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The world missed 2020, why China, and WHO becomes powergrab that fuelled a pandemic In early 2020.

China, the WHO and the powergrab that fuelled a pandemic

In early 2020, the world missed its chance to stop Covid-19. Insight exposes how Beijing's ten-year takeover of the global health watchdog sowed the seeds of disaster



After being heavily criticised by the World Health Organisation for its response to Sars in 2003, China decided it would not accept such public humiliation again. What followed was a concerted campaign over many years to seize power within the organisation.

A Sunday Times investigation raises serious concerns that the independence and leadership of the WHO were severely compromised by the time the first cases of a mysterious new coronavirus appeared in Wuhan in 2019 — with profound consequences for the course of the Covid-19 pandemic and the world.

Our investigation reveals:


● China secured WHO votes to install its chosen candidates as director-general.

● The WHO leadership prioritised China’s economic interests over halting the spread of the virus when Covid-19 first emerged.

● China exerted ultimate control over the WHO investigation into the origins of Covid-19, appointing its chosen experts and negotiating a backroom deal to water down the mandate.


A catastrophe in the making

Barely eight months after taking charge, the director-general of the WHO gave a speech that would prove extraordinarily prophetic. Tedros Adhanom Ghebreyesus warned that all nations were facing the ever-present threat that a new respiratory illness, such as the Spanish flu, might emerge and spread across the globe in weeks or months, killing millions.

It was why, the Ethiopian told the audience at his keynote speech in Dubai in February 2018, he had made it his daily priority since becoming the WHO’s chief to make sure he was up to date on the thousands of reports the health body received every month that might flag up signs of an outbreak.

The WHO, a Geneva-based United Nations agency with a £5 billion budget from 194 member states, was on a war footing. Tedros said it would act fast and decisively, because ignoring the signs of an outbreak could “be the difference between global spread of a deadly disease and rapid interruption of transmission”. So far this “new tighter focus” was working, he added.

Tedros Adhanom Ghebreyesus with Chinese premier Li Keqiang in 2017

GETTY IMAGES


So when the first alert of a mysterious respiratory illness in China, exactly as Tedros had described, was reported by health monitors in Taiwan at the end of December 2019, the health agency should have been prepared and ready for action.


In fact the WHO would receive considerable criticism for failing to help stop the spread of the Sars-CoV-2 virus in the opening weeks of the Covid-19 pandemic. Not only did the organisation fail to act but it also promulgated misinformation about the virus originating from China and even discouraged other nations from taking steps that might have contained the spread. For all his foresight, Tedros would be accused of being ineffective when the big test came.


The world paid a heavy price for the WHO’s inaction. As Tedros predicted, the virus has killed more than four million people, and there will be many more. The body that is charged with looking after the world’s health seriously malfunctioned in those opening weeks, when humanity most needed it to come to the rescue. Why?


Our investigation reveals today how a concerted campaign over many years by Beijing to grab power inside the WHO appears to have fatally compromised its ability to respond to the crisis. It raises serious concerns about the extent of Beijing’s influence over the WHO and its director-general, and how this undermined the organisation’s capacity — and willingness — to take the steps necessary to avert a global pandemic. Its leadership put China’s economic interests before public health concerns. The results have been nothing short of catastrophic.

Disinfection in a Chinese village in January 2020, when hospitals were being overwhelmed with Covid patients

CNSPHOTO/REUTERS


Beijing’s man

It is a story that stretches back many years before the Covid-19 crisis. After being strongly criticised by the health agency for attempting to cover up the 2003 Sars crisis, China set out to increase its influence over the WHO. By applying financial and diplomatic leverage over some of the world’s poorest nations, Beijing won a global power struggle to get its favoured candidates installed at the very top of the organisation.



As a result, years later, a body that was set up with the lofty goal of “attainment by all peoples of the highest possible level of health” has been co-opted into aiding the Chinese state’s campaign for global economic dominance. Its leadership began to speak differently, espousing statements and pursuing policies that were markedly convenient to China — even praising Beijing’s questionable allies such as North Korea, despite its appalling health and human rights record.


Beijing had been instrumental in installing Tedros as the £170,000-a-year head of the agency by pulling strings and calling in favours during the 2017 election for the job.

Tedros himself caused outrage by bestowing the role of WHO goodwill ambassador on Robert Mugabe, the notorious former Zimbabwean dictator, an appointment said to have had strong backing by the Chinese government, a long-standing close ally of the despot.

