Northwest Arkansas Democrat-Gazette
Year of pandemic puts WHO trials in spotlight
GENEVA — When the World Health Organization declared the coronavirus a pandemic one year ago Thursday, it did so only after weeks of resisting the term and maintaining that the highly infectious virus could still be stopped.
A year later, the U.N. agency is still struggling to keep on top of the evolving science of the coronavirus, to persuade countries to abandon their nationalistic tendencies and help get vaccines where they’re needed most.
The agency made some costly missteps along the way: It advised people against wearing masks for months and asserted that the virus wasn’t widely spread in the air. It also declined to publicly call out countries — particularly China — for mistakes that senior WHO officials grumbled about privately.
That created some tricky politics that challenged WHO’s credibility and wedged it between two world powers, setting off Trump administration criticism that the agency only now is emerging from.
President Joe Biden’s sup- port for WHO may provide some much-needed breathing space, but the organization still faces a monumental task ahead as it tries to project some moral authority in a universal scramble for vaccines that is leaving billions of people unprotected.
“WHO has been a bit behind, being cautious rather than precautionary,” said Gian Luca Burci, a former WHO legal counsel now at Geneva’s Graduate Institute. “At times of panic, of a crisis and so on, maybe being more out on a limb — taking a risk — would have been better.”
WHO waved its first big warning flag Jan. 30, 2020, by calling the outbreak an international health emergency. But many countries ignored or overlooked the warning.
Only when WHO Director-General Tedros Adhanom Ghebreyesus declared a “pandemic” six weeks later, on March 11, 2020, did most governments take action, experts said. By then, it was too late, and the virus had reached every continent except Antarctica.
A year later, WHO still appears hamstrung. A WHO-led team that traveled to China in January to investigate the origins of covid-19 was criticized for failing to dismiss China’s fringe theory that the virus might be spread by tainted frozen seafood.
WHO had repeatedly lauded China last year for its speedy, transparent response — even though recordings of private meetings showed that top officials were frustrated at the country’s lack of cooperation.
“Everybody has been wondering why WHO was so praising of China back in January” 2020, Burci said, adding that the praise has come back “to haunt WHO big-time.”
Some experts say WHO’s blunders had a high price, and it remains too reliant on ironclad science instead of taking calculated risks to keep people safer — whether on strategies like mask-wearing or whether the virus is often spread through the air.
“Without a doubt, WHO’s failure to endorse masks earlier cost lives,” said Dr. Trish Greenhalgh, a professor of primary care health sciences at Oxford University who sits on several WHO expert committees. Not until June did WHO advise people to regularly wear masks, long after other health agencies and numerous countries did so.
Greenhalgh said she was less interested in asking WHO to atone for past errors than revising its policies going forward. In October, she wrote to the head of a key WHO committee on infection control, raising concerns about the lack of expertise among some members. She never received a response.
“This scandal is not just in the past. It’s in the present and escalating into the future,” Greenhalgh said.
With several licensed vaccines, WHO is now working to ensure that people in the world’s poorest countries receive doses through the Covax initiative, which is aimed at ensuring poor countries get covid-19 vaccines.
But Covax has only a fraction of the 2 billion vaccines it is hoping to deliver by the end of the year. Some countries that have waited months for shots have grown impatient, opting to sign their own private deals for quicker vaccine access.
WHO chief Tedros has responded largely by appealing to countries to act in “solidarity,” warning that the world is on the brink of a “catastrophic moral failure” if vaccines are not distributed fairly. Although he has asked rich countries to share their doses immediately with developing countries and not to strike new deals that would jeopardize the vaccine supply for poorer countries, none has obliged.
“WHO is trying to lead by moral authority, but repeating ‘solidarity’ over and over when it’s being ignored by countries acting in their own self-interest shows they are not recognizing reality,” said Amanda Glassman, executive vice president of the Center for Global Development. “It’s time to call things out for the way they are.”
Irwin Redlener of Columbia University said WHO should be more aggressive in instructing countries what to do, given the extremely unequal way covid-19 vaccines are being distributed.
“WHO can’t order countries to do things, but they can make very clear and explicit guidance that makes it difficult for countries not to follow,” Redlener said.
