The WHO is weak, underfunded and was slow to deal with COVID-19: report

The World Health Organization failed in its response to COVID-19, a landmark report released this morning has found. Its authors argue the agency was too slow to respond to the viral threat, didn’t do enough to investigate its origins, and needs more funding and powers to respond to emerging infectious diseases. 

Written by 40 experts — including two academics from Monash University and the Burnet Institute — the 57-page report published in The Lancet comes off the back of two years of research examining virus suppression, economic crises, humanitarian issues, and rebuilding a fairer and more sustainable world. 

‘Delayed and vague’ response

WHO first acknowledged the possibility of human-to-human spread of the virus in January 2020, two weeks after Chinese authorities first alerted the agency to it. Members then met on January 22 in a closed-door meeting but didn’t declare a public health emergency of international concern until a week later. 

While false epidemic alarms are costly — and the 2009 swine flu scare possibly dampened responses — the agency “repeatedly erred on the side of reserve rather than boldness”. It was “delayed and vague” in its response, with recommendations based in outdated procedures and incorrect information, especially when assessing the risk of airborne transmission. 

Despite evidence from previous infectious disease outbreaks on the efficacy of masks, WHO didn’t recommend them until June 2020 — and only then advised they be used only in medical settings and by people who had symptoms. It hesitated to limit travel to and from China, and recommended travel measures including tests, masks, screening for symptoms and contact tracing only in July 2021.

It largely ignored the risk of airborne transmission, despite receiving an open letter from 238 scientists in July 2020 — not changing its stance until April 2021. 

Report author and chair of the Monash Sustainable Development Institute and Climateworks Centre Professor John Thwaites told Crikey that although WHO “made mistakes”, its inefficiency was compounded by the international community.

“There were multiple failures of global cooperation and it was very difficult for WHO because countries were not collaborating and they weren’t sufficiently supporting the [agency],” he said.

Western Pacific countries got it right

While WHO was slow to react, western Pacific countries — including Australia — responded better than many other parts of the world. This may be due to experience with the severe acute respiratory syndrome (SARS) and other infectious diseases. 

Thwaites said the region’s success was largely thanks to pro-sociality: “There were greater levels of trust in government in Australia and New Zealand and East Asian countries than in the USA and Europe. People were prepared to behave radically differently.”

He pointed to Australia’s long history of behavioural change and good public health programs around road safety and tobacco restrictions. Our medical institutions and research institutions were better prepared, enabling faster testing and collaboration with governments to update rules and advice. 

This led to a very low average mortality rate across east Asia and Oceania. Estimated total deaths were 300 per million population, compared with Europe and the Americas region with more than 4000 deaths per million population. 

Gender had a big impact

How COVID-19 messages were delivered — and by whom — played a massive role in building trust and leveraging responses. And women played a key part in this, the report found.

Women leaders were “often more concerned than male leaders about individual-scale effects and social welfare”, while small groups of governments often led by women kept death rates lower than in other countries. 

But women were also disproportionately affected by the pandemic. Worldwide, women make up 70% of frontline health and social workers and were some of the first to become infected. They were more likely to cut working hours and faced an “enormous increase in the demands on their time”, showed a larger increase in psychological distress, and faced an epidemic of domestic violence. 

Due to disruptions in education, earlier marriages, violence and interruptions to health services, the report estimates that 11.2 million girls and young women globally are at risk of not returning to care centres, schools or universities.

It recommends WHO’s core budget be substantially increased, new oversight authority given to examine the biosafety, biosecurity and bio-risk management of potentially dangerous pathogens, and more intense research into the origins of COVID, and countries should strengthen national health systems and provide universal coverage for physical and mental health. 

Thwaites hoped the report was a “wake-up call” and countries would learn from their mistakes, especially around distributing vaccines globally: “We haven’t achieved the level of global operation or multilateralism needed.”