Aynsley Hartney and Austin R. Schlueter
As of the time this article was written, there are over 80,000 reported cases of the coronavirus worldwide on every continent but Antarctica. With spikes protruding from its cell membrane, the coronavirus is so named for its likeness to the rays of the sun. However, unlike the life-giving nature of the sun, the coronavirus brings respiratory illness with symptoms similar to pneumonia. No cure is available, leaving symptomatic treatment and quarantine as the only path forward. As the story of the virus has transformed from local news to global alarm, China restricted travel for 35 million and imposed travel limits, but international health experts question if it is too late, as the virus has already spread outside of national borders. While stories of trade deals, ambassadors, and missiles often make the headline news, global health and infectious disease are important components of international diplomacy.
Infectious disease diplomacy is mandatory due to the ease of global travel and the transmission of disease across borders. Do countries have the right to enforce travel limits on foreign nationals? Should countries be required to set up checkpoints at major airports? Who has the responsibility of taking care of the sick? The World Health Organization (WHO) developed the International Health Regulations (IHR) in 1969 to help monitor and control global pandemics of cholera, the plague, or yellow fever by requiring Members States to report any cases of disease and implement measures for disinfecting vessels at ports, airports, and land borders. It was modified in 2005 to include any illness, and it added obligations for its members to maintain a certain minimum core of public health capacities to improve defense and containment measures. The effectiveness of this program was questioned during the H1N1 outbreak of 2009, as it was determined that some countries didn’t meet the minimum requirements for public health capacities. The program has potential to contribute greatly to global efforts to mitigate global health emergencies because it encourages and fosters a sense of collaboration, but a lack of capacity for public health emergencies is alarming. A 2007 report released by WHO claimed that less than 50% of national health sectors had a budget for health emergencies. To hold a strong front against global pandemics, there cannot be cracks. Collaboration and support must be distributed to ensure that all countries are up to par in the event of a global health emergency.
It is highly unfortunate that this rapidly escalating crisis has yet again exposed the fundamental flaws of the World Health Organization. The WHO plays a very crucial role in gathering data on diseases and public health, but it has no teeth to coordinate its actions worldwide. In times of public health emergencies, the agency can issue non-binding guidance and act as a coordinator for global governments within the country. The system has worked before, with the WHO's contributions to combating the SARS outbreak in Asia in 2003. However, lately, the WHO has become increasingly slow and decentralized, which contributes to its inefficiency. The WHO was widely criticized due to its haphazard response to the Ebola Outbreak in Sierra Leone, the DRC, and Liberia in 2014–arguably because of the rivalry between Geneva and the WHO's African regional office. Each regional office of the WHO chooses their own leader, which prevents an effective top down leadership approach–with almost zero incentive to be accountable to headquarters in Geneva.
The WHO, seeking to learn from its cumbersome response to the Ebola outbreak in 2014, implemented a system of staff rotation in and out of the regional offices to help reduce rivalry. If the WHO has learned anything from the past two decades, it should recognize that China has a transparency issue. Though China's response this time around has been to be more transparent with disease numbers, the WHO's praise of an authoritarian country’s methods and coordination is baffling–especially with China’s documented efforts to downplay the severity of the disease. Just because you get a 40 on your first test and a 50 on the next one does not mean you get a passing grade. With the number of cases growing worldwide, the world faces a major challenge, and the WHO faces a credibility challenge.
The H1N1 pandemic of 2009, Ebola outbreak of 2014-2016, and the Zika virus of 2015-2016 are three examples of the five global health emergencies of the past decade. WHO claims it is too early to declare the coronavirus, officially named COVID-19. This assessment is due to the limited number of cases worldwide and China’s drastic efforts to contain the disease. No doubt they will continue to monitor the situation, but in the meantime, Chinese researchers have already shared the full genomic sequence of the new virus to public databases, making it possible for health officials worldwide to study it and test for it. As this story develops, it will become clear whether further international collaboration will be warranted. Until then, be sure to wash your hands extra well.