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
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
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
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.