The Sunday Magazine

'WHO should never again have authority over a pandemic,' says law and public health professor

President Trump recently announced he was halting funding to the WHO, after mounting concerns about its alleged cozy relationship with China during a global pandemic. Despite denouncing Trump's decision, people are still asking pointed questions about the WHO's response to COVID-19. Amir Attaran has worked extensively with the WHO. He shares his insights on what has gone wrong with the WHO and explores its current and past relationships with the U.S. and Canada.

'This is the last pandemic WHO should ever touch because it keeps getting them wrong'

The World Health Organization has come under intense scrutiny for its response to the COVID-19 pandemic. (Fabrice Coffrini/AFP/Getty Images)
Amir Attaran is a professor in the Faculties of Law and School of Epidemiology and Public Health at the University of Ottawa. (CBC)

U.S. President Donald Trump's decision to halt funding to the World Health Organization has been met with widespread fury and condemnation. But even people who have denounced Trump's decision are asking pointed questions about how the WHO has responded to COVID-19.

Among them is Amir Attaran, a professor in the Faculties of Law and School of Epidemiology and Public Health at the University of Ottawa. He says Trump is using the organization as a scapegoat to distract attention from his own failures — but the WHO should never be allowed to handle a pandemic again.

He also says that Canada is one of the worst developed nations in the world when it comes to collecting and sharing public health data, and it will seriously hamper our ability to restart the economy, following the pandemic.

Here are excerpts from his conversation with The Sunday Edition's host Michael Enright. They have been edited for clarity and condensed.


WHO's handling of the pandemic

[I would give them] a C-minus. "C" if I'm in a better mood. They haven't done an exemplary job. They also haven't failed. That's important to say because … it has actually done much better this time than it did for Ebola some years ago. 

WHO is the body responsible for declaring a health emergency, or to use the full name, the Public Health Emergency of International Concern. WHO did this on January 30, and that was the ringing of the alarm bell. But WHO was somewhat slow to that conclusion. They could have reached that decision about a week earlier. Not terrible to be a week late, but still, slightly late.

In this case, what it did that was terribly wrong — so wrong that in my mind WHO should never again have authority over a pandemic — is that when it knew China was concealing the truth of the virus being spread in Wuhan, WHO went on praising China. They tried to coax China out of their shell. While diplomatically you can see why that would happen, it's also the wrong thing to do scientifically.

The United States is doing a terrible job on COVID because it's got a fantasist and a narcissist as president.- Amir Attaran

Trump's decision to pull WHO's funding

Mr. Trump is purely scapegoating. The United States is doing a terrible job on COVID because it's got a fantasist and a narcissist as president. He needs a scapegoat and it's easy for him to say that the WHO got everything wrong and he's blameless. 

Now, does that mean the WHO committed all the wrongs Mr. Trump pretends? Of course not. But inside all that series of Trumpian lies there is a truth. And the truth is that when China was trying to conceal the outbreak and WHO had reason to know that, WHO did not immediately denounce China and did not say, because China is hiding information from the world, we are recommending countries close off to China.

That is what WHO certainly should have done. In fact, it's what WHO promised to do years ago after its horrible blunders on Ebola, and WHO broke its promise. Now we have to really be very serious that this is the last pandemic WHO should ever touch because it keeps getting them wrong.

Calling out Trump

For him to think that he knows what drug is appropriate for a novel virus that scientists didn't even know about until a few months ago and the best brains around the world are tackling its immunology, its potential pharmacology for future drugs, its epidemiology for how it spreads — for Donald Trump to step into that and pretend that … he knows better is an outrage.

I'm very disappointed that WHO did not forcefully call out President Trump. To be honest, Prime Minister Trudeau should do the same. I know it will create difficulties in other areas. But unless we make it not advantageous for Trump to spout this nonsense, he will spout more nonsense and that will in time create a larger more dangerous epidemic on our southern border.

I'm very disappointed that WHO did not forcefully call out President Trump. To be honest, Prime Minister Trudeau should do the same.- Amir Attaran

Sanctioning Canada during the 2003 SARS epidemic

When that was happening, two countries in the world were most severely affected: China and Canada. They were also not truthful with WHO about the extent of how far the epidemic was spreading. China lied to WHO. So WHO slapped it with a recommendation: don't travel to China. 

Canada also deceived WHO, but in a different way. We didn't set out to lie. We were just so incompetent at handling the information about the epidemic spread, that we could never get WHO a straight answer. And they felt that we might be covering up, reasonably. So we were hit with travel restrictions; Toronto specifically. WHO did the right thing getting us and holding us to account then.

How well Canada is doing in collecting and sharing public health data

Canada, for the quality of its epidemiological data that the federal government possesses, is probably the world's worst country among advanced nations. Most health data is collected at the provincial level and it's only shared with the federal government if the province feels like it. Even when there is a deadly epidemic unfolding inside a province, there's no obligation legally, for the province to share that with the federal government. 

For many years,  we've had warnings that this inability of the provinces and the federal government to share timely, critical lifesaving information in a pandemic is a danger. The Auditor General of Canada, three times in the last couple decades, has said that Canada is not prepared for a pandemic. The auditor general said a large part of the problem was there is no data sharing between the provinces and the federal government except voluntarily. After SARS there was a federal government study of what went wrong and what the lessons learned were. One of the recommendations was this data-sharing problem has to be fixed. If it couldn't be fixed through voluntary efforts, then parliament needed to pass a law to make it mandatory on the provinces to share. In 17 years that hasn't happened.

Canada, for the quality of its epidemiological data that the federal government possesses, is probably the world's worst country among advanced nations.- Amir Attaran

What has to happen now

The Federal Government needs to pass a law or an order, an emergency order, obliging provinces to share data on each case of COVID that they know about. It has to always be provided to the federal government in the same way, so you're able to make apples-to-apples comparisons. That dataset needs to become part of a very solid bunch of epidemiological and economic models. So that as we confront the frightening but necessary job of reopening Canada, we're doing it with data that we have trust in, from all over the country. If we don't have those data, to build the models, to ask the what-if scenarios — what if we open the schools first, what if we put the airlines back in business — if we can't ask those questions, we will be reopening this country flying blind. And when you're flying blind, people die. 

The premiers are also looking with great big eyes at the tens of billions of dollars of federal relief coming their way. If they want the money, maybe they've got to cooperate a bit. Otherwise, I don't think it's appropriate for the federal government to give money out to provinces that aren't doing their part to open the economy in a safe and timely way.

Click 'listen' above to hear the full interview.

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