Can the World Health Organization Meet the Challenge of the Pandemic?

Speaking at a press conference in Geneva recently, Tedros Adhanom Ghebreyesus was friendly and calm, as he usually is. He explained his humanitarian mission as the director-general of the World Health Organization (WHO), and warned, “We shouldn’t waste time pointing fingers.” Then, suddenly, his demeanor grew darker, and everything he had just said seemed forgotten.

Tedros, as he is commonly called, said that he could handle a lot personally. “I don’t give a damn,” he said, about the death threats he has received, but he would not remain silent when it comes to racist insults, because they constitute an attack on all black people. There was a smear campaign going on against him, he said, and he knew who was behind it. “This attack came from Taiwan,” he said, and that the country’s Foreign Ministry had even been aware of the campaign.

This kind of a display of anger is rare among diplomats, especially since he couldn’t substantiate his accusations. But it underscored the extent to which the WHO head has come under pressure in the COVID-19 crisis.

“We don’t do politics in WHO.” That’s one of the mottos of the Geneva-based organization, which serves as a kind of health ministry for the United Nations and employs over 7,000 people. As the conflict over Taiwan shows, however, that position is proving harder than ever to maintain right now.  

Taiwan would like to become the 195th member of the WHO and has a powerful ally in Donald Trump. But China is opposed because the leadership in Beijing considers the island, with its 24 million inhabitants, to be part of the People’s Republic of China. The conflict has been building for years, but since the outbreak of COVID-19 it has taken on a new significance, just like everything involving the WHO and its leader. To better understand how the pandemic and the Taiwan conflict are connected, however, you have to take a look at the past.

The WHO is one of many international organizations founded after World War II. Its goal was to make a healthy life possible everywhere in the world, to implement medical standards and fight infectious diseases across any ideological boundaries. Its greatest success was probably the eradication of small pox, a bright moment for humanity in the midst of the Cold War.

When an epidemic runs the risk of flaring out of control somewhere in the world, the Geneva-based apparatus takes over global leadership of the response. It has tackled viruses like the swine flu, Ebola, zika and now it is in the midst of COVID-19, an unprecedented challenge.

An Easy Target

But the WHO now finds itself having to deal with an American president unlike any other before him. Trump has managed to drag the organization into his power games like a brute schoolyard bully. It proved to be an easy target, too, as vulnerable and disadvantaged as it is.

The United States is the WHO’s biggest financial backer, with $400 million (360 million euros) in contributions. But Trump recently announced that he wanted to stop these payments for the foreseeable future and that his government would investigate the mistakes he claims the organization has made in fighting the virus.

He had already reached his verdict, claiming that the WHO had “failed in its basic duty” as a result of it being too reliant on and too close to Beijing. Trump claimed that the WHO had spread Chinese “disinformation” early in the epidemic and thus helped the virus spread.

To support this argument, he could point to footage of Director-General Tedros during a Beijing visit in January. Tedros had himself photographed with Chinese leader Xi Jinping and praised him effusively. He said that China is setting “a new standard for outbreak response” without a single word of criticism of the Chinese’s censorship of alarm bells over the virus rung by doctors in Wuhan.

And even after evidence of COVID-19’s high levels of contagiousness appeared in Taiwan, the WHO sent a calming message into the world: “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus.”

It appears Trump wanted to create a distraction from his own mistakes in the fight against the coronavirus by attacking the WHO. But the U.S. president isn’t totally wrong. Australia immediately signed onto his criticism and called for a closer examination of the issue. Japan’s deputy prime minister even said that the WHO should be renamed the China Health Organization.

Tedros fought back in his own way. He posted a series of one-word messages on Twitter: Solidarity. Humanity. Unity. Love. Officials in Geneva say that he doesn’t see any reason to justify himself.

“A Fraught Political Environment”

German doctor Bernhard Schwartländer who, as the chef de cabinet at the WHO is one of Tedros’ closest colleagues, says his boss is “tenacious and steadfast in his pursuit of his ideas and principles.” He says Tedros is not willing to make just “any kind of deal,” and that his independence is what enables him “survive, even in a very fraught political environment.”

“It may be,” says Schwartländer, “that he could have expressed some things differently.” He says that once the coronavirus is under control one day, the WHO will take a critical look back at its own actions. Tedros, he says, “was the first person to say this himself.”  

Before his appointment in 2017, Schwartländer headed the WHO’s Beijing office for four years. It was a “great and exciting time” for him, he recalls , adding that the Chinese listened to him and respected him even if he didn’t say what they wanted to hear.

Like Tedros, he sees the Chinese approach to fighting the pandemic as a success story overall. “Within a span of several weeks, they beat the curve down completely,” Schwartländer says. He claims that other countries could learn a lot from that.

In the early stages of the epidemic, he says, many were uneasy in Geneva. “When we saw the first numbers and images from Wuhan, we thought, this is going to be something of a Moloch – that, like Chernobyl, something terrible is happening there.” But through their strict lockdown and construction of hospitals at break-neck speeds, he says, the country’s leaders managed to avoid a total medical disaster. When Tedros’ confidante speaks about China, you can sense a lot of respect in his voice.

