Politicians are telling us that the fight against Covid-19 is being led by expert advice. They make managing health emergencies sound straightforward: experts advise, politicians listen and policy gets made.
Yet we are still seeing conflicting advice around questions such as, do we stay one or two metres apart? Do we self-isolate for seven or 14 days if we are showing symptoms? And why are we diverging in how seriously we treat the pandemic, how we deal with it and how we prevent it in future?
The history of the World Health Organisation shows how global health has never just been about governments following expert advice. We must be honest about the political forces which are shaping responses to the pandemic.
In 1946 a group of experts gathered in Paris to discuss plans for a new organisation, which became the WHO. They all shared one key idea: the new body should be ‘non-political’.
Many of them had worked with the WHO’s predecessor, the League of Nations Health Organisation, which had been dragged down by the League’s failure in the 1930s. To avoid the same fate, they argued that the WHO should be independent of the UN (the reason why it’s not called the United Nations Health Organisation), that it should be a purely technical body above political conflict and that every country should be a member. The WHO’s first director general predicted a new era of global health cooperation which would ‘bring all the people in the world together.’
The reality didn’t live up to their hopes. The major powers made sure that governments kept control of the WHO’s work and its budget. Certain countries were excluded or withdrew for political reasons, like the socialist bloc countries in the 1950s. And its early work, particularly on diseases like polio and smallpox, was shaped by Cold War tensions.
The Covid-19 crisis has dragged the organisation into the global spotlight. The WHO’s director general, Dr Tedros Adhanom Ghebreyesus, has become a household name, and the organisation has won praise for its public information campaigns on social media. Its work coordinating health experts around the world has become more vital than ever.
But the crisis has also shown how the WHO’s work is far from being ‘non-political’ in the way its founders had aimed for. Because of Chinese opposition, Taiwan has had to fight the pandemic without the benefits of WHO membership. WHO advice has sparked political rows about national policies, not least in the UK. And the crisis has drawn attacks from US conservatives, who have criticised the WHO’s supposed deference to the Chinese government.
It is clear that governments are not always listening to the WHO. When Dr Tedros addressed G20 leaders last Thursday, he called for a united global response to the pandemic. But the meeting failed to produce the kind of globally coordinated action seen during the 2008 financial crisis. Governments are continuing to focus on national containment rather than cross-border cooperation.
“The line between technical expertise and politics is sometimes blurred.”
So why is politics apparently getting in the way of the experts and their advice?
The line between technical expertise and politics is sometimes blurred. Experts themselves often straddle the divide. Dr Tedros, for example, is both a leading international expert on infectious diseases and a former Ethiopian foreign minister. The same was true of many of the experts who founded the WHO. This certainly doesn’t mean that experts should be distrusted. But the idea of purely technical expertise entirely divorced from the murky realm of politics is too simplistic.
When politicians ignore advice it’s sometimes because they just don’t trust experts, as seems to be the case with Brazilian president Jair Bolsonaro. But it is also because dealing with pandemics on the scale of Covid-19 is ‘political’ in the purest sense – concerned with the exercise of power over a population. Politicians tell us they are listening to the experts partly because they want to avoid taking responsibility for their own decisions and make us forget their own inefficiencies and flaws.
When it comes to dealing with pandemics on a global scale, the politics of global health is even more important. International responses to the current crisis will not just be shaped by the technical advice of WHO experts, but by the political dynamics which govern our world today – the rise of populism and the far right, the conflict between China and the US, and the inequalities between rich and poor countries.
And it’s important to note that political influence is not necessarily a bad thing. The eradication of smallpox in the 1970s might never have been achieved without the impetus which came from the Cold War tensions between the US and the Soviet Union.
We can’t get through this crisis without listening to experts. The desire of those experts in 1946 to create a ‘non-political’ WHO was an admirable one – we can appreciate today how political conflict can get in the way of fighting disease. But the partial failure of their vision also tells us something important. Global health is always entangled with global politics, and we must be honest about the political forces which will shape the fight against Covid-19.
Dr David Brydan is a lecturer in the history of modern international relations at King’s College London