How the West gets the WHO and Tedros wrong
By Henok Reta, June 21, 2020
(Ethiopia Insight) — Western failings and US-China’s tensions led to unfair accusations against the global health body and its Ethiopian boss, Tedros Adhanom Ghebreyesus
In June 2014, attending a Partnership for Maternal, Newborn and Child Health conference in Johannesburg South Africa, I boldly predicted that Tedros Adhanom Ghebreyesus would be the next director general of the World Health Organization (WHO). I had just heard Margaret Chan, the Chinese-Canadian physician heading the WHO at the time, celebrating results achieved in reducing maternal and infant mortality rates across the globe.
Tedros, Ethiopia’s former Minister of Health, was one of those whose leadership and achievements she praised, dropping hints about her ‘preferred’ successor. In his remarks, Tedros, by then Ethiopia’s Foreign Minister, praised the political leadership at home while also referring to his successes at the Ministry of Health, causing many to see him as more of a typical African politician than a possible WHO’s conventional head. Nevertheless, he was chosen as the next Director-General of the WHO two years later.
In the past few months, the COVID-19 saga, the deadliest pandemic in over a century, has dominated global affairs, claiming almost half a million lives, while infecting just shy of nine million. Lockdowns have been put in place in many places and fundamental human rights are being suspended to help the fight against one of the nastiest viruses humans have ever encountered. With all states launching strategic crisis management plans to prevent, contain, and hopefully get rid of the pandemic by the end of the year, Tedros has become a global embodiment of a raging debate, finding himself denounced by government officials, media and affected families looking for someone to blame. A petition calling for his resignation hit a million signatures in mid-April.
The WHO was created in 1948 after diplomats from across the world met in San Francisco to launch the United Nations program in 1945. They set up a global health organization, whose constitution came in to force upon its establishment. China was one of the leading nations from the inception of the organization that aimed at consolidating national efforts to tackle health issues. WHO’s epidemiological mission to obtain information, assess it and then offer advice to member states on the precautions and treatment procedure to follow, were major advances in the first few decades.
Having adapted the International Health Regulations (IHR), the rules that countries must follow to identify disease outbreaks and stop them from spreading, the WHO developed a monitoring model for nations’ health systems but without interfering in domestic health policies for which it has no authority. Applying result-based management and supervision policies, WHO sends in experts, analyzes situations and can then respond to any health issue of member states threatening any uncontrolled spread posing a danger to the rest of the world, according to the WHO publication Working for Health and Growth.
Its job, in effect, is to promote standards, coordinate global efforts, develop ways to treat disease, release information, check out warnings and dangers, declare pandemics. Experts suggest WHO should be funded better in order UN to maximize its operation across the world, considering the delicacy of the business in which it is involved. Developing the capacity of its 8,000 and more public health experts and scientists to ensure they are up to the level for carrying out WHO’s responsibilities is vital. Looking into the funding details, experts highlight the difference in funding priority. Funders’ relative importance to each organization is another factor to consider during a pandemic. According to Brooking Institution, the World Bank’s International Development Association (IDA) and the UNDP are the organizations that receive the largest backing by top donors such as U.S., UK and Germany, while WHO and other organisations attract smaller countries like Switzerland, Norway, and partners like The Gates Foundation.
The litany of complaints and criticisms against WHO related to the coronavirus outbreak started to make headlines following the growth in infections and deaths in China’s Wuhan province, where the novel coronavirus is believed to have originated. Western media outlets blamed China’s initial lack of transparency for tens of thousands of deaths globally, for the massive economic recession, and accused the WHO of concealing China’s failures in handling the outbreak from the outset. Western media, including Fox News, have campaigned for the resignation of Tedros for alleged incompetency, adding claims of connivance between the WHO chief and Chinese officials. They attacked Tedros for whatever he said or tweeted that was positive about the Chinese Communist Party government, making allegations of a cover-up, some of which has been backed up credible media reports.
