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Coronavirus: Is President Trump right to criticise the WHO? Coronavirus: What are President Trump's charges against the WHO?
(about 1 month later)
US President Donald Trump has accused the World Health Organization (WHO) of mismanaging and covering up the spread of the coronavirus after it emerged in China. President Trump has threatened to withdraw funding from the World Health Organization, accusing it of mismanaging the coronavirus pandemic, particularly in its early stages as it emerged in China.
He added he would halt WHO funding while his administration reviewed its actions. We've been looking at some of the charges President Trump has levelled against the WHO and the health body's responses.
Peter Piot, from London's School of Hygiene and Tropical Medicine, said this would be "dangerous and short-sighted" Claim 1
But does Mr Trump have a point about the WHO's response to the virus? "The WHO failed to adequately obtain, vet and share information in a timely and transparent fashion."
What does the WHO do? This has become a regular theme of Mr Trump's criticism of the WHO, and in his letter to its head Dr Tedros Adhanom Ghebreyesus on 18 May, he renewed this attack saying the WHO "consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier".
Set up in 1948, it is the part of the UN responsible for global public health, co-ordinating vaccination campaigns, health emergencies and supporting countries with primary healthcare. Mr Trump specifically highlighted reporting by the Lancet medical journal.
It is funded by fees and voluntary contributions from its 194 member states, with the US the largest single contributor. The editor of the Lancet, Richard Horton, has written a letter in response, saying: "The Lancet did not publish any report in early December 2019 about a virus spreading in Wuhan. The first reports we published were from Chinese scientists on Jan 24, 2020."
Did the WHO fail to challenge China? In response to the criticisms levelled at it, the WHO says it acted properly in accordance with the information it was given by China, sharing it with medical and scientific experts around the world, including from the US.
President Trump has accused the WHO of failing to challenge China's early assertion there was no evidence of human-to-human transmission of the coronavirus. The WHO says it was told by China of "a pneumonia of an unknown cause" on 31 December 2019.
China first informed the WHO of "a pneumonia of an unknown cause, on 31 December". And this was flagged on WHO social-media accounts on 4 January.
On 5 January, the organisation said the information it had from China at that time showed there was "no evidence of significant human-to-human transmission". Then, on 5 January, the WHO put out an official statement saying it had asked for more information about the illness from the Chinese authorities.
And on 14 January, it tweeted preliminary Chinese investigations had found "no clear evidence of human-to-human transmission" of the new virus. On 12 January, China publicly shared the genetic sequence for the new coronavirus.
The same day, however, the Wuhan Health Commission said the possibility of limited human-to-human transmission could not be excluded, although the risk of sustained transmission was low. On 20 and 21 January, a regional WHO team visited Wuhan.
Around the same time, other WHO statements raised the possibility of some human-to-human transmission, referring to what was known about other coronaviruses such as severe acute respiratory syndrome (Sars). A public statement was issued by the WHO on 22 January setting out what they had discovered.
And on 22 January, the WHO, following a brief field visit to China, made a much clearer statement saying that human-to-human transmission was happening in Wuhan. On 28 January, Dr Tedros went to Beijing to discuss the outbreak with China's leaders.
It's worth adding that a full WHO delegation with international experts did not visit China until the second week of February. By the end of January, the WHO had declared the outbreak a public-health emergency of global concern.
At the end of January, the WHO had praised China for its efforts to contain the virus, including its "commitment to transparency". It has also been reported that WHO experts (drawn from 15 countries including China) met a week earlier to discuss whether to issue a global alert but could not agree among themselves.
Did the WHO ignore experts from Taiwan? Claim 2
Mr Trump said there was "credible information to suspect human-to-human transmission in December", an apparent reference to a warning Taiwan says it sent to the WHO. "Through the middle of January, it parroted... the idea that there was no human-to-human transmission happening despite... clear evidence to the contrary."
Taiwanese scientists had visited Wuhan shortly after the virus first emerged. President Trump identifies a critical few days here when the messaging from the WHO was evolving rapidly.
But the evidence published so far shows Taiwan's exchanges with the WHO did not mention human-to-human transmission. On 14 January, the WHO tweeted: "Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission."
