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The WHO and China: Dereliction of Duty
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from Asia Unbound
THE WHO AND CHINA: DERELICTION OF DUTY
The WHO’s weak response to China’s mishandling of the COVID-19 outbreak has
laundered China’s image at the expense of the WHO’s credibility. The time is
ripe for clear leadership from the WHO based on science not politics.
Denis Balibouse/Reuters
Blog Post by Michael Collins
February 27, 2020 1:53 pm (EST)
Print Email
Michael Collins is a research associate for Asia Studies at the Council on
Foreign Relations.
The World Health Organization (WHO) was founded in 1948 with the lofty goal of
ensuring the attainment of the highest possible level of health by all people.
In the years since, the organization has been instrumental in controlling or
eradicating communicable diseases and investing in healthcare capacity across
the globe. However, the WHO is now facing rising international criticism over
outsized Chinese influence in the organization’s response to the ongoing
COVID-19 outbreak.
More on:
China
COVID-19
World Health Organization (WHO)
Taiwan
The WHO Director-General (DG) Dr. Tedros Adhanom Ghebreyesus has been an
outspoken advocate for the Chinese government’s COVID-19 response. On January
28, Tedros met with Chinese President Xi Jinping in Beijing. Following the
meeting, Tedros commended China for “setting a new standard for outbreak
control” and praised the country’s top leadership for its “openness to sharing
information” with the WHO and other countries. Yet in Wuhan, the epicenter of
the COVID-19 outbreak, Chinese officials were busy arresting and punishing
citizens for “spreading rumors” about the disease, while online censors
controlled the flow of information. Despite growing evidence of China’s
mishandling of the outbreak and rising domestic Chinese outrage over the
government’s censorship, Tedros remains unmoved. On February 20 at the Munich
Security Conference, Tedros doubled down on his praise for China stating that
“China has bought the world time.”
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In contrast to his effusive praise for China, Tedros has been quick to criticize
other countries for their responses to the outbreak. He called upon nations not
to limit travel with China and warned against the “recrimination or
politicization” of the outbreak. Domestic Chinese news coverage prominently
features Tedros’ praise of Xi Jinping and criticism of foreign governments.
More concerning is Tedros’ delay in declaring COVID-19 a public health emergency
of international concern (PHEIC). On January 23, the WHO’s emergency committee
was split on whether to declare a PHEIC. With final authority resting with the
DG, Tedros decided to wait despite admitting that “this is an emergency in
China.” A week later, he declared a PHEIC. By that point, confirmed cases of
COVID-19 had increased tenfold with 7,781 cases across 18 countries. John
Mackenzie, a member of the WHO executive committee, publicly stated that
international action would have been different if not for China’s
“reprehensible” obfuscation of outbreak's extent.
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ASIA. MONTHLY.
DAILY NEWS BRIEF
A SUMMARY OF GLOBAL NEWS DEVELOPMENTS WITH CFR ANALYSIS DELIVERED TO YOUR INBOX
EACH MORNING. WEEKDAYS.
THE WORLD THIS WEEK
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THE WEEK, FEATURING BRIEFS, OPINIONS, AND EXPLAINERS. EVERY FRIDAY.
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China’s influence in the WHO is also evident in the organization’s treatment of
Taiwan. Since China acceded to the UN in 1971, it has periodically blocked
Taiwan’s WHO membership on the grounds that the democratically governed island
is part of China. From 2009 to 2016, China allowed Taiwan to join the WHO’s
decision-making body, the World Health Assembly, as an observer under the name
Chinese Taipei. After the election of President Tsai Ing-wen in 2016,
cross-strait relations chilled causing China to block Taiwan’s future
participation.
Taiwan’s exclusion has very real consequences during global health emergencies.
First, the WHO is an indispensable source of information for countries’ health
departments. Without membership, Taiwan must rely on China’s health department
for outbreak information often with delays ranging from several days to weeks.
China has been forthcoming with information during the COVID-19 outbreak, but
there is no guarantee of future cooperation leaving Taiwan in a precarious
situation. Second, the WHO’s inclusion of Taiwan as part of China’s territory
overstates the scale of the outbreak on the island leading to unmerited economic
and diplomatic consequences. Mainland cases of COVID-19 are now above 70,000
with over 2,500 deaths. Taiwan has only reported 32 confirmed cases to date.
However, several countries including Italy, El Salvador, Mongolia, Vietnam, and
the Philippines used the WHO’s country classification as justification to
restrict travel from Taiwan. While the Philippines and Vietnam eventually
reversed their travel bans on Taiwan, the island nation’s continued exclusion
from the WHO means that such a mistake is liable to recur.
More on:
China
COVID-19
World Health Organization (WHO)
Taiwan
Dr. Tedros’ inaction stands in stark contrast to the WHO’s actions during the
2003 SARS outbreak in China. Then WHO DG Dr. Gro Harlem Brundtland made history
by declaring the WHO’s first travel advisory in 55 years which recommended
against travel to and from the disease epicenter in southern China. Dr.
Brundtland also criticized China for endangering global health by attempting to
cover up the outbreak through its usual playbook of arresting whistleblowers and
censoring media.
What has changed in the nearly two decades since the SARS epidemic? As always,
it is important to follow the money. Since its founding, the WHO has required
voluntary budgetary contributions to meet its broad mandate. In recent years,
the WHO has grown more reliant upon these funds to address budget deficits.
Countries’ assessed contributions have grown by only 3% since 2014.
Extrabudgetary voluntary contributions have grown by 18% from $3.9 billion in
2014-15 to nearly $4.7 billion in 2018-19. This dependence on voluntary
contributions leaves the WHO highly susceptible to the influence of individual
countries or organizations.
For its part, China’s WHO contributions have grown by 52% since 2014 to
approximately $86 million. This is largely due to China’s increase in assessed
contributions which are based on a country’s economic development and
population. However, China has also slightly increased voluntary contributions
from $8.7 million in 2014 to approximately $10.2 million in 2019. While this
pales in comparison to the United States’ 2018-19 contribution of $893 million,
China’s growing contributions come as its influence across the UN is rising just
as U.S. leadership is declining. Going forward, China might appear to be a more
reliable partner for organizations dependent on members’ financial support like
the WHO.
China was also an important ally of Tedros in the WHO’s DG election in 2017.
Months before the election, Tedros was invited to speak at Peking University
where he called for stronger cooperation between China and the Global South on
health issues. China’s support for Tedros paid off immediately. The day after
his electoral victory, Tedros confirmed to Chinese state-media that he and the
WHO will continue to support the “One China” principle, which recognizes the
government in Beijing as the legitimate Chinese government. Three years later,
Tedros’ enduring support of China’s response to COVID-19 shows that their early
support for him is still paying dividends.
The WHO’s weak response to China’s mishandling of the COVID-19 outbreak has
laundered China’s image at the expense of the WHO’s credibility. The rate of
infection in China appears to be declining, but the risk of a global pandemic is
increasing. The time is ripe for clear leadership from the WHO based on science
not politics.
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