China's handling of coronavirus is a diplomatic challenge for WHO

Sarah Boseley Health editor
Photograph: EPA

The World Health Organization is having to perform a diplomatic balancing act over the new coronavirus outbreak, caught between China – whose draconian measures to contain the disease have delayed transmission to the rest of the world –and China’s critics, who say its behaviour is typical of its disregard for human rights.

At every press briefing, WHO director general Tedros Adhanom Ghebreyesus has defended China’s handling of the epidemic in the face of critical questions, very often from US journalists. At the end of January, when Tedros declared a public health emergency of international concern – having put it off a week earlier under what was assumed to be pressure from Beijing – he praised China for protecting the rest of the world.

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“In the past few weeks we have witnessed the emergence of a previously unknown pathogen, which has escalated into an unprecedented outbreak, and which has been met by an unprecedented response,” said Tedros. “China is to be congratulated for the extraordinary measures it has taken to contain the outbreak despite the severe social and economic impact that is having on China.”

He had similar fulsome praise for Cambodia, an ally of China, which allowed the cruise ship MS Westerdam to dock after it had been turned away from other ports. “This is an example of international solidarity we have been consistently calling for,” Tedros said. “Outbreaks can bring out the best and the worst in people.”

Taiwan, meanwhile, has been protesting against its “very high” risk rating, which is the same as China’s and has caused other countries to impose travel bans on its citizens. Taiwan has reported just 22 cases, compared with China’s figure of more than 72,400. Joanne Ou, a foreign ministry spokeswoman, told a news conference: “We urge the WHO to be professional and neutral: break away from China’s unreasonable claim. Don’t be kidnapped by China.” China has long blocked Taiwan’s independent membership of the WHO, considering the state part of its territory.

Tension between China and the US is playing a significant part in the handling of the outbreak, causing difficulties for the WHO as it continues to monitor the situation. Both nations have been using the situation to score points.

When Tedros visited China on 29 January and met President Xi Jinping, China’s ministry of foreign affairs said that Xi attached great importance to cooperation with the WHO. “China’s measures are not only protecting its people, but also protecting the people in the whole world,” it said. But it went on to suggest Tedros endorsed China’s political regime.

“Hailing the high speed and massive scale of China’s moves … Tedros said it showed China’s efficiency and the advantages of China’s system,” it said.

Over in the US, commerce secretary Wilbur Ross said the emergency would help the US economy. While he mentioned on Fox Business News that this was an unfortunate disease, he said: “The fact is, it does give business yet another thing to consider when they go through their review of their supply chain … So I think it will help to accelerate the return of jobs to North America.”

While the UK and European countries have taken measures to monitor people arriving from China, Donald Trump announced a ban on any foreign nationals entering the country if they have been in China during the previous 14 days.

Underlying the bad feeling is the jostling of the world powers, old and new, for influence over the United Nations agencies. The WHO is more democratic than some others, in that every country has an equal vote at its annual assembly. In contrast, tradition holds that the head of the World Bank is always American and the head of the International Monetary Fund is always a European.

The WHO is one UN body China has led. Tedros’s predecessor was Margaret Chan, who is Chinese, and was previously director of health in Hong Kong. But China is not content with that. Last year, it won the race to head the Food and Agriculture Organization, in the face of stiff opposition from the United States.

If it has been putting pressure on the WHO to defend its handling of the epidemic, “it is pressure that UN organisations have always had from the advanced economies,” said Osman Dar, director of the One Health Project at the Chatham House Centre on Global Health Security.

Now China’s tough handling of the Covid-19 outbreak has put the WHO and public health experts worldwide in a dilemma because, to some extent, it seems to have worked. “Another difficulty for WHO is that the prevailing orthodoxy around this epidemic is that these quarantine measures are a thing of the past,” said Dar. “They are no longer viable because a lot of us live in democratic societies with a lot of personal autonomy and huge transport links.”

But China acted with a speed and completeness that took everyone by surprise and is bringing the old assumptions into question, because it has bought the rest of the world time by confining the great majority of the epidemic in one province.

Dar said: “WHO is going to have to evaluate when is it appropriate to use this nuclear option – the mass quarantining of a community or town or city – when to do it and how to do it in a humane, socially responsible way that balances people’s rights. A lot of learning will come out of this experience.”