US President Donald Trump Comes Out Punching Against WHO COVID-19 Response – Threatens Permanent Defunding In 30 Days WHA73 19/05/2020 • Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Unlike China’s President Xi Jinping, United States President Donald Trump didn’t appear on camera yesterday at the opening of the first-ever virtual World Health Assembly. Instead he used Twitter to get his message across about China’s alledged coverup of early news about the novel coronavirus and WHO’s failure to act assertively vis a vis Beijing. In a letter to WHO Director General Dr Tedros Adhanom Ghebreyesus, released early Tuesday morning on his personal Twitter account, @realDonaldTrump, the US President said he would permanently halt funding to the Organization and reconsider US membership if WHO does not commit to “substantive improvements within 30 days.” “My Administration has already started discussions with you on how to reform the organization. But action is needed quickly. We do not have time to waste. That is why it is my duty, as President of the United States, to inform you that, if the World Health Organization does not commit to major substantive improvements within the next 30 days, I will make my temporary freeze of United States funding to the World Health Organization permanent and reconsider our membership in the organization. I cannot allow American taxpayer dollars to continue to finance an organization that, in its present state, is so clearly not serving America’s interests.” Annual 73d World Health Assembly – Votes on COVID-19 Resolution in Virtual Format Hours after Trump’s letter was published, the World Health Assembly approved a European Union-led resolution that responded, at least initially, to two of the most key US demands. The resolution mandates an independent, “stepwise” review of the WHO’s performance in the pandemic response, as well as a scientific investigation into the origins of the virus emergence in China. However, Trump’s blunt, in-your-face message, was dramatically different in tone and style from the statements being made by most of the WHO’s other 193 member states during the two-day assembly – showing solidarity with WHO in the face of the challenges posed by COVID-19, and saying the organization’s independence needs to be strengthened, not undermined. While other member states have oft criticized WHO, even bitterly, such remarks are usually made behind closed doors, while public discourse is softened by the language of diplomatic nuance. Style May Detract From Substance The US delivery style may, in fact, deflect attention away from a more serious examination of allegations about China’s missteps, including the represssion of free information flow and reprisals against Chinese and Wuhan whistle-blowers in the pandemic debacle, observers said. “President Trump is behaving like a schoolyard bully,” Suerie Moon, co-director of the Global Health Centre, Geneva Graduate Institute, told Health Policy Watch. “One of the weaknesses of the WHO is that it is not easily able to criticize any of its Member States, neither China nor the US. Trump appears to continue using WHO as a scapegoat to distract from what continues to be a highly-concerning epidemiological situation in the US. While the US can land a punch on WHO, there’s not much WHO can do to fight back. The US has a beef with China, but instead of raising these openly in the WHA yesterday, it went after a softer target. “The thing is, nobody likes a bully. Although the US has raised concerns that are shared by other countries regarding the origins of the virus, how it was initially handled by the Chinese authorities, and the degree to which the authorities shared information with WHO or internationally, this letter weakens the US ability to get other countries to support its desire to get answers to these questions.” Critics also point to the White House’s own repeated statements in late January and early February that praised China’s response and played down the impacts of the virus, both in terms of its infectious capacity and its impact on human health. These were shortcomings that Trump critics quickly replayed on his own Twitter feed just after the letter was issued, recalling statements that the President had made in late January saying “We have it totally under control,” as well as another tweet stating “China has been working very hard to contain the Coronavirus.” The other problem, others point out, is that reducing funding to WHO also weaken’s its range of independent action in times of crisis. “The WHO is not perfect, but it is structurally starved of core funding, leaving this unique institution, that has the potential to be the agency we all want it to be, and deliver so much, weakened, undermined and destabilized, by the very people who it serves – its member states,” said Tim Reed, executive director of the advocacy organization Health Action International. Letter Chronicles Alleged Chinese Delays and Concealment of Early Virus Reports The Trump chronicle of charges is roughly based on a report published by the US Congressional Research Services last week: COVID-19 and China: A Chronology of Events (December 2019-January 2020). The Congressional record cites a 30 December “urgent notice” by the Wuhan Health Commission about cases of atypical pneumonia that leaked online in China. By the next day thre was a flurry of Chinese media reports. Taiwan sent a warning to WHO on 31 December about an unusual cluster of cases, in isolation. And WHO sent a query to its China office for clarifications. WHO finally issued its first public alert on January 4, 2020. Based on that, the Trump letter charges that: “By no later than December 30 2019, the World Health Organization office in Beijing new there was a ‘major public health concern’ in Wuhan, including from Chinese media reports about “evidence of a new virus emerging from Wuhan, based on patient data sent to multiple Chinese genomics companies” and reports by a Hubei Province doctor, “that a new coronavirus was causing a novel disease that was, at the time, afflicting approximately 180 patients.” Despite the fact that “International Health Regulations require countries to report the risk of a health emergency within 24 hours, “China did not inform the World Health Organization of Wuhan’s several cases of pneumonia, of unknown origin, until December 31, 2019, even though it likely had knowledge of these cases days or weeks earlier,” the letter states. Lancet Study Published 24 January 2020 – Refers to 1 December Coronavirus Case Graphic shows 1 December 2019 symptom onset date for first of 41 Wuhan coronavirus patients studied, The Lancet 24 January 2020, Trump further claims: that WHO “consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier, including reports by the Lancet medical journal.” That was immediately rebutted by Lancet editor Richard Horton. He later told Health Policy Watch: “The first reports the journal published were on January 24, 2020. In a paper by Chaolin Huang and colleagues, the first 41 patients from Wuhan with COVID-19 were described.” The statement added, “The