Let’s find a solution rather than a culprit, particularly when it comes to the WHO and the coronavirus crisis, say Jose Martin-Moreno and John Middleton

In any human endeavour, when something goes wrong, it is natural to immediately ask who did not perform well, and ultimately who is to blame, but experience shows that doing this often makes the problem worse. The incriminated person or entity quickly looks for someone else to blame, or with whom to at least share the responsibility for the failure so that they themselves can be excused. 

While this often fruitless exchange of mutual accusations takes place, the problem or crisis grows ever bigger and the already limited creative energy that should be focused on solving it is diverted to attacking another party and defending oneself.

During the covid-19 pandemic we have seen within our countries all kinds of recriminations and finger pointing, including at, among others, the government, the opposition and various expert committees.¹

And we have also observed the same behaviour on the international stage, with other countries and multiple international organisations harshly criticised or directly accused… and the World Health Organization (WHO) singled out with particular fierceness.²

In the case of the latter, the criticism has gone beyond words. The current president of the United States, Donald Trump, has taken the decision to withhold the US budget contribution to the WHO, “pending a review of the organisation’s cover-up and mismanagement” of the covid-19 outbreak.³

The WHO, the United Nations agency specialised in health issues, has an intergovernmental structure that makes it extremely sensitive to the position of its Member States. But, despite this, it has played a key role in the fight against the coronavirus.

The organisation has been at the forefront of the global response to covid-19: from monitoring events and submitting daily situation reports to providing guidance to governments and the general population, including on hand hygiene and physical distancing to prevent infection.⁴

There is also technical work directed by the WHO, catalysing expert knowledge and synergy, which goes largely unnoticed. This includes, for example, the clinical trials under the name of “solidarity”, which are testing possible vaccines and treatments for covid-19, trials in which many countries are collaborating.⁵

Then there are the WHO’s roles in global procurement of, and standard setting for essential supplies. The WHO leads the Pandemic Supply Chain Network (PSCN), a public-private partnership to facilitate the procurement of critical covid-19 products for more than 120 countries.

In the field of medical devices for clinical management (including invasive and non-invasive equipment), the WHO is continuously reviewing the technical specifications of medical instruments used in intensive care units (ICUs).⁶ In particular, standards of effectiveness and safety are set for respiratory equipment that serve as a fundamental guide for developers and manufacturers.

And along with all of the above, it systemises the listing of candidates or in vitro diagnostics (IVDs) of covid-19 antigens and antibodies and urges diagnostics’ manufacturers to test for sensitivity and specificity.⁷ Finally, manufacturers are encouraged to contact the WHO if they have innovative products that could help in the fight against covid-19, so that their products can be supported and be made available to populations in need. This list is by no means a fully comprehensive description of all WHO’s contributions, only a sample. 

The US is not the only Member State to have shown its disappointment with the way in which the WHO has handled the prevention and control of this pandemic, but others have not even hinted at withdrawing their financial contribution to the organisation. Indeed, some countries have pledged to increase their contribution at this time of immense worldwide health need. They recognise that, if the WHO did not exist, it would have to be reinvented.

In the future all those involved in the management of this terrible pandemic (including the WHO leadership) will have to analyse their performance and acknowledge mistakes, but this should be done now.⁸ At this time, all leaders and responsible people should repeat a slogan: “Let’s focus on the solutions.” We must prevent the situation from deteriorating, and additional difficulties arising.

Fortunately, wonderful initiatives have emerged that more than compensate for the hardships caused by these international tensions: countries have pledged to cover part of the deficit due to the lack of US funding, charities such as Bill & Melinda Gates Foundation are stepping up work to fight the coronavirus,⁹ and other fundraising projects are raising money.

The generous initiatives mentioned are a source of inspiration, let us avoid becoming people who enjoy finding a culprit rather than a solution. When we are facing a great crisis, it is when people (leaders, professionals, family members, friends, or in short, all fellow citizens) must help each other, that synergy and the deepest affection can and must prevail.

Jose M Martin-Moreno is professor of medicine and public health at University of Valencia, Spain

John Middleton is president of the Association of Schools of Public Health in the European Region, Brussels, Belgium

Competing interests: none declared

References:

1. Oliver D. Covid-19—recriminations and political point scoring must wait. BMJ 2020; 368: m1153 (Published 25 March 2020)
2. Chung F. Covid 19 coronavirus: World Health Organisation accused of ‘parroting Chinese propaganda. NZ Herald, 3 Apr, 2020.
3. McKee M. Coronavirus has killed 30,000 Americans, and all Trump can do is blame the WHO. The Guardian, 16 April, 2020. 
4. WHO. COVID-19 preparedness and response.
5. WHO. “Solidarity” clinical trial for COVID-19 treatments.
6. World Economic Forum. Pandemic Supply Chain Network (PSCN)
7. WHO. Coronavirus disease (COVID-19) Pandemic – Emergency Use Listing Procedure (EUL) open for in vitro diagnostics.
8. Cornwell, A. Defeat virus first, criticise later, WHO envoy says after U.S. funding halt. Reuters, 15 April 2020. 
9. Gates Foundation. Bill & Melinda Gates Foundation Expands Commitment to Global COVID-19 Response, Calls for International Collaboration to Protect People Everywhere from the Virus. Press release, 15 April 2020.
10. Global Citizen. One World: Together At Home.