On May 29, President Donald Trump declared his decision to withdraw the U.S. from the World Health Organization (WHO) and leveled accusations that it had failed to alert the world of the gravity of the COVID-19 virus in a timely manner and is too closely aligned with China. It is imperative that we set aside our focus on assigning blame right now and focus on saving lives. There will be plenty of time for analyzing our successes and failures later. The health care workers of the world need us to work on getting them the tools to do their job and keep people alive until better treatments, and vaccines, can be developed.
We think of pandemics as things of ancient history, like the Black Plague in Medieval Europe. In fact, they are not so distant. In 1946, the Minnesota State Fair was closed down in the midst of a polio epidemic. My wife (a registered nurse) is the oldest child in her family because her three older siblings all died on the same day in the early 1960s when measles struck her home. Polio and measles are now vaccine-preventable and the challenge is simply to get the vaccine to everyone in need. Just a few years ago, a vaccine was developed rapidly to protect people from Ebola after a terrible outbreak in West and Central Africa threatened to spread to the rest of the world. The science of immunology and epidemiology has made huge strides in recent years. However, vaccines cannot be developed overnight and people are dying right now.
Years of experience, strong partners
How do you coordinate a global effort on this scale? WHO has people in almost every country and years of experience dealing with infectious diseases. It also has strong partners. In the Global Polio Eradication Initiative (GPEI), WHO partners with Rotary International, UNICEF, the U.S. Centers for Disease Control and Prevention, the Bill & Melinda Gates Foundation and now Gavi, the Vaccine Alliance. They have a working relationship with national governments across the globe. In 1988, when the GPEI was launched, there were 350,000 cases of wild poliovirus in 125 countries. Thirty-two years later, there were fewer than 200 cases of wild poliovirus in the world last year in just two countries: Pakistan and Afghanistan.
In 2004, I led a team of Rotary members to West Africa for an integrated vaccination campaign, where the oral polio vaccine and Vitamin A drops were administered, along with measles vaccine, bed nets for malaria prevention, and medicine to kill intestinal parasites. Each intervention had its sponsor. It was an incredible example of leveraging the work of multiple organizations to provide more comprehensive coverage to children than any one organization could have managed. At the same time, each organization was used to working alone, getting all of the publicity and having their way when it came to planning for a national campaign. There were some disagreements as we prepared to launch that threatened the effectiveness of the campaign.
In this context, the WHO national director arranged for me to join the chair of the Togo National PolioPlus Committee to address the public on national radio. We provided the names of all of the partners and the important contributions made by each, explained the importance of attending the vaccination events and addressed rumors that had circulated about the safety of the vaccines. Then, the WHO director summarized the schedule for the coming days and called on all parents to bring their children to the vaccination sites. Internally, he also worked to remind all of the organizations that our goal was the same, to protect children from illnesses that were preventable. The campaign was a huge success and the entire region has been free of the wild poliovirus for more than 10 years.
In northern Nigeria, where conflict with Boko Haram and related militant groups has made vaccinations dangerous and difficult, WHO coordinated the work of national health service agencies in several bordering countries, security forces in each country and international partners with such success that Nigeria has not had a case of wild polio in more than three years and the entire African region may soon be declared free of the wild poliovirus. There are many powerful nonprofit organizations with a focus on health care. Without WHO, they lack the organizational power and global presence to coordinate their efforts.
Pandemics cannot be treated piecemeal
The world was already full of conflict and discord before COVID-19. The coming months will be terrible ones, even in countries with relatively robust health care systems. For those with fewer resources, the outcome is still in the balance. Pandemics cannot be treated piecemeal. Viruses do not respect international borders. If any country fails to contain COVID-19, we are all vulnerable. WHO is needed now more than ever.
The current situation reminds me of a DC graphic novel that was made into a blockbuster movie, “The Watchmen.” In the movie, the nations of the world are locked in conflict and nuclear war seems inevitable. At the end of the movie, the villain turns out to be a former member of the Watchmen who has decided that only a tangible, external threat will be enough to unite the governments of the world to defend themselves. He engineers a horrible attack on New York City in which millions are killed and the governments of the world unite to face the “alien” invasion. It is not a happy ending, but at least the threat of nuclear war recedes as the world’s leaders realize that they cannot fight each other and face an external enemy at the same time. Truth is sometimes stranger than fiction, and it is hard to fathom why we are not uniting with WHO and the governments of the world to fight the COVID-19 pandemic. We have the resources if we work together.
As a major supporter of WHO, the U.S. has influence. If we pause our funding now, we weaken our most valuable partner. If we have complaints, we have every right to voice them. In order to have this voice, we need to be more engaged than ever. If a glimmer of hope can be seen in times like these, a recent article in the New York Times informed us that, in spite of publicly rejecting calls to ease sanctions on Iran to allow them to face the COVID-19 pandemic, we have worked behind the scenes to allow them access to the resources they need. I am hoping and praying that our announcement that we will withdraw from WHO is another “negotiating” tactic and behind the scenes we are working to repair the relationship and unite to strengthen WHO’s capacities in this time of need.
This is an opportunity for us to see the big picture and do the right thing for a world in need of our leadership. If we seize this opportunity, it will be a source of light in dark times.
Charles Adams Cogan, a member of the board of directors of the United Nations Association of Minnesota, Harold E. Stassen Chapter (UNA-MN), is a former Peace Corps volunteer and Fulbright scholar. He leads the Rotary District 5960 PolioPlus Committee since 2008 and has taken teams of Rotary members to West Africa for polio vaccination work. He received the International Service Award for a Polio-Free World from the Trustees of The Rotary Foundation in 2010 and draws on his experiences for this piece, but this essay is written as a private citizen and not as the representative of the UNA-MN, Rotary International, or any of the other non-profit organizations he serves.
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