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A worker sprays disinfectant to sanitize Duomo square in Milan, Italy. A worker sprays disinfectant to sanitize Duomo square in Milan, Italy, March 31, 2020 (AP photo by Luca Bruno).

The COVID-19 Pandemic Puts the Spotlight on Global Health Governance

Wednesday, Sept. 2, 2020

The novel coronavirus caught many world leaders unprepared, despite consistent warnings that a global pandemic was inevitable. And it has revealed the flaws in a global health architecture headed by the World Health Organization, which had already been faulted for its response to the 2014 Ebola pandemic in West Africa. Will there be an overhaul of the WHO when the pandemic is over?

Since the novel coronavirus first emerged in Wuhan, China, late last year, its combination of transmissibility and lethality has brought the world to a virtual standstill. Governments have restricted movement, closed borders and frozen economic activity in a desperate attempt to curb the spread of the virus. At best, they have partially succeeded at slowing it down. According to official records so far, millions of people worldwide have been infected, and hundreds of thousands have died from COVID-19, the disease caused by the coronavirus. The actual toll of the virus is far worse and will continue to climb.

Governments will now have to balance the need to resume economic activity with measures that limit the virus’s spread until a vaccine is discovered—an outcome that is still months away, at best. How they attempt to resolve that tension could have implications for how long they remain in power.

The novel coronavirus caught many world leaders unprepared, despite consistent warnings that a global pandemic was inevitable. And it has revealed the flaws in a global health architecture headed by the World Health Organization, which had already been faulted for its response to the 2014 Ebola pandemic in West Africa. But the WHO has also been intentionally hobbled by member states in how aggressively it can react to public health crises out of concerns over sovereignty.

In the case of COVID-19, the agency became a political punching bag for U.S. President Donald Trump as he looked to defer criticism of his own response to the pandemic. Trump repeatedly echoed accusations that the WHO initially downplayed the severity of the virus in deference to Beijing. But given the WHO’s dependence on cooperation from member states, it is unclear what the agency could realistically have done differently. Trump subsequently heightened tensions between the United States and its long-time Western allies when he froze U.S. funding for the WHO. And in July, his administration formally announced that the U.S. would withdraw from the body effective July 6, 2021.

The pandemic has also underscored the global health infrastructure’s inequalities, as poorer nations were outbid for critical medical equipment by developed countries in the early days of the pandemic’s spread. And to the extent that it has diverted attention and potentially funding from responses to other public health concerns, including food security and other infectious diseases, the death toll could be compounded.

WPR has covered the coronavirus pandemic as well as global health governance and past pandemics in detail, and continues to examine key questions about what will happen next. How quickly will a vaccine for the coronavirus be developed, and will it be shared equitably with all countries? Will there be an overhaul of the WHO when the pandemic is over? What lessons will countries take from this pandemic to prepare for future disease outbreaks? Below are some of the highlights of WPR’s coverage.


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Our Most Recent Coverage

In Algeria, Protests Pause for COVID-19 as the Regime Steps Up Repression

The coronavirus pandemic is challenging Algeria’s aging health care system. Yet rather than the virus itself, it is the regime’s use of the pandemic to quell popular dissent that is pushing the country deeper into crisis. The repression will likely only worsen Algeria’s long-running political stalemate.

The Coronavirus Pandemic: A Global Crisis

The pandemic is disrupting systems on a global scale, including the distribution of food and medicine, with potentially disastrous consequences. It is also threatening to rewrite the global order, as China looks to enhance its role on the international stage, while the United States shrinks from it. On the national level, the pandemic is wreaking economic havoc everywhere, even as domestic responses expose the depths of inequality and erosion of democratic principles in some countries.

The Uphill Battle to Reform the WHO

In response to Trump’s attacks on the WHO, governments around the world voiced support for its central role in addressing the coronavirus pandemic, particularly in more vulnerable countries. But Trump is not alone in questioning the agency’s reluctance to more aggressively challenge China’s initial response to the outbreak in Wuhan. And the WHO’s handling of the 2014 Ebola pandemic in West Africa had already drawn criticism and triggered reforms that many hoped would help it better address global pandemics like the coronavirus.


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The Global Health Governance System

The pandemic has underscored just how dependent global health is on philanthropy. Chinese billionaire Jack Ma has emerged as a major donor of medical supplies for developing countries, particularly in Africa, and Bill Gates has pivoted the entire emphasis of his foundation to focus on COVID-19. While their donations are critical, they might also ease the pressure on governments to meet the health care needs of their populations. A donor-dependent global health system also reduces accountability, and introduces the risk that if a donor’s interest wanes, so will the response.

Past Pandemics and Outbreaks

The coronavirus pandemic has revealed how little global leaders have learned from previous outbreaks like the SARS outbreak in 2002, H1N1 in 2009 and MERS in 2015. Even lessons from the most recent Ebola epidemic in the Democratic Republic of Congo about better integrating communities into the response and the importance of robust contact tracing were initially overlooked. There have been some improvements to emerge from those earlier experiences. Regional public health institutions, particularly in Africa, that were developed in the wake of previous outbreaks have demonstrated a capacity to lead the response to COVID-19. But for the most part, the picture is of a system that is impervious to reform.


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