As death toll passes 300,000, US-China discord hampers search for Covid-19’s origin
- The WHO has been in the thick of previous outbreaks to contain infectious diseases
- But this time is different – the toxic relationship between Beijing and Washington is getting in the way
The WHO has been in the thick of previous outbreaks to help contain
infectious disease. But this time is different. Illustration: Perry Tse
An unknown disease in China infected hundreds with pneumonia and people started to die. An international team under
flew in to help deal with the outbreak. That was 17 years ago.
.
A decade later, the WHO was on the ground during the 2014-16 Ebola
outbreak in West Africa, coordinating efforts to contain and trace the
virus.
It makes sense to bring in an international WHO team to investigate
disease outbreaks. The WHO is backed and funded by 194 nations and its
mandate when set up in 1948 states: “The attainment by all people of the
highest possible level of health.”
But the record shows that there is not a one-size-fits-all WHO response
to epidemics – it depends on the outbreak and capacity of the country to
deal with it. That’s why the US Centres for Disease Control and
Prevention handled the H1N1 pandemic flu in North America in 2009.
The WHO also lacks the authority to march into a country to investigate health conditions; it needs to be invited.
Today, with more than 300,000 people dead in
, getting the WHO involved on the ground to help search for the origins
of the coronavirus first identified in Wuhan in central China, is more
politicised than any outbreak in recent history. The United States and
China are using it as a proxy to attack each other as part of a broader
conflict over global influence and power.
From most accounts,
, but the poisoned politics of Washington and Beijing keep getting in the way.
“We’ve seen both China and the US react to this pandemic through the
lens of geopolitics and that’s been very, very disruptive,” said David
Fidler, a legal scholar and adjunct senior fellow with the non-profit
Council on Foreign Relations in New York. That was making it difficult
to even agree on what an investigation into the outbreak would focus on,
he said.
“No one was concerned about how Sars was going to affect the
distribution of power in the international system,” said Fidler, who
advised the WHO on rewriting its International Health Regulations after
Sars. The rules were changed to promote transparent reporting of
outbreaks and to help combat the growing threat from the cross-border
spread of diseases. In all, 196 countries signed on to the IHR
standards.
Robert Breiman had a front-row seat to the response to Sars, or severe
acute respiratory syndrome, in 2003. The epidemiologist was pulled from
his work on infectious disease in Bangladesh to lead WHO investigative
teams in China at the time.
“It was a very very different time than what we’re in right now in that
everybody was united around figuring out what this was and finding the
best ways to prevent illness,” said Breiman, also a former official at
the US CDC. “There was no political side at all.”
But Covid-19 appeared amid acrimonious relations and mistrust between
the US and China, following an 18-month trade war, recriminations over
civil liberties, and conflicts about Beijing’s claims to areas of the
South China Sea – to mention just a few areas of friction. The pandemic
just made it worse.
“The rhetoric, the escalating accusations, the conspiracy theories – it’s a spiral of adverse effects,” Fidler said.
Researchers generally agree that as with Sars, Covid-19 is caused by a
virus that likely migrated into humans from bats, perhaps via an
intermediary animal in the wildlife trade. That may have happened at
In 2003, researchers from the University of Hong Kong were the first to
trace the Sars infection to similar wet markets in Guangdong province in
southern China, concluding that civet cats sold in the markets were the
likely intermediate host.
The university’s Dr Leo Poon Lit-man, one of the first researchers to
decode the Sars genetic sequence and develop diagnostic tests, explained
why it was important to trace and understand the origin of pathogens.
“By understanding the transmission routes, we may develop control
measures,” he said. “There could be several dozens of that type of virus
circulating in China. Also, there are similar viruses in the region.
Could it happen again? How could it happen?”
The WHO has said that China’s scientists are investigating the origins
of Covid-19. This includes environmental sampling at markets and farms
in areas where the first human cases were identified and tracing the
source and type of wildlife species and farmed animals sold in wet
markets.
Poon, who is not involved in the Covid-19 investigation, said
researchers would need to trace where any infected animal came from. It
could have been shipped to Wuhan from elsewhere in China or other parts
of the world, he said.
“My gut feeling is the wet market played a role, like what you had for
Sars. But now, we don’t have evidence, it is still speculation,” he
said.
Meanwhile, more than four months have passed since China alerted the WHO
about the outbreak. China has said it collected hundreds of samples
from the Wuhan market, including dozens with the virus, but it has not
publicly shared further details. There is still no clarity on any
intermediate animal or how the virus got into humans.
In that time, millions of people have been infected, many millions more
have lost their livelihoods as lockdowns to stop the spread of the
disease have shut down businesses around the world.
Governments are spending trillions of dollars on bailouts and world
leaders want answers about the origin of Covid-19 to prevent it from
happening again.
As part of those demands, the European Union will co-sponsor a
resolution for an “independent review” of the international health
response to Covid-19 when the World Health Assembly convenes for a
virtual meeting on May 18.
The WHO last week said it was in talks with China to investigate the
origin of the virus, following up on a week-long joint mission in
February. China so far has not agreed to any international
investigations, stating only that it supports a WHO-led global review of
the outbreak at an “appropriate time after the pandemic is over”.
“What we object to is the attempt to politicise the tracing of origin of
the virus by the US and some other countries, who are so eager to
launch an international inquiry based on the presumption of guilt,”
Chinese foreign ministry spokeswoman Hua Chunying said last week.
The WHO has also been dogged by criticism that it pandered to Beijing in its handling of Covid-19 information.
The Trump administration last month said it would suspend funding to the
health body to investigate the WHO’s relations with China. This raises
doubts about whether Washington would accept the results of any WHO-led
investigation into Covid-19.
All of which highlight the structural flaws in the global health system
for dealing with epidemics and the International Health Regulations
introduced after Sars.
“IHR essentially mandates that outbreaks of potential international
importance should be investigated with whatever it takes, as early as
possible, and that should include when needed, [the] WHO,” said Breiman,
now a professor of global health at Emory University’s Rollins School
of Public Health in Atlanta.
The rules also required complete transparency about the scope of the
outbreak, he said. “That’s sometimes where the IHR breaks down, because
there’s no enforcement capability.”
Antoine Flahault, director of the Institute of Global Health at the
University of Geneva, stressed that whether countries ask the WHO to
work with them to combat a disease on the ground comes back to their own
capacity and inclination.
If a country had the means “usually it does not accept any intrusion in
their territories and they want to take the lead on such missions”,
Flahault said.
But in the case of China, the issue was more than just scientific
know-how, said Sara Davies, a global health governance expert and
professor of international relations at Australia’s Griffith University.
“China is not a democracy with an open, free and fair press and with
groups of scientists who work independent to the government, and so it
creates a constant undercurrent of mistrust about the information that
comes out,” Davies said.
Yanzhong
Huang, a senior fellow for global health also at the Council on Foreign
Relations, said he thought the WHO and China would reach an agreement
about a joint mission to investigate the virus’s origins. Though, the
question remains: would its findings be accepted?
“The key issue is who will be included in this investigation and which
places will they be allowed to visit,” Huang said. If they did not get
access to the Wuhan lab that some US politicians have linked to the
pandemic then those individuals would question the credibility of the
assessment, he said.
But no investigation at all runs a higher risk. “If you don’t know the
origin, the animal could continue to shed the virus, and you are never
going to stop it,” he said.
Politics aside, Poon at HKU said international collaboration on research
into the coronavirus was essential because the virus itself knew no
borders.
As a public health scientist, his role was to find out the facts to
prevent other epidemics, he said. “What we want to know is the truth.”