In recent years, Western leaders have seen Africa, and particularly Ethiopia, as central to China’s strategy to weaken longstanding American clientism on the continent. Often viewed as a gateway to Africa, Ethiopia hosts the African Union (AU), and the UN Economic Commission for Africa (ECA). Kuang Weilin, China’s former ambassador to Ethiopia and the AU, once told reporters that whatever China did in Africa through the African Union was because of its mutual special relationship with Ethiopia. One landmark in this special relationship has been the $200 million dollars 20-storey office-tower of the AU, a gift from China’s state-owned construction company in 2012.
Ethiopia itself now owes more than $12 billion in loans to China. A 2018 CNN report on Sino-Ethiopian investment in infrastructure claimed Ethiopia’s capital, Addis Ababa, was starting to look like a Chinese city. From trains and buildings to roads and highways, from industrial parks and factories to vocational institutes and small businesses, China has become a major player in the development of Ethiopia’s infrastructure.
The late prime minister Meles Zenawi sought closer ties with China shortly after his trip to country in 1995, breaking away from Ethiopia’s historic western partners. In addition to Ethiopia’s economic boom after the millennium, political ties have grown. The current ruling party of Ethiopia, now Prosperity Party after the changes and reforms that began in 2018, has continued warm relations with the Chinese Communist Party. When China was struggling with problems over Tibet and Taiwan, Ethiopia backed Beijing and encouraged key members of the African Union to do the same. One of notable analysts who studied the deep rooted Ethio-China strategic partnership over the last couple of decades, is former U.S. ambassador David Shinn. He once said “Ethiopia and China have developed an especially close relationship in the 21st Century. Chinese influence in Ethiopia today is equal to or rivals that of any other country, including the United States. It was not always so.”
In turn, China has never criticized Ethiopia for its poor human right record, long a point of controversy between Ethiopia and the West. It lobbied for Ethiopia’s interests in the United Nations’ Security Council, and is believed to have played a role, along with the U.S. and the U.K., in pushing Ethiopia’s, and IGAD’s efforts to isolate Eritrea. Ethiopia’s government sent influential and experienced ambassadors to China, including former president Dr. Mulatu Teshome, and former Foreign Minister Seyoum Mesfin to encourage the vast economic possibilities and political stability for “Africa’s China”, as economist Tyler Cowen called Ethiopia in 2018. In an emerging China-centric world order, Ethiopia, along with the rest of Africa, has benefitted substantially from China’s influx of credit and co-funded investments.
Whenever western powers, particularly the U.S. see this, they have a knee-jerk reaction, producing toxic political rhetoric, talking of China’s ulterior motives and influence vis-à-vis U.S. Indeed, the former hegemonic powers are having a hard time adjusting to their diminished impact on the continent and wherever China sets its feet. Particularly, after Donald Trump’s presidency, this rivalry showdown between the “West/US” and the “East/China” has been on display in Africa. And some even attribute every major global crisis to the repercussion of wrestling between those power houses. The COVID-19 crisis could be one of those phenomena that shape the new world order. Indeed, arguably allegations and criticisms over the pandemic owe more to anti-Chinese positioning than any focus on the issues of how Tedros or his organization have handled the outbreak. This is a foolhardy approach.
Tedros, China and the media
Any bid for senior UN positions involves the need for support from other countries. Tedros’ bid for the position of WHO Director-General was quasi-governmental and involved others in the campaign. According to Sunday Times columnist, Rebecca Myers, Chinese diplomats campaigned for the then-Ethiopian Foreign Minister, using Beijing’s financial clout and opaque aid budget to build support for him among developing countries. There were suggestions China would be pleased with any African or Asian heads for any UN agency because of the difficulties of dealing with more critical Westernized director-generals.
Peter Navarro, the White House’s Trade Council Director, recently accused China of helping its “proxies” get elected to UN agencies, mentioning Tedros as one of the five director-generals of UN agencies favoured by China. A very outspoken critic of China, Navarro even suspected China seeded the world with the virus, which they could have controlled rather keeping it a secret while it was spreading to become a global pandemic. With more than 2.3 million cases and 121,000 deaths from COVID-19, so far, the U.S. is the worst affected country in the world and has been dependent on laboratory equipment and testing kits distributed by China.