WHO’s top officials have said repeatedly that it is not the agency’s style to criticize countries.
At a news briefing this month, WHO senior adviser Dr. Bruce Aylward said simply: “We can’t tell individual countries what to do.”
VACCINE DIPLOMACY
As the U.S. ramps up vaccinations at home, nations from Lebanon to Uzbekistan are receiving free or subsidized coronavirus vaccines from U.S. adversaries China and Russia. But the Biden administration, facing urgent demand for the shots at home, has not responded with a global vaccine effort.
Despite concern that the nation is losing a vaccine largesse arms race, Biden has resisted actions that would appear to draw resources away from Americans. That leaves U.S. adversaries a largely free field. It also has sparked a debate within the administration about how to balance national security, humanitarian needs and political concerns.
China’s “vaccine diplomacy” campaign is on the agenda for an unusual virtual summit today among Biden and leaders of Australia, India and Japan. One possibility is that the four democracies agree in principle to pass out vaccine surpluses after their home populations’ needs essentially have been met.
J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies, said the Biden administration should not underestimate the risk of losing out in a soft-power contest that authoritarian nations could exploit for years.
“The Chinese and the Russians are advancing their vaccine diplomacy and are winning friends and influencing people and expanding their sphere of influence,” he said.
Beijing, for example, has promised to deliver Chinese-made vaccines to more than 50 nations, including nuclear-armed Pakistan, whose cooperation is key to a successful U.S. military withdrawal from Afghanistan, and the Philippines, an anchor for U.S. operations in Southeast Asia and traditionally a bulwark against Chinese military expansion.
Russia is pushing hard to raise the profile of its homegrown Sputnik V vaccine by pursuing numerous licensing deals. Russian vaccine backers signed an agreement Tuesday that could pave the way for production in Italy, a potentially big step in expanding Moscow’s efforts into the West.
Krishna Udayakumar, director of the Duke Global Health Innovation Center, said that the United States is “missing the opportunity to more strongly assert U.S. leadership on the global stage.”
Udayakumar said the United States could donate more doses to other countries without significantly affecting their availability to Americans. “That’s especially striking in our own backyard in Latin America, where the burden of covid is enormous and countries are struggling,” he said.
Biden disappointed Mexican President Andres Manuel Lopez Obrador last week by taking U.S. vaccine donation off the table for now.
Still, the reaction among Americans could be explosive if Biden supplies vaccines to other countries while many in the United States are still struggling to get the shots. Biden signaled this week that he feels pressure to balance domestic and global needs.
“If we have a surplus, we’re going to share it with the rest of the world,” he said Wednesday. “We’re going to start off making sure Americans are taken care of first, but we’re then going to try to help the rest of the world.”
FAUCI ‘SHOCKED’
Meanwhile, Dr. Anthony Fauci said Thursday that he would have been stunned if he knew a year ago that the United States’ covid-19 death toll would reach such devastating levels — and blamed the grim tally partially on politics.
“We had such divisiveness in our country that even simple, common-sense public health measures took on a political connotation,” Fauci said on NBC’s “Today” show.
The country’s top infectious-disease expert said the country diverged into two distinct tribes in a year that brought more than half a million covid-19 deaths.
“If you wanted to wear a mask, you were on this side,” Fauci said. “If you wanted to stay in and avoid congregate settings, you were on this side. It wasn’t a pure public health approach.”
When the WHO declared covid-19 a global pandemic last year, the U.S. case count had only just eclipsed 1,000, but fears of the virus prompted officials to put in place the first international travel restrictions.
That same day, Fauci had told Congress that “things will get worse” but declined to offer a figure on how many fatalities might be in store. He said it would depend on the U.S. response.
Former President Donald Trump, in stark contrast to health officials, tried to play down the severity of the virus, saying March 12, 2020: “It’s going to go away.”
On Thursday morning, Fauci said he would have never predicted over half a million deaths in America, which has by far the highest national death count in the world.
“It would have shocked me completely,” Fauci told NBC. “I did not in my mind think that ‘much worse’ was going to be 525,000 deaths.”