Comments by "NotMe Us" (@notmeus1968) on "Gottlieb says WHO should investigate China's handling of initial coronavirus outbreak" video.

  1. For all the responsibility vested in the WHO, it has little power. Unlike international bodies such as the World Trade Organization, the WHO, which is a specialised body of the UN, has no ability to bind or sanction its members. Its annual operating budget, about $2bn in 2019, is smaller than that of many university hospitals, and split among a dizzying array of public health and research projects. The WHO is less like a military general or elected leader with a strong mandate, and more like an underpaid sports coach wary of “losing the dressing room”, who can only get their way by charming, grovelling, cajoling and occasionally pleading with the players to do as they say. The WHO “has been drained of power and resources”, said Richard Horton, editor of the influential medical journal the Lancet. “Its coordinating authority and capacity are weak. Its ability to direct an international response to a life-threatening epidemic is non-existent.” At the same time, the international order on which the WHO relies is fraying, as aggressive nationalism becomes normalised around the world. “All the previous rules about global norms, public health and understanding of what’s expected in terms of an outbreak has crumbled,” said Lawrence Gostin, director of the WHO Collaborating Center on National and Global Health Law. “None of us know where this is leading.” The WHO was born during the moment of hopeful internationalism that followed the chaos of the second world war. The idea of global collaboration in fighting disease was not new – in the 19th century, at periodic International Sanitary Conferences, countries had standardised quarantine procedures for cholera and yellow fever – but the WHO constitution, adopted in 1948, envisioned a far grander global mission, nothing less than “the attainment by all people of the highest possible levels of health”. One of the WHO’s favourite success stories is the role it played in eliminating smallpox, a disease that was still killing millions each year in the 50s, despite the existence of a vaccine. Although the WHO worked on immunisation research, its most vital role was organisational and diplomatic. In 1959, it convinced the Soviet Union to manufacture 25 million vaccine doses, which the WHO would distribute. Not to be left behind, the US donated millions of dollars to vaccination programmes, both directly and through the WHO. By the late 60s, every nation in the UN was sending a detailed weekly report to WHO headquarters on their number of smallpox cases and recent progress. And in 1979, WHO declared smallpox eradicated, a first in world history. The WHO didn’t provide the most money, immunise the most people, or invent key technologies such as the bifurcated needle, but it is hard to imagine smallpox having been defeated without it. If the story of smallpox eradication shows the WHO acting as something like an international ministry of public health, it doesn’t explain its current position as an emergency service, surveying the world for disease outbreaks and springing into action to contain them. That is a more recent addition to its portfolio, which came after a period, in the 80s and 90s, when the WHO seemed to be losing its earlier dynamism. The diseases it was partly created to address – smallpox, yellow fever and the plague – had either been eradicated or were in decline, and it was slow to identify new threats such as HIV/Aids. Under the leadership of Dr Hiroshi Nakajima, from 1988 to 1998, the organisation stagnated, and some member states complained about poor management and alleged petty corruption. Two things happened at the turn of the century that would shape the WHO we now see tackling the Covid-19 crisis. In 1998, the fiery former prime minister of Norway, Dr Gro Harlem Brundtland, was elected director general. And in 2002, a farmer in China’s Guangdong province became sick with a deadly, never-before-seen respiratory disease that quickly spread among the hospital staff who had treated him, and went on to become the first pandemic of the newly globalised 21st century: one that arose suddenly, had no treatment or cure, and spread with the speed and reach of international business
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