allegations levelled against WHO in President Trump’s letter are serious and damaging to efforts to strengthen international cooperation to control this pandemic. It is essential that any review of the global response is based on a factually accurate account of what took place in December and January.” In fact, a Health Policy Watch review of the study 24 January 2020 Lancet study, in question found that it refers back to 1 December – as the earliest symptom onset date for the patients studied. It notes that: “The symptom onset date of the first patient identified was Dec 1, 2019”. Patients were hospitalized between Dec 16, 2019, and Jan 2, 2020, the study authors further noted. WHO Policies on Travel Restrictions Faulty – Statements Pandered to Beijing – Says Trump The Trump letter further cites a litany of alleged “grossly inaccurate” or “misleading” claims by WHO about the virus and it’s praise for China’s response. These include reference to WHO’s tweets on 14 January that there was “no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCov) identified in Wuhan China.” The letter also alleges Chinese pressure on WHO to defer a declaration of the outbreak as an international public health emergency. And it slams WHO praise for the Chinese government’s “transparency” with respect to its reporting on the coronavirus. Other key points mentioned include: Reprisals against Chinese scientists and health professionals – The letter describes how the Chinese medical expert who first sequenced the genome of the virus and posted it online 11 January, had his lab closed by the authorities the next day for “rectification” – even as the WHO praised China for its transparency in posting the genome sequence. Travel restrictions – The letter also criticizes WHO’s reluctance to recommend international travel restrictions to contain the virus, including statements in early February that spread of the virus ouside of China was “minimal to slow” and travel restrictions caused “more harm than good,” while millions of people leaving the Wuhan epicentre spread the virus around the world: “You also strongly praised China’s strict domestic travel restrictions, but were inexplicably against my closing of the United States border, or the ban, with respect to people coming from China… Incredibly, on February 3, 2020, you reinforced your position, opining that because China was doing such a great job protecting the world from the virus, travel restrictions were “causing more harm than good.” Yet by then the world knew that, before locking down Wuhan, Chinese authorities had allowed more than five million people to leave the city and that many of these people were bound for international destinations all over the world. WHO-led Fact-finding mission to China: The “Even after you belatedly declared the outbreak a Public Health Emergency of International Concern on January 30, 2020, you failed to press China for the timely admittance of a World Health Organization team of international medical experts. As a result, this critical team did not arrive in China until two weeks later, on February 16, 2020. And even then, the team was not allowed to visit Wuhan until the final days of their visit. Remarkably, the World Health Organization was silent when China denied the two American members of the team access to Wuhan entirely. Virus Spread by Asymptomatic Carriers: Trump cites WHO statements in early January about the absence of proof of human-to-human transmission and from early March downplaying the risk of asymptomatic virus, saying “It is now clear that China’s assertions, repeated to the world by the World Health Organization, were wildly inaccurate.” Discrimination Against African Migrants: And it notes that WHO failed to comment on China’s “racially discriminatory actions” against Africans migrants that were evicted or refused services – which was the subject of a complaint by several African ambassadors to China on 11 April. Praise for China: Throughout this crisis, the World Health Organization has been curiously insistent on praising China for its alleged “transparency.” You have consistently joined in these tributes, notwithstanding that China has been anything but transparent. In early January, for example, China ordered samples of the virus to be destroyed, depriving the world of critical information. Even now, China continues to undermine the International Health Regulations by refusing to share accurate and timely data, viral samples and isolates, and by withholding vital information about the virus and its origins. And, to this day, China continues to deny international access to their scientists and relevant facilities, all while casting blame widely and recklessly and censoring its own experts. WHO Performance In SARS Era Praised – Including Including Its Recommendations For Travel Restrictions WHO Director General Dr Tedros speaks at World Health Assembly The letter concludes by sharply contrasting the COVID-19 policies of Dr. Tedros Adhanom Ghebreyesus with decisions taken by former Director General Gro Harlem Brundtland, during the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) in China, and other parts of Asia: “Perhaps worse than all these failings is that we know that the World Health Organization could have done so much better,” he states. “Just a few years ago, under the direction of a different Director General, the World Health Organization showed the world how much it has to offer. In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. “She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example. Investigations Mandated by European Union-led Resolution at the WHA – Key to Way Forward The letter concludes with reference to the European Union-led resolution that should pave the way for an indepdent investigation of the origins of the virus and a review of WHO’s performance, stating that the resolution will fill the gap in areas where WHO has failed to act firmly: “The World Health Organization has failed to publicly call on China to allow for an independent investigation into the origins of the virus, despite the recent endorsement for doing so by its own Emergency Committee. “The World Health Organization’s failure to do so has prompted World Health Organization member states to adopt the “COVID-19 Response ” Resolution at this year’s World Health Assembly, which echoes the call by the United States and so many others for an impartial, independent, and comprehensive review of how the World Health Organization handled the crisis. The resolution also calls for an investigation into the origins of the virus, which is necessary for the world to understand how best to counter the disease.” “….It is clear the repeated missteps by you and your organization in responding to the pandemic have been extremely costly for the world,” Trump states in the letter’s concluding paragraph. “The only way forward for the World Health Organization is if it can actually demonstrate independence from China.” Image Credits: Donald Trump, WHO. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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