As hospitals became flooded with patients in Wuhan in January 2020, the health agency repeatedly relayed to the world the Chinese government’s false claims that there was no evidence the virus could pass between humans. It made a specific point of cautioning countries not to impose bans on travel to and from the virus hotspots — which meant many weeks were lost before countries independently decided to seal their borders. The WHO’s approach ensured that China’s short-term economic prospects were protected. Meanwhile, the virus was allowed to spread round the globe like wildfire.


More recently, we can reveal, a backroom deal negotiated between the WHO and China has seriously damaged the chances of the world getting to the bottom of one of the most important questions facing mankind today: the origin of the Covid-19 pandemic.

When the world’s nations gave Tedros the job of discovering how the virus first came to infect humans, his team struck an agreement in secret with China that emasculated the inquiry. It meant that the WHO’s “independent” mission — its fact-finding team travelled to Wuhan early this year to carry out an investigation — was, in the words of one expert, little more than a “shameful charade”. There may well be no second chance.


Legacy of Sars

The health agency’s reaction to Sars, the first pandemic crisis of the 21st century, had been very different. In many ways that lay at the root of the later difficulties that would come to a head with China.


The Sars outbreak started in November 2002, when a number of people in Guangdong province, southern China, began to fall ill with flu-like respiratory symptoms; by January 2003 infected patients were streaming into the region’s hospitals.


The Chinese government had immediately enforced its strict laws, which classified all new infectious diseases as a state secret before they were officially announced by the ministry of health. As a result, the WHO was kept largely in the dark about the outbreak until the son of one of its former employees emailed the agency in February 2003 with some alarming news. The message described a mysterious virus in Guangdong that had already killed 100 people but claimed the authorities were insisting “it was not allowed to be made known to the public”.


The cat was out of the bag, and after stern questions from the health agency China did share some limited information about the new virus the following day. However, government officials in Guangzhou, the city at the centre of the outbreak, were still maintaining that the illness was under control. This was untrue. Sars had already spread to other parts of China.

The Chinese were still anxious to play down the extent of the outbreak. At one stage 30 patients with the virus were said to have been driven round Beijing in ambulances, and 40 others were moved out of a hospital into a hotel to hide their existence from a visiting team of WHO scientists.


Tough on China: former WHO director-general Gro Harlem Brundtland

PAUL HILTON/EPA/REX/SHUTTERSTOCK


China’s reluctance to disclose the duration, scale and evolution of the disease led Gro Harlem Brundtland, then the WHO director-general, to get tough. She was a former prime minister of Norway and not scared of ruffling feathers. “Brundtland was a very brave politician with a lot of legitimacy,” recalls Gian Luca Burci, a legal adviser to the WHO at the time. “She didn’t shy away from criticising China and basically saying, ‘We don’t believe you. You should come clean.’”


Brundtland put pressure on China and took the brave decision to issue strong advice against travelling to the affected areas, which included Hong Kong and Toronto as the virus spread.

“The WHO really stepped into a vacuum, and it really exerted its authority as an emergency manager,” Burci said. “I would say the unanimous perception is that the WHO played a central role and essential role in allowing Sars to be controlled in a matter of months.”


Brundtland publicly criticised China’s cover-up and said the outbreak might have been contained if the WHO had been alerted earlier. “Next time something strange and new comes anywhere in the world, let us come in as quickly as possible,” she urged.


The virus was brought under control in the early summer with only 8,000 cases and just under 800 deaths. The public ticking-off had been humiliating for Beijing. There was also an economic price for China: the health agency’s travel advice had contributed to an estimated $6 billion loss to the country’s GDP.


China began taking a keen interest in the WHO after the bruising it received over Sars. A senior source now working at the health agency has described how in 2005 Beijing was behind a group of countries that attempted to “limit” the authority of its director-general.

Their efforts led to new regulations for the WHO’s governance, which compel the director-general to consult an emergency committee — made up of international experts and often including a China representative — before he or she calls an international public health emergency or recommends travel restrictions.



A further opportunity for China to extend its influence within the agency presented itself a year later when Brundtland’s recently appointed successor as director-general, the Korean doctor Lee Jong-wook, suddenly died after undergoing brain surgery.


One of the leading candidates was Dr Margaret Chan, a Chinese national. She was a former Hong Kong health director who had been criticised during the Sars crisis for her supine attitude to mainland China. The Hong Kong legislative council found she had been too slow to respond to the Sars outbreak and too unquestioning of the misleading information from Beijing. Hong Kong suffered a higher Sars death rate than anywhere else in the world.


Chan had, nonetheless, moved to a new job with the WHO in Geneva, and when Jong-wook died, the Beijing government rallied behind her candidacy, ordering its embassies to lobby international friends to get behind her in the November 2006 election to choose a replacement.