Taiwan is not one of the WHO's members as the territory is not recognised by the UN. But the same day, the head of the WHO's emerging diseases unit, Maria van Kerkhove, appeared to contradict this, suggesting to journalists that "limited" human-to-human transmission had been observed in Wuhan. She did however stress that there was no clear evidence of "sustained" transmission between people.
The WHO says it has been sharing all information with Taiwanese health experts. It wasn't until 22 January that the WHO confirmed there was clear evidence of human-to-human transmission in Wuhan.
But last month, after a senior WHO official refused to discuss Taiwan's response to the outbreak, the organisation was accused of being unduly influenced by China. The WHO has denied media reports that it delayed making this evidence public at China's request.
"Constructive criticism of the WHO's effusive praise for China is warranted," public health expert Lawrence Gostin told BBC News. Claim 3
"The WHO should have been more critical and looked more closely at the situation." The WHO has "an alarming lack of independence" from China.
But he added President Trump's remarks were an attempt to shift blame for the US's own lack of preparedness. In his recent letter to the head of the WHO, Mr Trump, accuses the organisation of being too close to China, failing to remain objective in its handling of the outbreak.
The WHO has said in response to Mr Trump that it will review its actions, but added that all its guidance was intended to limit human transmission. It's certainly the case that the WHO has publicly praised China's response to the coronavirus outbreak and its "commitment to transparency", something that has clearly angered the US president in recent weeks.
And although the WHO has been criticised for praising China's initial response to the virus, Mr Trump himself had praised the Chinese, in a tweet, on 24 January. However, many other experts and political leaders, including Mr Trump, have also praised China's initial response to the outbreak.
However, Chinese officials did initially try to cover up the outbreak in Wuhan and silence those raising concerns. On 24 January, Mr Trump was effusive in his support for China's efforts.
Did the WHO misadvise on travel bans? Dr Michael Ryan, of the WHO, says the organisation wanted to keep the lines of communication open with China as it battled to contain the virus.
Mr Trump said the WHO had misadvised "there was no need for travel bans" and "fought" with the US over banning travel from China and other countries. The WHO has also been accused of being unduly influenced by Beijing over the status of Taiwan.
The WHO has never directly criticised the US approach and it is up to national governments to implement border or travel restrictions. The issue here is that Taiwan is not a member of the WHO, as the island is not recognised by the UN.
But it did publish initial advice, on 10 January, recommending no international restrictions and repeated this the same day it declared a public health emergency, in late January. The WHO, however, says it does engage with Taiwan and share information with it.
The WHO has said: "Restricting the movement of people and goods during public health emergencies is ineffective in most situations." Taiwan says it raised the alarm about the possible human-to-human spread of the virus at the end of December after some of its scientists had visited Wuhan.
It believes closing borders could lead to a rise in people trying to travel illegally and so possibly spread rather than stop infection. Taiwan says its warnings were ignored or not taken seriously.
But this advice was eventually ignored by most countries, including the US, where Mr Trump stopped all foreign nationals who had been in China in the 14 days prior from entering the US from 2 February. But the evidence published so far shows Taiwan's exchanges with the WHO did not specifically mention human-to-human transmission.
Mr Trump has said this reduced the spread in the US. Claim 4
And the White House's top medical adviser, Dr Anthony Fauci, has said: "Our shutting off travel from China and, more recently, travel from Europe has gone a long way to not seeding very, very intensively the virus in our country." "One of the most dangerous decisions... from the WHO was... to oppose travel restrictions. They actually fought us."
But a study published in February by the Journal of Emergency Management found travel bans had been effective in decreasing the spread of previous viruses, such as Ebola and Sars, in the short term only. The US restricted travel from China and other countries from 2 February.
But there is no record of the WHO publicly criticising this move.
And it would have been highly unusual for it to do so.
But it had, on 10 January, put out advice recommending no international travel restrictions in response to the virus.
And this was reconfirmed in a statement at the end of February, saying travel bans were not usually that effective and could have an adverse social and economic impact, although they might be justified for a short period of time at the start of an outbreak.
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