The Covid-19 pandemic establishes (once again) that the United States and the rest of the world need to do far better at protecting their populations from infectious disease. Virtually every government missed opportunities to limit the damage at every stage. As U.S Secretary of State Antony Blinken said, “China didn’t do what it needed to do,” resulting in the virus getting “out of hand faster and . . . with much more egregious results than it might otherwise.” It failed to inform other States of the outbreak promptly, and to prevent infected individuals from travelling abroad. Many other countries, including the United States, failed to implement known mitigation measures, accelerating the spread of the pandemic. Moreover, the World Health Organization (WHO) acted too slowly.
Across much of the globe, no one was prepared. Moreover, in almost every country, the response was immediately so politicized that it likely multiplied the ultimate toll. Without the huge investment made by the United States in vaccine development and production, and the impressive speed with which the world’s pharmaceutical industry mobilized, we could well have experienced a catastrophe equivalent to the flu pandemic of 1918-1920.
The United States should take the lead in preparing for future pandemics. But that will require improving and reforming — not abandoning — the WHO and coordinating an international effort that could — but does not necessarily need to — entail a new treaty addressed specifically to pandemics.
To be sure, relying on an international agency has its costs. But the United States has often advanced its interests and international well-being through multilateral efforts. During my time as the State Department’s Legal Adviser, the United States helped develop or ratified such agreements as the Antarctica Convention, the Intermediate Nuclear Forces Treaty, the International Space Station, the Maritime Terrorism Convention, the Chicago Convention concerning air pollution, and the Genocide and Torture Conventions.
The United States also continues to support and benefit from “specialized” (as opposed to “political”) United Nations agencies. They include the International Civil Aviation Organization (ICAO) and the International Maritime Organization (IMO), which have adopted standards that provide indispensable guidance for commercial aviation and maritime safety.
From the early 1990s, however, the United States has soured on multilateral efforts. This was particularly the case with the International Criminal Court (ICC), where the negotiations were seen as controlled by States determined to criminalize U.S. departures from a narrow view of the legitimate use of force. That treaty, and other disappointments, led both Republican and Democratic administrations of the United States largely to give up on engaging internationally through multilateral agencies, even to advance its own interests.
The United States needs to return to engaging constructively with international organizations. Committing to a more robust international effort to respond to transnational health threats does not mean surrendering sovereign authority or essential interests. Rather, it means recognizing that improving the performance of States, including the United States, and of relevant international agencies, requires genuine engagement with governments and NGOs to rectify weaknesses that are widely acknowledged.
One essential aspect of an effective plan is to set aside the issue of whether biological or chemical health threats may have been created deliberately in violation of the Biological & Toxin (BTWC) or Chemical (CWC) Weapons Conventions. The United States and other governments are more likely to cooperate in dealing with health threats in a context that avoids national security issues and accusations. As an example, when governments agreed to support the creation of standards for civilian aviation, they also agreed to exempt military aircraft. Global maritime conventions became practicable by exempting national navies. This policy division also is evident in WHO’s limited authority to consider radiological threats caused by nuclear activities.
Even as the United States extends support to the WHO, it also is essential to deal forthrightly with its weaknesses. The WHO is, among other things, spread too thin. It has many less-concrete and less-urgent objectives than protecting against biological or chemical threats. The United States should insist that the agency address biological and chemical hazards through a separate entity to ensure these concerns get the intense attention they warrant, and to enable States to target financial support for related activities. This factor in part explains the current push to create a separate multilateral agency (somehow related to the WHO) to deal exclusively with pandemics. That seems an unlikely an unnecessarily costly and complicated outcome. But whatever path is taken, infectious disease requires a separate, higher priority than regular health concerns.
Reform must also include providing the WHO with new powers and capacities that it needs. Identifying all the necessary reforms requires input from scientific and regulatory experts, but should include the following areas:
- Reporting Requirements: Information is at the heart of the WHO’s role, and the need for accurate and prompt reporting is acute in dealing with pandemics and emergencies. Reporting requirements related to biological or chemical threats should be made mandatory. Enforcement will be difficult, but this aspect of international cooperation should be recognized as indispensable.
- Scientific Input: The WHO process for identifying needs and developing proposals relies on a 34-member expert committee. A smaller group should be selected to deal with infectious-disease issues, based on its members’ expertise and political independence. Other specialized international organizations have apolitical technical committees that generate and screen proposals, as do the U.S. National Institutes of Health, and the U.S. Food and Drug Administration.
- Safety standards: WHO has adopted safety standards for labs engaged in potentially dangerous research. These standards should be mandated so that member States are required to certify facilities, regardless of whether they are private or under government control.
- Preparedness: Recent pandemics have demonstrated the need to improve international preparedness. Necessary equipment should be manufactured in advance and stored at convenient centers. Teams should be organized and kept in readiness, as the WHO has done in the past with member State assets.
- Global Assistance: The United States should lead efforts to assist needy populations, not only with supply and advice, but with financial aid and pricing arrangements based on need. The Biden administration is correct in accepting that role regarding the crisis in India, and the WHO is the proper forum in which to rally other key developers and manufacturers to join this effort. Their combined strength should effectively ensure that States can meet their moral duties without sacrificing the health of their own populations, or surrendering benefits based on intellectual property, natural resources, facilities, or contractual arrangements.
- Relations with Member States: Effective international action will require independent personnel operating out of WHO offices. They should act as partners of national personnel, however, rather than as superiors, recognizing that member States will enhance WHO’s authority only if its role is limited to assisting national systems to satisfy their obligations as well as the needs of their populations.
The Covid-19 pandemic has caused great damage. But it should also lead States to address international health threats more urgently and effectively. The need to strengthen the WHO’s capacity to resist political pressure should not obscure the ultimate interest in advancing global health. As Secretary of State George P. Shultz testified after the Soviets shot down the Korean Air Lines passenger plane in 1983: “President Reagan made sure the world knew the full unvarnished truth about the atrocity; nevertheless, he also sent our arms control negotiators back to Geneva, because he believed that a reduction in nuclear weapons was a critical priority.”
In that monstrous case, the United States and others did not abandon ICAO, despite its limited capacity to force remedial action, but U.S. representatives insisted upon holding a hearing and developing a public record of Soviet misconduct. Similarly, while maintaining its support of the WHO, the United States and other members should insist upon a full explanation of the spread of Covid-19. While China will do all that it can to prevent such a hearing it is the sort of constructive demand for accountability that would tangibly demonstrate the U.S. determination to hold the WHO and its members to the high level of conduct needed to increase global health security in the future.