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

The COVID-19 Pandemic Puts the Spotlight on Global Health Governance
A worker sprays disinfectant to sanitize Duomo square in Milan, Italy, March 31, 2020 (AP photo by Luca Bruno).

The novel coronavirus caught many world leaders unprepared, despite consistent warnings that a global pandemic was inevitable. And it 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 in the aftermath of the pandemic?

After the novel coronavirus first emerged in late 2019 in Wuhan, China, its combination of transmissibility and lethality brought the world to a virtual standstill. Governments restricted movement, closed borders and froze economic activity in a desperate attempt to curb the spread of the virus. At best, they partially succeeded at slowing down the first wave, without stopping the subsequent multiple waves that experts had warned about. According to official records so far, more than 629 million people worldwide have been infected, and more than 6.5 million 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, even as deaths have begun to slow considerably.

With each successive wave, governments had to balance the need to resume economic activity with measures to limit the virus’s spread, while also ramping up distribution of vaccines that, though developed rapidly, were allocated unevenly, especially in the Global South. How they attempted to resolve these tensions in many cases had major political implications. Ultimately the emergence of variants that are more contagious but, when combined with vaccinations, less lethal have led many countries to consider COVID-19 to be endemic, with some leaders—including U.S. President Joe Biden—even declaring the pandemic over. Others, particularly China, continue to implement draconian policies to contain and eradicate the coronavirus.

Though it caught many world leaders unprepared, global health authorities and experts had consistently warned that a global pandemic was inevitable. That it nevertheless spread so easily 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 former U.S. President Donald Trump as he looked to deflect 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. The WHO was also subsequently faulted for not pressing Beijing harder for more access during its investigation into the origins of the pandemic.

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. They continue to face similar obstacles when it comes to gaining access to vaccines. 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. Now that most wealthy countries have succeeded in vaccinating their populations, will they share vaccine supplies equitably with the rest of the world? Will there be an overhaul of the WHO in the aftermath of the pandemic? 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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Monkeypox Proves We Haven’t Learned the Lessons of COVID-19

Throughout the early days of the global monkeypox outbreak, it appeared as though the world failed to learn any lessons from earlier disease outbreaks, including the coronavirus pandemic. This apparent inability or unwillingness to learn is startling, and runs the risk of weakening global health governance.

The Coronavirus Pandemic: A Global Crisis

The pandemic disrupted systems on a global scale, including the distribution of food and medicine, with disastrous consequences. It also threatened to rewrite the global order, as China sought to enhance its role on the international stage, while the United States scrambled to rebound from its disastrous initial handling of the pandemic. On the national level, the pandemic wrought economic havoc everywhere, even as domestic responses exposed the depths of inequality and erosion of democratic principles in some countries.

The Global Health Governance System

The pandemic underscored just how dependent global health is on philanthropy. In the early months of the virus’s spread, Chinese billionaire Jack Ma emerged as a major donor of medical supplies for developing countries, particularly in Africa, and Bill Gates pivoted the entire emphasis of his foundation to focus on COVID-19. While these kinds of private 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.

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 was 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.

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. Some improvements have emerged 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.

For all of WPR’s coverage of the coronavirus pandemic, click here.

Editor’s note: This article was originally published in September 2020 and is regularly updated.