Neither is willing to empower the WHO to intrude more forcefully into states’ domestic affairs – as it must to protect global public health.
To many observers, the rival approaches taken by Presidents Donald Trump and Xi Jinping towards the WHO in the age of the coronavirus are high-profile examples of the two countries’ distinct takes on multilateral institutions and cooperation. Most believe that COVID has merely accelerated trends evident at least from the start of the Trump Administration. The United States, preoccupied with making itself internally great, now withdraws from institutions that it constructed as part of the liberal international order (the WHO, UNESCO, the Transpacific Partnership, the Paris Agreement, the U.N. Human Rights Council . . .), enabling China to step to the fore.
There is some truth to this simple story. Whereas U.S. Secretary of Health and Human Services Alex M. Azar used the occasion of the last World Health Assembly to lambast the organization for failing to contain COVID-19 by, among other things, failing to demand accurate and timely information from China, President Xi used the same occasion to praise the WHO for leading the necessarily global response. Whereas Azar’s “j’accuse” speech implied a conspiracy between the organization and “one member state” in particular to ignore transparency and enable a virus originating in China to decimate the planet, Xi stressed his country’s and the organization’s devotion to openness with respect to a virus that does not respect borders and makes nationality irrelevant. Whereas the Trump Administration emphasized the difference between Taiwan’s accurate and timely submission of information and China’s initial obfuscations (including about what was happening in the cradle of the outbreak, Wuhan; the likelihood of human to human transmission; and the fact that Chinese researchers sequenced the virus’ genome as early as Jan. 5, 2020), Xi said all the things that the world wanted to hear about the need to strengthen global governance on public health, increase material and other support for African countries, respond more quickly to public health emergencies, and observe WHO’s recommendations. Whereas the Trump Administration subsequently halted funding for the organization and announced its intention to withdraw, Xi supported the call for a “comprehensive review” of the global response to COVID-19 and pledged that any COVID vaccine developed in China would be treated as a “global public good” that would be accessible and affordable to developing countries. Many commentators accept this narrative and treat the contrasting postures towards the WHO as occasions for determining who is up or down in the US/China worldwide popularity sweepstakes.
It cannot succeed, in short, without intruding more forcefully into states’ domestic affairs.
All of this misses a bigger picture. It is increasingly evident that the multilateral health regime led by the WHO is failing to protect the human right to health, and needs reform. As evident in the WHO’s own reviews of its prior failings, global health experts have long known what must be done to achieve the level of international cooperation necessary to handle pandemics. The WHO must be empowered to go beyond states’ own self-interested reports of emerging health risks and hold states accountable when their reports are inaccurate. Its International Health Regulations – the principal instrument that defines member states’ public health obligations under international law – must be interpreted to genuinely require states that deviate from the WHO’s science-based recommendations to explain why their own alternatives (travel bans, export restrictions on PPE, and the like) are preferable and consistent with both human rights and trade obligations. The who, why, and when of proclamations of public health emergencies issued by the WHO must be transparent, making it clear under whose influence such emergencies are proclaimed and the precise reasons for subsequent WHO recommendations. And the WHO needs better enforcement mechanisms. Its toothlessness has fostered organizational pathologies. For example, mindful of China’s intransigence in withholding information about SARS in 2003, the WHO has showered China with praise for being just a bit more cooperative when it comes to the current virus.
The WHO cannot protect states from each other or eliminate a slide towards lowest-denominator solutions unless it is empowered to “name and shame” states unwilling to tell the truth, aggressively inquire about states’ core medical capacities, and punish efforts to silence whistleblowers. It cannot succeed, in short, without intruding more forcefully into states’ domestic affairs. The Trump Administration makes no bones about opposing such supranational scrutiny. But China, in its deeds as opposed to its words, has scarcely been any more forthcoming. In case after case – from its response to the Philippines v. China arbitration over rights in the South China Sea, to its efforts to curtail “name and shame” efforts by numerous U.N. human rights bodies – China has resisted all efforts by international institutions to “look under the hood” at its own actions. It is an ironic poster child for multilateralism.
Nothing in Xi’s speech before the WHO Health Assembly commits China to making the WHO more effective against this or future pandemics. The country whose approach to international law has, for decades, been defined by the Five Principles of Peaceful Coexistence – which commentators have accurately described as sovereignty times five – has not changed its fundamental posture. Xi is only more subtle than Trump. Both see the choice between sovereignty and genuine multilateral cooperation as a zero-sum game. In his Assembly speech, Xi gave the game away when he nodded in the direction of an eventual “comprehensive review” of the handling of COVID-19 – but only as directed to reviewing “global responses” and not about its origins and who might have lied about them. His vague support for strengthening international cooperation did not endorse any of the well-known prescriptions for WHO reforms, and China will probably continue to resist all of them. Of course, Xi’s rhetorical commitment to acting strictly on the basis of science is belied by its intense opposition to having Taiwan as a WHO observer – thereby denying the organization secure and ready access to the expertise of Taiwan’s medical community (and vice versa). Indeed, a country that blocked the U.N. Security Council from considering any resolution about COVID-19 on the false ground that public health was outside the Council’s “geopolitical” ambit – despite the Council’s prior actions on Ebola – should not be expected to become a convert to making the U.N. system effective.
Make no mistake: when it comes to the WHO and multilateralism more generally, Trump and Xi are both free-riders.
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José E. Alvarez is the Herbert and Rose Rubin Professor of International Law at New York University School of Law and lead faculty advisor of the U.S.-Asia Law Institute
The views expressed in USALI Perspectives essays are those of the authors, and do not represent those of USALI or NYU.
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