It wasn’t only China, in fact. Some European pundits also slammed the West for paving the way for Tedros’ election success, citing the U.K.’s acceptance of Tedros at the G-20 summit. As Ethiopia’s top diplomat he helped Ethiopia to stay in the West’s good graces after the passing of Meles Zenawi, and kept Western funds steadily flowing into Addis Ababa, despite growing concerns about the former prime minister Hailemariam Desalegn’s leadership, violations of human rights, and the imposition of states of emergency. Tedros, indeed, played an important role in reaffirming Ethiopia’s position as a stable and strategic partner in the war against extremism and terror in the Horn of Africa.
American or Western criticism of Tedros started way earlier than the coronavirus outbreak. It was only seven months into his tenure when he appointed Zimbabwe’s Robert Mugabe as a goodwill ambassador for WHO, though this was quickly rescinded after widespread, and understandable, complaints. He also appointed Tereza Kasaeva, a little-known Russian official to run WHO’s tuberculosis program, a decision that raised genuine concerns because her national record revealed her own and Russia’s poor record on TB and HIV. The western media went further in probing Tedros’ tenure as board chair of the Geneva based Global Fund, launched in 2002 to fight HIV/AIDS in developing countries.
The fund has been rocked by claims of fraud and misappropriation of budget and, according to the Clinton Foundation, whistle-blowers claimed substantial amounts of money were misspent in Mauritania, in Mali, and in Djibouti. What has awoken Western media, however, is Tedros’s acquaintance with the Bill & Melinda Gates Foundation, a key partner of the health sector. The Foundation donated a total of $2.24 billion in partnering with the Fund. Similarly, the Gates Foundation has emerged to be the second-largest funder of WHO since 2017. It has contributed almost $327 million to the WHO’s general and fiduciary funds. Following President Donald Trump’s move in cutting off the funds of WHO, the philanthropic organization reassured the beleaguered organization of its continued support.
Tedros’ track record as a Minister of Health was a success story for employing some 30,000 health extension workers, mostly female high-school graduates with only a year-long training, to set up of an exemplary primary health care system that the rest of the continent can emulate. As a result, he was praised internationally for the reduction in newborn and maternal deaths in Ethiopia, and that led to him being tipped him for the role in Geneva. His time as health minister between 2005 and 2011, was, however, also marred by scandals about public health, caused by his political loyalty to the regime that was widely viewed as authoritarian, including by the western media and NGOs.
The infamous cover-up of the cholera outbreaks—the government insisted everyone call it ‘acute watery diarrhea’—in Ethiopia, between 2006 and 2010, under his watch, fired up criticism of his candidacy for WHO director general when he started campaigning in 2016. That lack in transparency, Tedros still hesitates to admit it as a cholera epidemic that he was complicit in the cover-up, coincided with a similar stance by WHO earlier. According to leaked emails, produced by the Associated Press, WHO had a similar track record over delays in declaring a global emergency during the Ebola outbreak in West Africa between 2014 and 2015. This failure, which some have tried to call a ‘cover-up’, is said to have intensified the threat and increased the number of deaths by then. Critics have cited these analogous incidents to question Tedros’ ability to divulge the facticity behind the scene that the world needed to know urgently for the sake of planning responses for the pandemic.
However, not everybody is against Tedros. Despite concerns over his apparently “China-centric” positioning, part of scientific community stand by him. “He coaxed China into letting a small team of WHO (experts) on the ground in China, which was no easy task,” said Lawrence Gostin, director of Georgetown University’s O’Neil Institute for National and Global Health Law. Gostin, although sharply critical of Tedros in the past, has now been telling fellow Americans that the WHO chief deserves “high marks” for his handling of the coronavirus. J. Stephen Morrison, a U.S. global health expert, acknowledging Tedros’ difficult situation facing a “once-in-a century public health calamity,” has criticised President Trump for blaming WHO and Tedros in pursuit of his own political gain.
