Melbourne: The World Health Organization needs greater freedom from politics when it recommends measures to fight global health crises, according to one of the leaders of an independent panel evaluating the response to the Covid-19 pandemic.
Concerns about reactions to recommendations like potentially trade-disrupting border closures may undermine the global health agency’s ability to fight new health threats, said Helen Clark, both a former prime minister of New Zealand and administrator of the United Nations Development Programme, in an interview.
“We expect from the world’s leading global public health authority to offer the best public-health advice that it can,” Clark said. “And that advice needs to be able to be offered in a way that tells ‘truth to power.’ And in a sense, if the ‘power’ doesn’t like it, that’s not WHO’s problem. It must act in what it sees as the best interests of public health.”
Both WHO and many of its member countries have been scrutinized for their responses to the pandemic that has struck about 47 million people, killing more than 1.2 million and stifling economies worldwide. Clark and panel co-chair Ellen Johnson Sirleaf, the former president of Liberia, were tapped in July to review the lessons learned from the WHO-coordinated international health response.
The WHO has been open to their inquiries, and member states have been “responsive,” Clark said. The panel is slated to present its progress to the World Health Assembly on Nov. 10 and release a full report in May.
This conversation has been edited for clarity.
Bloomberg: The U.S. understood in early January the implications of the novel coronavirus better than most countries outside Asia. Why is it in such difficulty now?
Clark: They were right on to it from an early stage. But, of course, it’s one thing to be right on to it; it’s another to adopt a set of measures that will deal with it. One of the early points of contention is that the U.S., New Zealand and a range of other countries rather quickly implemented travel bans from China. And the WHO, for essentially political reasons, doesn’t endorse or advocate travel bans because it fears it will not get that cooperation from the country that is the subject of them.
Clark: It was an absolutely indispensable measure. As I recall, Auckland Airport was accepting around nine international flights from China a day. If we hadn’t stopped them, it would have been catastrophic. I think as countries start to reopen — New Zealand, Australia, others that have had reasonable success — for the foreseeable future, it’s going to be about a “bubble” approach. Having had success and stamping it out and continuing to stamp it out whenever it appears, you don’t want to import cases willy-nilly.
Changing Perceptions
Bloomberg: Will this experience of travel bans and border closures change the way they are perceived as a public-health measure?
Clark: There’s no public-health grounds for saying that they don’t help. It’s all political. But as the evidence shows, it didn’t stop a lot of countries, including my own, putting on travel bans because it was the sensible thing to do.
Bloomberg: Does WHO need to stick to being more of a technical agency, and less political?
Clark: Yes. It needs to be depoliticized. If we could ever get multilateralism right, it needs to be in something like this, where there’s an existential threat that matters to every human being on Earth.
Bloomberg: The New York Times reported this week that, from the earliest days of the outbreak, the WHO has been “both indispensable and impotent.” Do you agree?
Clark: Well, there’s obviously more than a bit of truth in it because the WHO doesn’t have power. It only has the power to exhort, to encourage, to recommend that countries do something, to expect that countries will abide by the letter of the International Health Regulations. And it those responses aren’t forthcoming, it doesn’t have any enforcement powers. Ever since the declaration of a Public Health Emergency of International Concern at the end of January, [WHO Director-General Tedros Adhanom Ghebreyesus] and the WHO’s emergency team have day after day been talking about what needs to be done, why and how. But have enough been listening? No.
Bloomberg: Would it have helped if, in the first weeks, the WHO was less gushing in its praise of China’s reporting of the outbreak?
Clark: The WHO is an international organization, and I led one myself for eight years. You’re in a position where it’s very difficult to criticize any member state because you need their cooperation. You have no powers except to persuade people to come along. That’s why discussion is out there about whether the International Health Regulations should be toughened. Is this a Chernobyl moment of the kind which led to strengthened powers of access and enforcement for the International Atomic Energy Agency on issues of nuclear materials? And should there be an international convention as such, which places more responsibilities on member-states? Would they accept the powers and sanctions that came with it? All that remains to be seen. But for now, the WHO is depending on cooperation. I think that explains a lot about the way it’s behaved.
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Bloomberg: To what extent could more effective Group of 20 leadership have averted or mitigated this crisis?
Clark: Quite significantly. And also action at the United Nations Security Council level. It has been unable to pass the kind of resolution that was passed on Ebola in late 2014, when it declared Ebola to be a threat to global peace and security. How much more of a threat is this truly global pandemic? The Security Council needs an overhaul for many reasons because it’s, in a way, fighting the last World War. That’s not the threat we face today. Global health security is a huge issue, which should be considered within the province of the Security Council.
If we can contrast the G20 response with that of the 2008-2009 global financial crisis, of course, there’s no comparison. The G20, representing 85% of the global economy, dug very deep to ensure that the global economy didn’t go over the cliff. It needs to dig a lot deeper now. Let’s see what comes out of the realm of meetings that go on this month. But to date, it hasn’t looked so encouraging.
Bloomberg: How critical will this month’s meetings be?
Clark: G20 mobilizing more for the international and regional financial institutions is extremely important. The International Monetary Fund needs more cash to do the bailouts required of a wide range of countries. This is a crisis where high middle-income countries have been thrown back into impoverishment because of something that was completely beyond their control. So the need for support is wide, and it’s in the global interest that the international financial institutions are equipped to deal with that.
Bloomberg: What specifically are you wanting to see?
Clark: Definitely more support for the global financial institutions. My understanding is that, conservatively in May, it was assessed that they needed around $2.5 trillion to deal with the circumstances that countries in the developing world are faced with. They haven’t had that. And that’s now thought to be an underestimate. In 2009, with the global financial crisis, it was a package of $1 trillion. That’s laughable at the moment. We need much more to provide the fiscal space, the debt deferrals, waivers, et cetera, for a range of countries to make it through this.
Pull Together
Bloomberg: I can’t see where the money is going to come from.
Clark: The larger countries have mobilized money for themselves. But this is a crisis where we can’t just save ourselves if those all around us are going under. Where are our markets? Where are the consumers for our products? In a global crisis, you have to pull together. That was recognized with the GFC. It hasn’t yet been recognized significantly here, as the general approach has been for everyone to save their own skin.
Bloomberg: ‘Solidarity’ has been used a lot, but we have seen less evidence of it.
Clark: That’s the problem. To the extent there’s been solidarity, it’s been in the petty cash. The recommendations of the Global Pandemic Monitoring Board for the $8 billion dollars or so for the development of vaccines, therapeutics and diagnostics came through, but that’s the petty cash. There is a lot of cooperation with the Access to Covid-19 Tools (ACT) Accelerator. That’s, of course, extremely helpful. But it’s at this larger economic support level that we need to see more action.
Bloomberg: Will public health be seen differently as a result of Covid-19?
Clark: I think so. It’s clearly not just a health crisis. It’s an economic crisis, a social crisis. It’s a peace and security crisis. The reality is for countries that bungle the public health response, the economic damage is going to be deeper and longer lasting. So getting health right, having a healthy, secure population is absolutely critical to getting economies right and for business to prosper. -Bloomberg
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