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The World Health Wars

Guest:  Dr. Amesh Adalja, senior scholar at the Johns Hopkins University Center for Health Security

The World Health Organization isn’t immune from geopolitics – how does the international tug-of-war affect global health?

As the coronavirus pandemic ravages health and economic structures, the World Health Organization (WHO) is under fire. Amid international spats, politicians have scapegoated the UN agency – and more credibly criticized it for underestimating the dangers of COVID-19. The Trump Administration has now announced that the US is quitting the WHO, accusing the 194-member organization of becoming a puppet of China.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, joins Altamar to explain the strengths and limitations of the WHO – and the dangers of defunding the global health watchdog. An expert on emerging infectious diseases, pandemic preparedness, and biosecurity, Dr. Adalja is also an Associate Editor of the journal Health Security, co-editor of the volume Global Catastrophic Biological Risks, and a contributing author for the Handbook of Bioterrorism and Disaster Medicine.

Dr. Adalja expressed concern at the idea of the US – the WHO’s largest donor – cutting off funds: “We don’t want to defund the WHO in the middle of a pandemic. I think we have to realize that the WHO is going to be our eyes and ears as the developing world starts to face this pandemic, and we want to make sure that those countries are able to control this virus. And they’re going to rely heavily on WHO expertise, because they don’t have the equivalent of the U.S. CDC in their countries.” Importantly, WHO is a key resource to help governments work on all the world’s pressing diseases – from measles to Ebola, malaria, tuberculosis, and HIV/AIDS.

WHO plays an essential role in supporting global health efforts worldwide – especially amid the coronavirus crisis. Founded in 1948, the WHO is more relevant than ever “because it is a group of technical experts that can help countries develop response plans to this coronavirus, they can help with data collection, they can help with response systems, they can help with preparing countries to be able to deal with this virus and serve a coordinating function in the globe to try and align policies to contain the virus,” said Dr. Adalja.

But WHO also has institutional challenges. Dr. Adalja identified some of the WHO’s mishandlings of the early stages of COVID-19, including its “hesitancy to declare a public health emergency of international concern, as well as its recognition that this was a pandemic, stating for some period of time that this was something that could be contained when multiple people in the field realized…this was not going to be something containable.”

Dr. Adalja also addressed criticism of the WHO’s relationship with Beijing and the need to institute reforms: “There were also concerns about the treatment of China…its suppression of free speech… It would have been important for the WHO to call out these actions by China. That being said, the fact is that the United States has made its own mistake with this outbreak and we can’t blame the WHO’s failures for what the United States has done during this outbreak…but there is an opportunity for the WHO to reform, to get better, and to be less susceptible to political influence.”

In the race for a vaccine, Dr. Adalja notes that “we are making rapid progress.” He predicts that whichever country “makes the first vaccine that’s viable likely will vaccinate their own country first, even if that’s not the best public health measure.” To achieve a more apolitical WHO would involve restructuring its funding. According to Dr. Adalja, he could “imagine groups like the Gates Foundation putting money into the WHO to relieve the WHO of the pressure to placate member-states, but I think it’s going to be very hard because the WHO is ultimately going to end up victim to politics like everything is when it comes to global diplomacy.”

In the meantime, the organization could become more inclusive. Dr. Adalja made a strong case for including Taiwan – a leader in public health and disease prevention. He argued that as a public health organization the WHO must “allow all countries to participate…irrespective of their UN membership, irrespective of what China may think…because for public health, there shouldn’t be borders here, we really need to learn from everybody, we need to have situational awareness of every country, that’s one simple thing that the WHO could do in order to enhance public health.”

Find out more about the geopolitics of the WHO, available for download here.

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Episode 74