Tedros’ response to his critics has, however, been less than effective. Aspects of a good leader include a calm assured demeanour, the ability to keep the trust of all around him, and the ability to stay in control no matter what the situation is. Arguably, what many would like to see in Tedros in this situation would be a display of compassion, attentiveness, clarity, and, not least, apology prior to any investigations. In fact, his immediate reaction to the allegations and concerns has been to try to deflect and create sympathy for his own role. This apparent attempt at evasion and diversion, shying away from accepting any blame, is not likely to convince the West he is committed to address their concerns.
Many believe Tedros should have publicly and quickly emphasized his determination to deal with any problems, rather than attributing wrongdoing and undesired outcomes to external sources. One explanation for the ‘blame game’ is that shifting accountability is an unconscious defence mechanism, designed to insulate fragile egos. Taking responsibility for allegations and shortcomings and apologizing for them is the best way to start clearing up a mess. Externalizing is always dangerous and sometimes counter-productive.
Tedros’ WHO leadership problems are somewhat reminiscent of Kofi Annan’s experience as UN Secretary General from 1997-2006. From the peacekeeping scandals of the UN forces deployed in Burundi, Sierra Leone, and Bosnia to the UN’s administered Oil-for-Food Program in post-Saddam Iraq, the UN was heavily criticised by many Western media and human right activists. Rather than taking any official responsibility for the allegations and failures for which he was always held responsible, Kofi Annan made accusations that his critics were racially motivated. As with many Africans, I empathized with him, but the best way to deal with allegations and criticism is to take ownership, reassuring everyone that thorough investigations would be carried out to restore credibility and trust.
PR gap—the missing link?
The problem with Tedros could be incompetence, as some claim, but I would question the level of incompetence and from where it comes. UN agencies are run by teams of experts who play major roles along with the director general. WHO has plenty of experts, but does Tedros have the public relations experts necessary to deal with crisis situations? We have not seen a concerted neutralization effort by the WHO leadership, apart from some efforts by Dr. Bruce Aylward, senior advisor of the Director-General who has downplayed Donald Trump’s accusations of WHO’s China-centric views, and more importantly noted for his “the world is in your debt” admiration when talking about the role of the people of Wuhan.
Aylward was asked by Tedros to lead the WHO-China joint mission on COVID-19 during the onset of the outbreak and has spearheaded several similar missions in the past. He was one of the most quoted media favourites when he led the first WHO/ UN response on the Ebola outbreak in West Africa, and the Zika response. And I expected him to team up with Tedros for media events which the WHO Director-General has conducted almost single-handedly.
If clarity is the goal, and this is especially desirable in the midst of a global health crisis, it would have been wiser to organize a well-oriented public relations team to deal with the allegations and finger-pointing. In New Zealand, whose effective crisis management response and clarity of communications throughout the lockdown period has been praised, the Prime Minister has been accompanied by the Director-General of Health and the Minister of Economy at press conferences to ensure a sense of transparency and accountability, easing the public’s concern.
Despite the unfairness, even irrelevance, of mentions of Ethiopia as a sort of colony for China, by Jesse Watters, a political commentator on Fox News, or comments on the political ideology of the ruling party when Tedros served as a minister, Tedros has hardly defended himself and WHO successfully. Indeed, his failure to respond to the allegations and the mounting pressure on WHO is a clear sign of what he and most fellow Africans leaders lack—effective public relations. Ignoring that Western media criticisms spring largely from their anti-China stances, we should nevertheless accept the growing concern of those who have raised questions about WHO’s competence and effectiveness. We should respond to these.
Equally, we should not be defensive. Apropos of any proposed investigation into WHO or Tedros, it should be made clear to western media that emphasising Tedros’ background or Ethiopia’s relations with China have nothing to do with his performance at the WHO. In the last resort, most of the attacks on Tedros, and indeed on WHO, are as Lawrence Gostin said “utterly irresponsible” during a “once-in-a-century” public-health crisis. Moreover, they are part of the anti-China policy of President Trump and the U.S., and have little to do with the actual competence of either the WHO or of its Director-General.