Margaret Chan drew criticism as Hong Kong’s health chief for believing China’s claims about the 2002-04 Sars outbreak FABRICE COFFRINI/AFP/GETTY IMAGES


Just five days before the vote, a summit was held in Beijing for leaders of the African nations. China pledged to cancel large amounts of their debts and double aid donations to the continent in a move that was openly acknowledged by state-backed analysts in the country as designed to secure backing for Chan.


It was an “extraordinarily aggressive campaign”, according to Professor Lawrence Gostin, the director of the WHO’s Collaborating Centre on Public Health Law and Human Rights. “[China] got burnt really badly during Sars,” he said, adding: “It wanted someone much more friendly and gentle if an outbreak came again.”


Chan won with two thirds of the votes in the final ballot. China had succeeded in getting its candidate to the top “precisely to avoid another humiliation”, according to a source working at the WHO at the time.


The African link

During her 10-year reign in the agency’s top job, Chan certainly gave the appearance that she was very grateful to China for propelling her into the role. In April 2010 she made a trip to North Korea, one of China’s neighbours and allies, and made the extraordinary claim the country’s health system was the “envy” of most developing nations.


A few months later a report by the human rights group Amnesty International described the shambolic state of North Korea’s “crumbling” health system. Hospitals at times lacked heat, power and medicines, the report said, and amputations were sometimes performed in candlelight without anaesthesia by doctors who were living on the poverty line because their wages were not paid.


Chan made a number of key appointments that appeared carefully calculated to please the Chinese government. In 2011 she made the Chinese soprano Peng Liyuan a WHO goodwill ambassador, praising the singer’s “world-famous voice” and “compassionate heart”. The other reason Chan might have selected Peng was not mentioned.

Peng is married to Xi Jinping, China’s president. She holds the rank of major-general in the People’s Liberation Army and wore her uniform to sing for the troops after they quashed the pro-democracy protests in Tiananmen Square. Chinese state censors have since attempted to erase these pictures from the internet.



Chan also chose to appoint China Central Television’s James Chau a goodwill ambassador. Later, during the 2020 pandemic, more than 100 UN-affiliated associations would write to the WHO calling for him to be removed from the role because he was a well-known propagandist for the Chinese government.

The biggest test for Chan was also the moment she drew the most criticism — and there was a Beijing link to this too. She took two months to declare an international emergency over the 2014 ebola outbreak despite repeated warnings from her own experts.

Leaked emails obtained by the Associated Press revealed that the delay was caused by WHO officials who did not want to upset the African countries hit by the outbreak and damage their economies. More than 1,000 people died during the delay.

One of the countries affected, Guinea, had struck a big mining rights deal that allowed a state-backed Chinese firm to excavate one of the world’s biggest untapped iron ore reserves. Fearing that the foreign investors might be scared away, Alpha Condé, then the country’s president, claimed that ebola was under control in Guinea in a speech at the WHO’s Geneva headquarters.

His lie went unchallenged. “Margaret Chan’s WHO was accused of being too close to Alpha Condé,” the senior source from the WHO said. In the end the UN took the highly unusual step of appointing David Nabarro, a British doctor, to co-ordinate the international effort on ebola because it was so concerned about the WHO’s failure to get to grips with the outbreak.

In 2017 Chan crowned her final year in office by welcoming Xi to Geneva. While he was there, she signed an agreement that committed the WHO to working alongside China on health as part of the country’s Belt and Road initiative. It was the first time any UN agency had signed up to the initiative, which seeks to extend Chinese influence and trade in more than 70 developing countries by financing infrastructure projects.

The initiative is highly controversial because its critics argue that China uses it to shackle countries, particularly in Africa, to “unsustainable debt” as a way of gaining access to the continent’s raw materials and buying political favours.



“I think health is too special to get into the really seedy politics that Belt and Road is part of, and I wouldn’t want the WHO to be associated with it,” Gostin argues. “The cost in terms of human rights and debt, and other adverse events for Africa, was a bridge too far.”



Turning on the money taps

Under bright skies in the rolling parkland on the banks of Lake Geneva a large group of protesters with placards gathered outside the Palace of Nations for the 70th meeting of the World Health Assembly (WHA), the body with representatives from all UN member states that controls the WHO.


The protest that day — May 22, 2017 — was against Tedros standing to replace Chan, who had served her final term. The demonstrators were highlighting human rights abuses by the Ethiopian regime, which was reported to have tortured dissidents, displaced villages and ordered police massacres of protesters. Until the previous year Tedros had been a minister in that Ethiopian government.


