Throughout the COVID-19 pandemic, the World Health Organization (WHO) has been a central figure leading the response efforts. At the same time, the organization has come under increased criticism, and even had portions of its funding halted by the United States. As the pandemic continues to grow—with over 3,000,000 confirmed cases and over 200,000 deaths globally—and criticism of the WHO deepens, it is essential to contextualize the organization’s response within its mandate and to review the actions it has taken to curtail the disease’s spread.
The WHO is a specialized agency of the United Nations and is governed by member states through the World Health Assembly. Similar to other specialized agencies—e.g., the Food and Agriculture Organization (FAO)—the WHO does not have the authority to dictate state actions. It is primarily responsible for coordinating responses to emergencies, monitoring health risks, and promoting health. Despite the WHO’s size and budgetary limitations—it operates under budgetary requirements and with less funding than the New York State Department of Health—it is contributing on a number of important fronts in the fight against COVID-19 related to these aspects of its mandate.
Notification and Monitoring
The WHO was first notified of several cases of pneumonia with an unknown origin in Wuhan, China on December 31, 2019, via the International Health Regulations (IHR). Five days later, on January 5, the WHO published news of the outbreak and stated they would continue to closely monitor the situation.
As the number of cases of the novel coronavirus grew, and reports of exportations to other countries increased, WHO Director-General Dr. Tedros Adhanom Ghebreyesus convened the first meeting of the IHR Emergency Committee on January 22-23. As outlined under the IHR, the committee provides their recommendations to the director-general on whether an event constitutes a “public health emergency of international concern” (PHEIC). While a PHEIC was not declared following the first committee meeting, the director-general reconvened the committee days later and, based on their recommendations, declared a PHEIC.
Early on, Dr. Tedros designated the COVID-19 outbreak as a priority for the WHO. As with previous outbreaks, he visited affected countries and spoke with national governments and responders. On January 28, Dr. Tedros and a team from the WHO traveled to China and met with President Xi Jinping to discuss the outbreak and China’s response. The WHO remained engaged with China to monitor and report on the situation while pleading with other countries bolster their preparedness.
Country Preparedness and Capacity Building
Many countries lack basic medical and public health infrastructures, critical supplies, and basic response trainings necessary to prepare for and respond to COVID-19 cases on their own. The WHO provides technical training courses on COVID-19 in 13 languages, and has reported approximately 1.2 million enrollments. It has shipped critical supplies to countries worldwide, such as 1.5 million diagnostic kits that went to 126 countries, and millions of masks, gowns, gloves, and other personal protective equipment which were sent to 133 countries.
In collaboration with the World Economic Forum, the WHO set up a Pandemic Supply Chain Network which is a public private collaboration to address global supply chain issues and the scarcity of essential equipment. The WHO, working with the UN system and other partners—including Emergency Medical Teams and the Global Outbreak Alert and Response Network—provide technical expertise to countries to assist their response efforts and have developed a Strategic Preparedness and Response Plan to guide partners in operationalizing response plans.
The WHO has also conducted several country missions to assess national capacity and support efforts to strengthen preparedness and response capabilities. It regularly liaises with donors and has established the COVID-19 Solidarity Response Fund where countries, organizations, and individuals can donate to provide the essential resources necessary to fund a global response to COVID-19.
Promoting Research and Development
The virus that causes COVID-19, SARS-CoV-2, is a novel coronavirus, and much of the work to date has involved research efforts to better understand its natural history and transmissibility, and to obtain evidence-based data on effective public health interventions. The WHO has acted as the coordinating body on gathering information, establishing priority areas for research, and disseminating findings to the general public.
On February 11 and 12, the WHO convened a meeting with leading health experts and funders from across the globe to “accelerate global research that can contribute to containing the spread” of the pandemic, and to “facilitate that those affected are promptly diagnosed and receive optimal care.” A research roadmap was developed that outlines the current level of knowledge about COVID-19, identifies gaps, and determines priority research areas.
A WHO-China Joint Mission from February 16-24 was deployed to determine preparedness and response priorities based on China’s experience. Numerous studies are currently being published on SARS-CoV-2, and the WHO is compiling a database of journal articles related to COVID-19. The WHO and partners have also launched a Solidarity Clinical Trial to rapidly identify whether any of the investigational therapeutics prove effective in slowing disease progression or improving survival outcomes and a Solidarity Vaccine Trial to coordinate the prompt evaluation of the efficacy and safety of vaccine candidates for SARS-CoV-2. Most recently, in a “landmark collaboration” WHO are partners have launched the Access to COVID-19 Tools Accelerator to ensure equitable distribution of and access to COVID-19 vaccines, diagnostics, and therapeutics.
Combatting the Infodemic
The nature of the pandemic has meant that the WHO has had to go beyond addressing typical health concerns and quickly address the rising infodemic. While misinformation has been an issue in previous outbreaks, the level of misinformation associated with COVID-19 has been much higher.
In response, the WHO launched an unprecedented campaign to counter misinformation head-on. The WHO holds regular press briefings to provide updates, and launched a platform—the Information Network for Epidemics (EPI-WIN)—to share tailored information and public health advice. The WHO also provides tools like myth busters and FAQs, and has partnered with WhatsApp, Viber, and social media companies to directly combat misinformation. The WHO developed over 40 technical guidance documents with evidence-based public health recommendations to provide the most updated and validated information.
What is clear from the range of interventions and steps taken is that the WHO has been involved in almost all aspects of the response to combat the pandemic. While some of the criticism levied at the WHO does not take into account the organization’s mandate and operational capabilities as defined by its constitution and the IHR, other concerns of possible missteps in WHO’s response have shown there are still areas for improvement and ways to refine the response.
As with any outbreak response, an after-action review should be conducted to assess WHO’s performance and highlight these areas for improvement and lessons learned to further enhance the organization’s ability to coordinate and effectively respond to future large-scale outbreaks. The existence of an international organization like the WHO that coordinates global health issues is vital in stopping any pandemic. The WHO’s steadfast voice advocating for solidarity in the response has contributed to protecting the most vulnerable and helped save lives, and we need it to continue to do so now, and during future outbreaks.
Lucia Mullen is an analyst at the Johns Hopkins Center for Health Security, where part of her research focuses on global health policy.