one the world is going through presently.

(1) Institute of Medicine. 2004. Learning from SARS: Preparing for the Next Disease Outbreak: Workshop Summary. Washington, DC: The National Academies Press. https://doi.org/10.17226/10915

* Published in print edition on 15 May 2020

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