Tedros, a former epidemiologist then aged 52, had been the health and then foreign minister after joining the government in 2005. Last year David Steinman, a US economist nominated for the Nobel peace prize, called for Tedros to be personally prosecuted for genocide over his alleged involvement directing Ethiopia’s security forces. He denies any involvement in human rights abuses despite his lengthy period in government.


As foreign minister Tedros had formed a close relationship with China. He would often praise the Chinese leadership, which invested more money in Ethiopia than any other country did. In 2014 he wrote a joint article with the Chinese foreign minister in the state-controlled China Daily newspaper that waxed lyrical about the bond between the countries. “We are sincere friends, reliable partners and good brothers who share both happiness and adversity, each rejoicing in the successes the other has achieved,” they wrote.


The African Union countries had wanted their candidate to replace Chan as director-general. They had previously helped Chan get elected, and it was now their turn. As an African with close links to China, Tedros was the perfect candidate.


As the election approached, China had again turned on the money taps. A month before the vote, a multinational ministerial conference was held in Pretoria ostensibly with the aim of stepping up China-Africa co-operation in health. During the conference China agreed to offer a cataract surgery programme for free to the African countries.


Then, nine days before polling, Xi hosted an event in Beijing at which he pledged more than $100 billion in extra funding for its Belt and Road initiative — a large portion of which would be channelled into investment in developing countries. This included new investment in Kenya, Indonesia and Hungary.


David Nabarro witnessed at first hand the WHO leadership’s incompetence during the Ebola crisis FABRICE COFFRINI/AFP/GETTY IMAGES


Tedros’s main opponent was Nabarro, whose first-hand experience of the WHO leadership’s incompetence during the ebola crisis had convinced him of the need for reform. Nabarro was not alone in his concerns about the WHO, and he reportedly received support from the US, the UK and Canada. This appears to have been the first time the West had woken up to China’s creeping influence over the health agency.

The contest between the two men for the WHO director-generalship took place under new rules that had been introduced by Chan. Previously, the director-general had been chosen by the 34 members of the WHA executive board, but the new rules gave an equal vote to all the assembly’s 194 member states.

Critics of the rule change, such as J Michael Cole of the Canadian think tank the Macdonald-Laurier Institute, have pointed out that the WHO was essentially copying the electoral system that propped up the famously corrupt regime of the former Fifa president Sepp Blatter.

As with football’s governing body, tiny countries that might be susceptible to financial aid were given an equal vote to countries many times their size. Cole said tiny island countries such as those in the Pacific were “easy targets” for Chinese influence.

During the campaign Gostin, who was supporting Nabarro, accused Tedros of covering up three cholera outbreaks during his time as Ethiopia’s health minister. Tedros again strongly denied the allegations. Certainly the mud did not stick. With China’s help he won by 133 votes to Nabarro’s 50.


‘Model’ China

Within a month of taking over in July 2017, Tedros was on his way to China to emphasise the health agency’s continued commitment to the partnership under the Belt and Road initiative.

“China’s long experience and expertise in health systems and policies will be invaluable to achieving the WHO’s global priorities, especially in health crisis management,” he wrote in the China Daily. “China can share its lessons learnt and best practices with other countries, offering them models of success.”


Months later Tedros made an extraordinary announcement, seemingly without consulting colleagues. He had appointed Mugabe, the tyrannical Zimbabwean president, as a goodwill ambassador for the WHO. Diplomatic sources affiliated to the health agency have told us that the honouring of Mugabe was made at the behest of Beijing as a political payoff for the dictator’s years as a staunch ally of the Chinese government.


Xi has described Zimbabwe as China’s “all-weather friend”. In turn Mugabe called Xi “a God-sent person”. The Chinese government’s connection to Mugabe stretches back to the 1970s, when it helped fund his guerrilla war in Zimbabwe before he took power. More recently it ploughed cash into his regime when it was struggling under western sanctions.

It was an ill-judged move by Tedros. The Canadian prime minister, Justin Trudeau, described the announcement as a “bad April Fool’s joke”, Ireland’s health minister said it was “offensive and bizarre” and the UK prime minister’s office said it was “surprising and disappointing, particularly in light of the current US and EU sanctions against [Mugabe]”.

There was particular bemusement because Zimbabwe’s healthcare system had deteriorated so badly under Mugabe’s rule that he himself had sought treatment at a luxurious private hospital in Singapore rather than trust his own country’s doctors. A report by the group Physicians for Human Rights in 2009 gave examples of how Mugabe had damaged his own health system in his efforts to cling on to power.


The appointment was withdrawn just four days after Tedros announced it. But it did not stop him continuing to lavish praise on China’s leaders. Nine months later, on another trip to Beijing in July 2018, he described China’s health reforms as “a model for universal health coverage” and “a bulwark against health emergencies”. In other words, they would help to prevent a future pandemic.


