Rep. Roger Marshall, M.D.: WHO desperately needs reform – here’s how to protect global health now
For the last 70 years, the U.S. and countries around the world have put their trust in the World Health Organization (WHO) to alert the global community of disease outbreaks and provide technical expertise in public health. In return, the WHO has – time and again – demonstrated its systemic organizational problems and lack of accountability.
The COVID-19 pandemic is just one more example of the WHO’s willingness to let politics govern over their core responsibility as a global public health watchdog.
As a physician, I’m especially concerned about the WHO’s failure to properly respond to these outbreaks. Nearly 100,000 Americans have died from COVID-19, and this international health organization must be held to strict medical and information sharing standards going forward.
Decisions by the WHO guide and impact the abilities of medical providers to provide proper guidance and care for their patients.
The director-general of the WHO, Tedros Adhanom, made several disastrous mistakes in mitigating and preventing the COVID-19 outbreak. On Jan. 14, the Chinese government denied human-to-human transmission of the virus was occurring, and the WHO quickly endorsed their message. It’s shocking that the WHO made no attempt to independently verify the claims of an undemocratic government widely known for its iron muzzle on the media, the “Great Firewall” of Internet controls, and an unapologetic history of concealing the truth.
Then again, this easy solidarity with China is no surprise when considering Tedros was largely backed by China when seeking the WHO’s top position. More notably, his home country is one of Africa’s leading partners for China’s “Belt and Road Initiative” and China remains their largest source of foreign investment.
Politics, unfortunately, had much to do with the Tedros decision to state that the Chinese response to the outbreak was “transparent” and had his full confidence. As Tedros was helping the Chinese government, hospitals across Wuhan became overwhelmed by sick patients while Chinese officials silenced the medical community with one hand, and stockpiled personal protective equipment with the other.
However, thanks to unwavering international pressure, Tedros declared the outbreak a public health emergency and changed course.
It’s doubtful the WHO would have reacted differently without Tedros catering to China. This isn’t the organization’s first failure at responding to a disease outbreak. The 2014 Ebola outbreak in West Africa and the 2009 H1N1 influenza pandemic sparked heavy criticism of the WHO’s poor performance and prompted many external and internal investigations calling for reform. While some reform measures have been adopted, WHO continues to lack accountability, and without it, medical expertise and public health will always come second to politics and propaganda.
Independent investigations of the COVID-19 outbreak will undoubtedly be written and recommendations for reform will be outlined. Minor technical changes will be adopted and the ones threatening political favor will be ignored. In order to ensure meaningful changes are actually made, countries need to abandon the carrot and grab the stick.
The U.S. is the largest volunteer contributor to the WHO, and with these persistent problems, the Trump administration rightly decided to halt funding pending an investigation into its handling of the COVID-19 outbreak.
As the Trump administration continues to pry open political motivations driving the WHO, over 60 countries, including Canada, Australia, New Zealand and Japan, as well as the European Union, have signed a resolution backing the investigation. That resolution was recently adopted unanimously during a virtual meeting of the World Health Assembly, despite repeated complaints from China.
It is time to reevaluate the organizational structure of the WHO to ensure future responses are based on science, not propaganda.
Participating countries should consider establishing a small select voting body of medical experts, similar to the structure of the United Nations Security Council, with the purpose of championing cooperation in solving global health issues. This body could oversee significant policy issues like outbreaks, major capital expenditures, and assess actions taken by other countries during public health emergencies.
Accountability comes with the power to make decisions that member states are then obligated to implement. This would be supplemented with international pressure.
The U.S. — the largest single provider of humanitarian assistance, the largest contributor to the WHO, and global watchdog — must lead this fight to ensure the WHO fulfills its role in global health and pandemic response.