Tedros is the first African to lead the WHO. The 55-year-old biologist and immunologist is from Ethiopia, where he served as the country’s health minister and then foreign minister between 2005 and 2016. These were years in which China was making inroads into Africa, sending in consultants, giving out billions in loans and supporting infrastructure projects.

China had been particularly busy in Ethiopia. The Chinese built (and immediately bugged) the headquarters of the African Union in the capital city of Addis Ababa and constructed the city’s commuter rail network.

A political consultant who was stationed in Ethiopia as a high-ranking European diplomat and knows Tedros well, describes him as a “thoughtful” person with balanced judgment. He adds that he’s “a really nice guy” in person. The ex-diplomat recalls that despite all of the influence that China bought itself in Ethiopia, he had never noticed anything disreputable about Tedros. “That’s not his style.”

Kjetil Tronvoll, a professor of peace and conflict studies in Norway, has followed the WHO director-general’s career closely. “I first met him 20 years ago, and he stood out, had expertise,” he says. But Tronvoll claims Tedros also made at least one mistake along the road: When Ethiopia got hit by cholera outbreaks starting in 2006, and Tedros was the country’s health minister, he played down the situation. Tedros claimed there weren’t enough tests available to determine there was an epidemic. But Tronvoll argues those words were likely steered by a decision by Ethiopia’s leader to keep things under wraps.

Tedros stood out from the country’s leadership at the time. He belonged to the Tigray People’s Liberation Front, the most powerful group in Ethiopia between 1991 and 2019. But he was always a civilian and never an armed fighter. “This clearly set him apart,” says Tronvoll. “If you had been fighting as a teenager, made tremendous sacrifices, lived through horrific experiences — that leaves an imprint on you. And he didn’t have that.” Tedros served a repressive system run by leaders with military training. But Tedros also transcended them as a foreign minister with a knack for charm.

Nevertheless, his years serving a government with little space for freedom of expression and for human rights might have made him insensitive to those concerns. How else could he have come up with the idea, in the autumn after his election as WHO director-general, of making one of Africa’s most notorious dictators a poster boy for his organization?

According to Tedros, Robert Mugabe of Zimbabwe was appointed WHO goodwill ambassador because his country offers universal health care. Tedros only withdrew the appointment following protests.

Tedros owes his election to become the WHO’s director general in part to the support of the African nations, for whom the World Health Organization is especially needed. Its missions there are overseen from the headquarters of its Africa division in Brazzaville, the capital of the Republic of Congo. Emergency Coordinator Michel Yao runs his team from a fortress-like structure above the cataracts of the Livingston Falls.

A visit in February and later phone calls conveyed a sense of how the virus was spreading into new countries and what the WHO was undertaking to combat it. The Strategic Health Operations Center had classified 47 countries into three categories, but only eight countries were adequately prepared as of February. At the time, Yao said, “We can’t send experts everywhere.” But they did what they could.

In late March, the emergency coordinator sounded almost exasperated. He said teams had been assembled, but they hadn’t been able to reach their destinations because most air travel in Africa had come to a halt. By that point, the virus had reached almost all African countries.

Then came a bit of good news, although not from Brazzaville. The first aid aircraft had taken off from Addis Ababa in mid-April, filled with medical aid supplies from a UN sister organization, the World Food Program (WFP). Tedros sent a Twitter message to the head of the WFP reading, “Thank you my brother.”

A New, Modern WHO

In chef of cabinet Schwartländer’s view, the cooperation with the WFP shows the face of a new, modern WHO, as conceived in Geneva – a provider of fast, concrete help in collaboration with many partners. “This includes other UN organizations, states, and private foundations,” he says. He argues that it’s about fostering a logistical network that can be used flexibly.

This includes, for example, a collaboration with Chinese billionaire Jack Ma, the founder of the internet platform Alibaba. “His foundation has repeatedly made generous donations to us, most recently 100 million surgical protective masks and a million masks of very high quality,” Schwartländer says.

The World Health Organization has been working with private benefactors for many years now. Critics argue that this has created a dependency, and that those who donate can determine how their money is spent. They claim that these resources only rarely lead to a long-term improvement in health services. The third-largest contributor to the organization’s current budget is the Bill and Melinda Gates Foundation, with approximately $341 million.

Most recent large donations came from a benefit concert with Lady Gaga and other celebrities. Bestselling author Yuval Noah Harari has donated $1 million. The organization’s total budget is $4.8 billion, which sounds like a lot of money, but is tight for a global health giant. Mara Pillinger, who works on international health policy at Georgetown University in Washington D.C., argues that “the budget of the WHO is around the same as the budget of a large hospital in the U.S. — and most of it is tied up.”

Will China Fill Gap?

If Donald Trump now leaves a large financial gap in the WHO’s budget, as he has announced he would, it could lead Xi Jinping to increase his country’s share of the contributions. Two special payments have already been announced by China.

Even if officials in Geneva might want to see things differently, money is rarely non-political. But for the Taiwanese, who have thus far admirably steered their country through the COVID-19 crisis, cooperation with the WHO wouldn’t get any easier if Beijing’s influence were to continue to expand.