Only the WHO could have conducted this kind of investigation. I know because, since the 1990s, I have led responses to numerous infectious disease outbreaks, initially at the US Centers for Disease Control and Prevention (CDC) and later at the WHO, where I became the Director-General's Special Advisor for Pandemic Influenza and then Assistant Director-General for Health Security and Environment. I have worked with many countries -- large and small -- as well as frontline health workers, agricultural and veterinary professionals, civilian and military public health scientists, diplomats, ministers and presidents to try and find useful, practical and sustainable ways to strengthen the health security of all countries.
In the real world, no country acting on its own can handle today's major emerging infectious disease events. They are too difficult, the global context is too complex and the infections are able to cross borders too easily.
In the past two decades, SARS, avian influenza, pandemic influenza H1N1, MERS, Ebola, Zika and Covid-19 have emerged unpredictably across the world -- in Asia, Africa, the Middle East and North America. Each has caused illness and death, confusion and fear, policy uncertainties and had severe social and economic consequences. While Covid-19 is the latest of such outbreaks, others will follow, and it is entirely possible that one of them could be caused by a pathogen that will be even more easily transmissible and more lethal than the virus causing Covid-19.
In an outbreak, getting information early is key to responding effectively. Countries need the earliest possible warning to mobilize their response. They also need basic facts about the epidemiology, the disease and the pathogen so they can assess risks and make sound decisions related to communications, diagnostics, medicines and clinical care and public health measures.
WHO is at the heart of the global system to obtain and assess such information and to provide it to every country as soon as possible. WHO gathers some information through electronic searches of media but, more notably, it obtains details and confirms what is factual by using formal channels with governments and by holding informal discussions with individuals. This approach can work very well, but only if countries do their part and willingly share important information with WHO.
Such criticisms related to technical or scientific matters underscore a recurrent difficulty for WHO. On the one hand, it is expected to be a leader in providing new scientific information, but at the same time, it is expected to be a guarantor of scientific information that is considered widely credible and well-accepted. This role is especially important for less resourced countries. When scientific evidence and understanding is rapidly evolving, as is the case with the understanding of how SARS-CoV-2 is transmitted, WHO will often lean toward being conservative, which explains why it sometimes is perceived as acting too slowly.
So, why hasn't WHO simply conducted an "independent" mission to address such concerns? There are two main reasons. Right now, the timing is wrong. Covid-19 shows little sign of going away soon and focusing on blunting its impact in the short term is the top priority. But, more fundamentally, WHO can only operate within a country with the host government's permission. Without such an invitation, WHO can no more march into China to investigate its Covid-19 response, than it can march into the US or any other country to conduct a similar assessment.
Nonetheless, at the right time, a thorough, objective and independent assessment of China's early response by a WHO-led team will be equally important for China and the international community. The impact of Covid-19 has been too great, the suspicions of information being held back are held by too many, and China and the world need to know whether major changes are required to do better the next time round.
To the contrary, when the value of WHO's non-emergency work is also considered, it is clear that the US walking away will undermine global efforts to improve the health of all people, including the strengthening of health systems, reducing chronic diseases and risk factors such as smoking and obesity, bolstering the health and nutritional status of children and mothers, completing the eradication of polio and improving the quality of vaccines and immunization efforts. While the WHO tends to receive more attention during large outbreaks, the majority of its work involves efforts to achieve the longer-term health priorities established by the World Health Assembly.
That said, whatever shortcomings are identified, my decades of experience confirm that WHO's global presence is irreplaceable and essential for improving health globally. From the vantage point of both crisis management and achieving global health priorities, withholding support from the international body is neither right not smart.
The US should set the example that many of us hope for, and stand with its allies, which in the face of Covid-19 and other health challenges, includes WHO and every other country in the world.