Dr Owain Williams By: Dr Owain Williams
Lecturer in IR and Human Security
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19 May 2020 : World Health Assembly High-Politics

I start my day of working in a rota on and off with the two year old. Endless snacks, stories and TV, mixed with bouts of work. It is a crazy way to work, but has been the pattern for nearly 3 months. Most of the time it is just impossible and frustrating. When I do get to it, I am tired from watching the live feed of the World Health Assembly (WHA) much of the night. It has been a torrid 24 hours in global health, and the current geopolitics of COVID, and just plain geopolitics of declining US hegemony, both playing out in the normally stultifying technocratic business of WHA procedures and speeches.

I thought I would take some time off the neoliberal thread and spend some on analysis of what has taken place in the now virtual WHA. I know from some comments on this site that people are using in it for its analysis, especially those not so versed in Global Health, which is great. In the first instance, and quite simply, the WHO and the WHA have become the site of a fairly simple to understand game of geopolitical blame shifting and diversion.

Trump very openly (he can be no other way unless it is his dealing with tax or Russia) attacked the WHO again yesterday in a press conference and series of Tweets. He describes the organisation as a ‘puppet of China’, and states that they ‘were wrong so much, and always on the side of China’. In some ways this is partially true in the early weeks of January at least. He also publishes a letter to the WHO that threatens permanent US withdrawal of funding, unless 'major reforms’ and ‘major substantive improvements’ are made to the WHO within 30 days. Any observer of institutions knows that these order of changes are not possible in such a time frame. It is just grandstanding. Trump has been blame shifting his own botched response to COVID to WHO and China for some 8 weeks now. It is a move designed for domestic consumption, the President not concerned with the trade-off being giving up the US position as a long-standing leader and shot-caller in global health

Secretary Aznar’s statement to the WHA continues the attack.  He puts it bluntly, ‘we must be frank about the primary reasons this outbreak spun out of control – there was a failure by this organisation to obtain information that the world needed, and that failure cost many lives.’ For China, this hands Xi and co a golden opportunity, one of visibly supporting global health and the WHO as the USA visibly leaves its leadership role open and vacant.

President Xi’s speech all hinges on the unveiling of a massive aid package for COVID, both for COVID response and help for the developing countries it has affected. The package is worth $2 billion. In addition, China will establish a humanitarian and supply chain hub in China for housing and distributing relief, medical technologies and PPE, and perhaps for the eventual distribution of a possible vaccine. It will also twin Chinese hospitals with African counterparts for assistance. This largesse in funding international organisations is not in China’s traditional play book, and sees them using global health and COVID as a moment of soft power grab. They are moving from the bilateral form of aid to the multilateral, and this is significant for geopolitics.

But of course, the Chinese are also blame shifting and attempting to divert attention from the failure to disclose person to person transmission of COVID in early January. At whatever level of the Chinese political the system attempts to bury what was transpiring in Wuhan took place, the local, provincial or the state (or all of them), this was a signal failure of that political system, and more or less a repeat of attempts to bury the SARS outbreak. While not as sustained as the SARS cover up, the COVID legacy is more marked in global terms, and will take much to divert attention from China's back and forth game with a politically careful WHO. China and Xi have being trying to claw back ground on this since the middle of January at least. This driver also plays out in a number of ways at the WHA yesterday.

First Xi backs the overwhelming member nation backing of an Australian-EU resolution for a comprehensive formal investigation of how the crisis emerged and how it was handled. This will put both WHO and China under the microscope. Xi, with no real choice given the international spotlight, backs the need for a ‘comprehensive evaluation’, though only when COVID is under control. Even with the benefit of time to bury evidence and buy favour, China will be examined critically for its handling of COVID in its earliest days. As will the WHO. The continued exclusion of Taiwan from WHO further plays to the idea of a cosy relationship between the WHO and China, albeit inclusion and exclusion being in the hands of national members, and not that organisation. Taiwan withdraws from a bid to win back observer status, and the finger of blame points back to China and the WHO.

Second, lost in a great deal of the higher politics of Taiwan’s observer status to the WHO, the enquiry and US posturing, is the issue of under what conditions a vaccine will be produced and shared. In the run up to the WHA over 140 world leaders signed a letter of support for a vaccine to be treated as a global public good (a Peoples’ Vaccine) not subject to patent rights or preferential national allocation. Xi supported this yesterday, while the US and some European countries opposed, reflecting exactly where the commercial heartlands of Pharma are to be found. There is one impassioned speech by a Caribbean head of state (far too late to record which country) making an angry plea for the equal distribution and access of less developed states to medical technologies in general. China will win many friends on this stance, but it is nonetheless the right thing to do.

So the usually fairly dull WHA (if you are not a global health geek) became a real high politics event, still couched in the language of bureaucratic procedure, but still very visible. This is just the first day and the blame game will go in for many years to come.

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