The dawn of the new decade has brought in a protracted challenge for countries in the form of a deadly virus named COVID-19. It has highlighted the fragility of health institutions and governance. It has brought to light the degree of upheaval that can be caused by a deadly disease. The preparedness and the mighty prowess of various developed countries is being questioned. The virus has brought humankind to its knees. With an increasing number of fatalities and an unabated rise in the number of infected people, a situation of complete lockdown in countries is the new norm.
The World Health Organisation (WHO), a specialised agency of the United Nations, is responsible for international health and goodwill. A body that emerged in post World War II to coordinate with health safety and look into the outbreak of various infectious diseases is today losing its ground. The role of organisations such as the WHO is extremely important in a pandemic because, in times of a globalised world, when borders have become porous, and world intensely connected, anything can cause a trigger and spread across countries. The WHO and the International Health Regulations (IHR), a global health treaty, has a huge role to play in such times.
The IHR (2005) is an agreement between 196 countries including all WHO member-states in order to work together for global health security. A disease such as COVID-19 is not completely unknown in nature, its nature similar to that of the Middle East respiratory syndrome-related coronavirus, or EMC/2012 MERS (MERS ), severe acute respiratory syndrome (SARS) and Ebola of 2014. All viral diseases are non-discriminatory in nature, infecting all, the rich and the poor.
Humankind got lucky as the deadly disease whose origins still remain unknown is not airborne but spreads only through human-to-human transmission. SARS, MERS and Ebola have highlighted that health workers are always at high risk of infection. This means adequate masks and PPEs should be in place. Yet, during the COVID-19 crisis, a shortage of resources and support mechanisms has been witnessed.
The COVID-19 catastrophe can be seen both in high-income countries as well as developing countries, equally grappling with problems, ranging from a shortage in safety gear, personal protective equipment (PPE), medicines such as hydroxychloroquine that are likely to cure the virus, and stressed economies. What is seen in the case of COVID-19 is that a problem that could have been contained in a country, China, which first reported it as ‘pneumonia of unknown cause’ on 31st December 2019, should have enforced an immediate lockdown but waited until 23rd January to do so.
A patient had already been reported COVID-19 positive in Thailand on 13th January. What could have remained within a country soon became a widely spread pandemic. Only as late as 11th March, 2020, did the World Health Organisation declare the virus a pandemic. By then, according to a news briefing by the WHO Director-General Dr Tedros Adhanom Ghebreyesus: “… more than 118,000 cases in 114 countries, and 4,291 people have lost their lives. Thousands more are fighting for their lives in hospitals.”
Unlike COVID-19, the Ebola virus (2014-2016), which was declared an epidemic, could not spread easily through human transmission and was more geographically limited to West Africa with few cases reported in the United States. The role of the World Health Organisation was questioned back in 2014 for its inability and its lackadaisical attitude.
The World Health Organisation has the mandate to serve humans and fight the deadly outbreak. The countries have to follow the International Health Regulations under international law. The signatories to International Health Regulations agree ‘to build their capacities to detect, assess and report public health events’. It involves building in core areas like laboratories, surveillance and even appropriate use of isolation. The WHO website clearly states that “IHR also includes specific measures at ports, airports and ground crossings to limit the spread of health risks to neighbouring countries and to prevent unwarranted travel and trade restrictions so that traffic and trade disruption is kept to a minimum.”
However, the WHO has not proved its credibility in alerting nations and giving timely appropriate guidelines. There needs to be accountability of the WHO. It should ensure that countries are investing sufficient funds for laboratories, medical gear, medicines, and better facilities at hospitals. As the COVID-19 crisis is still lurking in countries, the WHO has been accused of ignoring the danger of the virus. According to Financial Times, Taiwanese Health officials had alerted the WHO and Chinese authorities about the human-to-human transmission of this virus. The WHO failed to pass a timely alert to other countries and even ignored the Taiwanese officials alert. Although on 30th March the organisation had declared a global health emergency, it remained complacent and declared it as a pandemic only in March, by when the infection had risen 12 folds.
Questions were raised at the WHO during the Ebola epidemic, as are being raised now. Many had advocated reforms in the WHO. The WHO has to lead from the front in health crisis, and therefore needs to be transparent and accountable. Although the WHO has stated an optimum doctors to population ratio, little is done to keep a check on countries with less number of doctors and health workers. It looks like it is a repetition of what happened during the Ebola epidemic, but this time, the degree of crisis is high. The pandemic has brought in huge casualties and greater misery. The WHO should look into the utilisation of the funds and enhancing the capacity in different countries to address the unprecedented catastrophe of COVID-19.
The Sustainable Development Goal 3 states ‘Good Health and Well Being’. This can not be achieved in isolation. It calls in for concerted efforts from all the countries to synergise in finding treatment and vaccine. There is a need for global cooperation to fund the Research and Development (R&D) for developing vaccines, and medicine. The public healthcare system has come to a standstill, with COVID-19 as the main focus. Patients with other ailments are suffering. The preparedness level and availability of resources in rural areas are little known. While prevention is better than cure, there should be preparation so that no one has to suffer if any crisis strikes.
A disease such as COVID-19 carries with it misery and seeds which are non-discriminatory. Misery for the relatives who lose their dear ones, and seeds that signify scope for change, giving direction to areas where improvement and attention is warranted.
Since COVID spreads through human-to-human transmission, no travel and trade restrictions could have controlled the spread of the virus. With witnessing SARS, MERS, Ebola in the past, even though the origins of the COVID being little known, only a better state of affairs in levels of alertness, preparedness, and in giving out the health care service could have saved many lives. A resilient system that can handle the most unexpected crisis should be put in place. The World Health Organisation must take a leading role.