Editor’s note: The Trump administration gave formal notice in July that it intends to withdraw from the World Health Organization – an organization the U.S. helped create in 1948 and for which it is the biggest funding source. A research scientist in the School of Information Sciences, Ian Brooks is the director of the Center for Health Informatics, a WHO collaborating center, and he is part of an invitation-only working group convened by the WHO looking at how to navigate the information being provided to the public about COVID-19. He spoke with News Bureau arts and humanities editor Jodi Heckel.
What is your view of the criticisms that the WHO was slow to declare COVID-19 a pandemic and is controlled by China?
WHO did not declare COVID-19 a pandemic until March 11, but that is purely semantics. A pandemic is not a higher level of warning than the PHEIC – public health emergency of international concern – that was declared Jan. 30.
WHO is not independent to act as it wishes. It does not make health policies; it can only recommend them. Once the 194 member countries agree to a health policy, WHO is the organization responsible for carrying it out. We may like them to have the authority to investigate every report of an unusual disease, but they do not. Would we have wanted to have a WHO team show up uninvited to investigate the unusual flu cases seen in Kansas in 1918? It is a question of national sovereignty.
China probably did not provide all the information WHO wanted as soon as it wanted, partly because not all the information was known – eight months later we are still learning new things about the virus – and partly because what was known would have had to go through China’s political vetting process before release. This is not unusual. China CDC is a political organization, but so too is the U.S. CDC and every other major public health agency. The current numbers coming out of many countries and U.S. states are also being filtered through political decision-makers.
Even with these restrictions, events in January moved very fast. At the time of China notifying WHO on Dec. 31, there were only seven serious cases of an unknown disease, and it wasn’t until Jan. 11 that the first known death occurred. Human-human transmission was confirmed nine days later, and it was only a further 10 days before the PHEIC was declared. In hindsight, these times could have been shortened, but one month from being told something unusual had been seen to declaring a global health emergency does not seem excessively slow.
As to WHO being dominated by China, I recently took part in a working group convened by WHO to figure out how to handle the “infodemic.” There were 97 participants representing 29 countries. These included seven from China; there were 28 from the United States.
What role is WHO playing in trying to control the COVID-19 pandemic? How will this decision by the U.S. to withdraw affect those efforts, both in the U.S. and internationally?
As the U.N. specialized agency for health, WHO is the only organization that can coordinate the global response to a global public health threat. It is currently distributing personal protective equipment and test kits to 133 countries and overseeing multicountry clinical trials. It will be responsible for equitable distribution of vaccines among its member states. Perhaps most importantly, it is generally seen around the world, regardless of political background, as the trusted authority on public health issues.
It is unclear what direct effect the U.S. withdrawing from WHO could have on the COVID-19 pandemic, since the withdrawal will not be final until July. Hopefully by then a global vaccination campaign will be well underway. I do know that it is a huge distraction for WHO staff and is taking up valuable time.
One lesson that we should learn from this pandemic is that we really are all in this together. We are so connected that a new disease appearing anywhere on the planet can quickly impact the whole world, and only a global response can control it. Until there is a widespread vaccine, pockets of the virus anywhere have the potential to quickly reinfect the population everywhere. Isolation is not a practical long-term prescription for a country.
How would a U.S. withdrawal from WHO affect the work of the Center for Health Informatics and other WHO collaborating centers in the U.S.?
A country withdrawing from WHO is unprecedented and I am not sure anyone really understands the repercussions, including what it would mean for the 83 U.S.-based collaborating centers. Faculty members and university-based centers could still be invited to take part in WHO-sponsored activities, but the formal designations may have to be rescinded, as each one must be approved by the host government. With the loss of the designation, it would be harder for us to receive funding and data for joint projects.
The complete withdrawal of cooperation from the 27 collaborating centers at the CDC and other federal government agencies would surely lead to CDC losing some of its global preeminence and top staff.