The World Health Assembly is not normally the focus of worldwide attention. But this year’s session, bringing together all the member states of the World Health Organisation, came during the most serious global pandemic for a century, and at a time of intense political sparring over the origins and course of the disease. Under these circumstances, the assembly turned into a forum for geopolitical manoeuvring between China and the United States and highlighted the obstacles to a coordinated global response to the covid-19 crisis.
The pandemic caused by the SARS-CoV-2 coronavirus has caused over 320,000 deaths and affected countries in every part of the world. With its high infection rate, it is a textbook case of a global public health challenge that requires countries to work together in response. On top of the direct threat to health, the virus is also likely to have a dramatic impact on many other areas of global activity, including trade, debt, financial flows, security, migration and action to deal with climate change. Yet the pandemic arrived when the multilateral system was already under enormous strain, weakened by a loss of support for internationalism and by great powers’ attempts to use international institutions for competition rather than cooperation.
The WHO has been at the centre of the world’s public health response to the coronavirus. Its record has been fiercely debated. Critics have charged the organisation with being too deferential to China, where the outbreak began late in 2019. On 14 January, the WHO relayed without question a Chinese report that there was no clear evidence of human-to-human transmission. The WHO did not declare the spread of the virus to be a public health emergency of international concern until the end of January. Even then, it recommended against international travel and trade restrictions. The WHO’s director-general, Dr Tedros Ghebreyesus, has been effusive in his praise of China’s efforts to contain the virus, without commenting on the human rights implications of China’s surveillance and restrictive measures. The organisation has denied Taiwan observer status since 2016 and appears to have disregarded early warnings from Taiwan about the coronavirus.
Citing these facts, the US has mounted an escalating campaign against the WHO over its relationship with China. In April, Donald Trump announced a freeze in US funding of the WHO, to which it is the largest contributor. Trump charged that the WHO “really blew it” and was “very China-centric”. On Monday, as the World Health Assembly began, Trump threatened to cut funding permanently and suggested he would reconsider US membership of the WHO if it did not commit to “major substantive improvements” in the next 30 days. The US has been pressing in particular for an immediate independent investigation into the origins of the virus, while US officials have repeated unverified suggestions that it may have emerged from a Chinese lab rather than through animal-to-human transmission.
A pattern is emerging of the US attacking multilateral institutions while China attempts to shape them around values that Europeans do not share.
Meanwhile, China used this week’s assembly to try to polish its image as a supporter of multilateralism, attempting to step into the leadership void left by the US turn against the WHO. Chinese president Xi Jinping told the assembly that his country would donate $2 billion to fighting the disease and would send doctors and medical supplies to Africa and the rest of the developing world, where the disease is now escalating. He also called for any vaccine to be made available as a global public good. Away from the assembly, China has mounted an aggressive diplomatic and public relations campaign to promote its handling of the virus and push back against any criticism.
For Europeans, the manoeuvring around the WHO repeats a pattern that is becoming all too familiar: the US turns its back on or attacks multilateral institutions, while China attempts to shape the system around values and interests that Europeans do not share. Most European governments believe that there are questions to answer about the international public health response to the coronavirus, and would like to see the system strengthened, but also want to avoid a divisive blame game at the height of a global pandemic. In this instance, Europe was able to score at least a minor diplomatic victory, winning consensus support for a compromise resolution at the World Health Assembly that called for an intensification of global cooperation based around the WHO; for equitable access to testing, treatment, and vaccines; and for an independent evaluation of the WHO’s performance “at the earliest appropriate moment”.
This was the second time that the European Union has had some success in fostering international cooperation in response to the pandemic, following the pledging conference to raise money for global health that it organised two weeks ago. But these limited successes should not blind Europe to the scale of the challenge that remains in trying to restore an effective and cooperative international response. For a start, reforming the WHO will not be easy. While some of Tedros’s language about China reflected his own personal approach, the more serious problems are structural. The WHO depends on state cooperation to supply information, allow inspection visits, and implement recommendations.
Within those limits, the international health regulations that the WHO adopted in 2005 grant the director-general a reasonable degree of power, including the right to request states to verify information about diseases on their territory, to declare a public health emergency, and to make temporary recommendations about how states should respond. But these powers must be exercised in a way that does not forfeit the cooperation of the states involved. Some sensible small-scale reforms have been proposed, including greater transparency about the discussions of the committee that advises the director-general on whether to declare an emergency, and introducing an intermediate level of alert. The WHO’s institutional aversion to travel bans is certain to be reconsidered after the experience of covid-19. The WHO also suffers from a perennial shortage of money. But it is doubtful whether states will be willing to give the WHO much greater power, or to increase their contributions in any significant way. It is not obvious how the system can be fully defended against great powers that are determined to use it for their own geopolitical ends.
In the meantime, more urgent questions about the current pandemic remain to be answered. How will a fair global distribution of any treatments or vaccines that are developed be organised? There are already signs that the US and China are competing to reap the geopolitical benefits of being the first country to develop a vaccine, in a way that one investor compared to the US-Soviet space race during the cold war. European leaders have called for a global approach, but the EU itself has been criticised for placing export restrictions on protective equipment during the height of the outbreak in Europe.
A second looming question is how rich countries will help the developing world to withstand the impact of the virus and recover from the economic damage it will cause. While the international financial institutions and the G20 have offered debt relief to the developing world for 2020, they are likely to need to extend this moratorium on repayments further or even forgive some debts. In a significant move, China joined the G20 suspension of debt repayments. But will it continue to coordinate with other creditor nations in the year ahead?
The covid-19 crisis demands international cooperation but also highlights the current absence of global leadership and the way in which multilateral institutions have become battlegrounds. This dynamic has also been visible in the UN Security Council, where sparring between the United States and China has prevented the adoption of a resolution supporting a global ceasefire to help contain the virus. The EU will find allies around the world who are eager to work in a more cooperative way – but any effort to repair the international system will also need a strategy to deal with the US-China standoff.
The European Council on Foreign Relations does not take collective positions. ECFR publications only represent the views of their individual authors.