Earlier today, The Washington Post published this story: WHO has praised China's coronavirus response. That baffles some health crisis experts. The story's comments section is full of people damning and blasting WHO DG Dr. Tedros and President Xi Jinping with equal fervor and fine impartiality. Sentiment in the twittersphere is not much different. I must beg to differ.
When my wife and I taught in China long ago, just as Deng Xiaoping was launching his country's astounding rise to wealth and power, we had no lack of reasons to damn and blast his government.
But we also ran across a few foreigners—usually tourists, not regular expats—who found excuses for every Chinese snafu and injustice. For them, any old imperialist abuse trumped every new communist abuse.
We called these people "China sucks."
I was not then, and am not now, a China suck. But in following disease outbreaks for 15 years, most of them in poor, repressive countries, I hope I've learned a little realism.
Rudolf Virchow's wisdom is at the top of this blog for a reason. Every serious disease outbreak, whether of a new virus or an old bacteria like Cholerae vibrio, is also a political event. It's a challenge not only to those who contract the disease, but to their government—in many ways a nastier challenge than protesters rioting in the streets.
Governments know how to deal with rioters. But an outbreak is worse because you can't beat a coronavirus case back into glowing health. The victims are implicit critics, pointing out that their government has not prepared, or has not responded effectively. Few governments have the confidence to admit their errors and make dramatic amends.
The World Health Organization is in an even worse bind. It is the creature of the United Nations, whose members decide what budget it shall operate with. For many years that budget has been disastrously low, obliging WHO to seek extra support from rich nations, NGOs, and even billionaires like Bill and Melissa Gates. He who pays the health organization calls the tune, and many urgent concerns have gone unfunded because they didn't mesh with donors' political concerns or personal hobbies.
Still the outbreaks come, and still WHO's response depends on how much it can collect in its begging bowl.
Under these conditions, WHO must maintain good relations with all member nations, especially those dealing with outbreaks. When it issued a travel advisory about Toronto during the SARS outbreak, the Canadian government was extremely unhappy, and I'm sure WHO's ears are still ringing from our complaints.
That experience also probably slowed the response of then-DG Dr. Margaret Chan when she was called upon to declare West Africa's Ebola a PHEIC: If Toronto's economy took a beating from SARS, West Africa's economy would be left for dead by a cessation of trade and travel.
And so it was, when a PHEIC was eventually declared, but Chan's reputation never recovered. (And she was the person who, as Hong Kong's chief medical officer, had the guts to order the slaughter of all poultry in Hong Kong in 1997 to stop the spread of H5N1 avian flu.)
So WHO must be very, very polite to governments. Not only can they forbid access and deny information, but when budget time comes round they can cut WHO's budget and leave it a worse beggar than before. (An organization like MSF, with its own huge private funding, is much more prepared to kick diplomatic ass and take government names.)
I can also see President Xi's predicament without having to like him or his policies. He is the beneficiary of decades of Communist Party rule (which punished Xi's high-ranking father during some campaign or another). He knows, better than most rulers, how tenuous any great power really is—especially after the examples of the USSR in 1991 and the US in 2016.
He also knows the Communist Party has much to be proud of, including rearing generations of bright young students. (And I had the pleasure of teaching some of them in 1983.) Those kids have pulled China back at last into the status of a world power; a fraction of them have formed a formidable healthcare system that analyzed H7N9 and sent experts to fight Ebola in West Africa.
Those healthcare workers don't even remember the days of the barefoot doctors and the Bamboo Curtain; many of them have trained in the West. They understand our system as well as their own, and this outbreak poses a terrible dilemma for them: do they tell the government that taught them, sent them overseas, and gave them careers that it's screwing up? Or do they shut up, buckle down, and try to save lives until they lose their own like Dr Li Wenliang?
If Xi and his Communist Party lose legitimacy in the eyes of China's healthcare system, the Chinese people will be right behind their doctors in calling bullshit.
But what is the alternative? It's easy to damn Beijing and thereby congratulate oneself on one's higher moral values. It's harder to offer something to replace the current regime without a cost in lives comparable to that of the 19th-century Taiping Rebellion.
We've already seen that communist dictatorships do not replace themselves with jolly democratic republics in powdered wigs like the American Revolution. Dictatorships become huge carcasses, fought over by warlords and oligarchs who make the old dictators look positively enlightened. (So, alas, do jolly democratic republics.) Then the winners become a new kind of threat to the world, just when, to be honest, it needs fewer threats.
President Xi's actions in the past month show how seriously he takes the coronavirus outbreak as a threat both to his people and his government. Dr. Tedros' praise for his government's response and transparency is not so much an objective assessment as a political placebo. As the Lovin' Spoonful observed long ago, "Well, the doctor said, give him jug band music; it seems to make him feel just fine."
Dr. Tedros' jug band music will buy Xi Jinping some time to jerry-rig a response that keeps the supplies and staff pouring into Hubei and other hot zones—hopefully, without creating a fatal shortfall elsewhere. Meanwhile he also has to hold together a country of 1.4 billion people and an economy the whole planet depends upon.
So let us cut Dr. Tedros and President Xi some slack. Unless we are prepared to bring in a replacement government in 24 hours, we have no business second-guessing them.