One of the oddities of China’s influence within the WHO was that it managed to achieve it while paying little money towards the running of the organisation. In 2018-19 China gave the health agency $89 million, whereas the UK contributed $464 million and the US $853 million.


Tedros praised President Xi’s ‘rare leadership’ as Covid spread across the world in January 2020 LI XUEREN/XINHUA/AP


Gostin described the vast shortfall as “galling”. He is critical of the way China instead uses its money to pay for health projects in deals it negotiates directly with individual countries. This gives Beijing more diplomatic and economic leverage with the countries themselves. “China’s foreign policy is extraordinarily mercantile and self-interested,” he said. “It’s all done on bilateral country negotiations, where [China] has got a ton of leverage.”


China has used this approach to take over other parts of the UN system. In June 2019 a Chinese candidate was elected head of the Food and Agricultural Organisation, after reports that Beijing had cancelled $78 million of Cameroon’s debt in exchange for the withdrawal from the race of a candidate from the country. It meant that, of the UN’s 15 specialised agencies, four were headed by Chinese nationals.


The cover-up begins

The main “bulwark” at the beginning of the Covid-19 pandemic was a wall of secrecy in China. On December 30, 2019, Dr Li Wenliang, an ophthalmologist at Wuhan Central Hospital, sent a message to medical colleagues in an online chat forum suggesting they wear protective clothing because he had seen several cases of a virus that appeared to be transmitted between humans like Sars.


Li was summoned for an inquisition by the authorities, with seven of his friends. They were investigated for ”spreading rumours” and warned against ”publishing fictitious discourse”. Li would later die from Covid-19.


The following day — the last of the year — the Wuhan Municipal Health Commission publicly admitted for the first time that a number of people had been struck down with a similar illness in a bland public announcement reporting 27 cases of pneumonia-like infection.


What the statement did not say was that the illness had already been identified by the Chinese authorities as a new coronavirus — not unlike Sars — that appeared to be passing between humans. This crucial information — as well as any indication of the alarm already secretly felt by scientific and health officials in China — was withheld from the world.

However, earlier that day Taiwan had been closely monitoring reports in the Chinese media that might indicate a new medical phenomenon and it noted that an internal hospital alert had been reported in an obscure business publication. The Taiwanese authorities sent the WHO an email raising concerns about a number of “atypical pneumonia cases” in Wuhan that had been “isolated for treatment”. The only reason patients would need to be isolated was that Chinese hospitals feared the virus could pass between humans.

The health agency did not heed the Taiwanese warning. The island’s relations with the WHO were strained because of China’s claims of sovereignty over its territory.


In the months before the pandemic Beijing had used its influence to block the island from attending meetings of the WHA for a third year in a row. The UK and the US were among a number of nations that wanted Taiwan to be given access and had warned Tedros that the country’s absence “created serious gaps in the global health security system”.


Taiwan’s vice-president, Chen Chien-jen, an epidemiologist by training, would later accuse the WHO of brushing aside this early evidence it had provided on suspected human-to-human transmission and of failing to pass the early warning on to the world. In the weeks that followed, the island’s relationship with the WHO deteriorated further when Tedros wrongly claimed in public that it was behind a series of racist online attacks against him.

In the first two weeks of January desperate scenes were unfolding at Wuhan hospitals as patients with flu-like symptoms began to flood in. The mayhem and death were described by Dr Peng Zhiyong, the director of the intensive care unit in Wuhan University’s Zhongnan Hospital, several weeks later in an interview he gave to the Chinese media outlet Caixin Global.


Within four days of the arrival of the first patient, Peng said, all 16 intensive care beds were full and the situation was “dire”. More than 40 members of his team then contracted the disease from patients. Things were even worse at another hospital in the city, where two thirds of intensive care staff had reportedly been infected.


The doctors fought the epidemic in gruelling conditions. Some wore nappies inside their protective suits to avoid taking breaks. Peng said many patients were turned away because the hospitals could not cope. “Some patients even knelt down to beg me to accept [them]. But there was nothing I could do since all the beds were occupied,” he said. “I shed tears while I turned them down. I have run out of tears now.”


The doctors were in no doubt the virus was passing rapidly between humans. Few of Peng’s colleagues went home after their shifts, for fear they would infect their families.

Yet the Chinese authorities systematically tried to cover up the human spread by issuing diktats, suppressing whistleblowers and scrubbing social media. On January 3 a confidential notice was issued forbidding labs to publish details of the virus without authorisation. On January 6 the hashtag