In China, a small team of international experts led by a Canadian epidemiologist arrived on Monday and got to work investigating the novel coronavirus outbreak.
In Geneva, hundreds of physicians, scientists and public-health leaders prepared for a two-day conference that will set global priorities for studying and fighting a new virus that has killed more than 1,000, sickened more than 42,000 and spread to two dozen countries.
The two events, unfolding thousands of kilometres apart, are both fronts in the World Health Organization’s battle against the coronavirus – a battle that is shaping up as the latest test of the United Nations health agency’s ability to take on new pathogens in an interconnected world.
The WHO’s response to 2019-nCoV, as the virus is known, has drawn both plaudits and derision.
Some critics say the agency has heaped more praise on China than its government deserves, while others worry about the long-term consequences of some member states defying the WHO’s advice against closing borders to travellers from China.
Still others agree with Steven Hoffman, director of the Global Strategy Lab and a professor of global health at York University, who says the WHO is “between a rock and a hard place.”
“They need the co-operation of China in order to mount an effective global response to this outbreak," Dr. Hoffman said in an interview from Geneva, where he is taking part in the WHO’s 2019-nCoV research and innovation forum Tuesday and Wednesday.
"If I was the head of the World Health Organization, my No. 1 priority would be to keep China engaged in the global response. If the cost of doing that was praising China, then I would do it.”
The WHO’s director-general, Tedros Adhanom Ghebreyesus, has repeatedly hailed the Chinese government for its handling of the epidemic, including after meeting with President Xi Jinping in Beijing on Jan. 28.
“The speed with which China detected the outbreak, isolated the virus, sequenced the genome and shared it with WHO and the world are very impressive, and beyond words,” Dr. Tedros said on Jan. 30, as he declared the outbreak that began in the City of Wuhan a global health emergency. “So is China’s commitment to transparency and to supporting other countries.”
That sentiment has since been undermined by reports that the Chinese government initially suppressed information about the outbreak, including by detaining Wuhan doctor Li Wenliang for saying that a “SARS-like” virus had emerged in the city at the end of December.
He later died after contracting the acute respiratory illness caused by 2019-nCoV.
The advance team of experts that landed in Beijing on Monday – led by Canadian Bruce Aylward, an epidemiologist, emergencies physician and long-time WHO staff member – arrived nearly two weeks after the Chinese government first agreed to allow international experts in.
However, Michael Ryan, executive director of the WHO health emergencies program, told reporters Monday that the agency’s physicians and scientists were already in constant contact with their Chinese counterparts.
“This is not a voyage into the dark," Dr. Ryan said. "This is going to reconnect with scientists that we’re already working with on a day-to-day basis.”
Kumanan Wilson, a doctor at The Ottawa Hospital and a member of the University of Ottawa’s Centre for Health Law, Policy and Ethics, said the WHO hasn’t admonished strongly enough the countries, including the United States, that have ignored the WHO’s advice against travel restrictions.
The U.S. and some other countries have barred foreign nationals who recently travelled to China, despite Dr. Tedros urging member states not to impose travel restrictions on China.
The Canadian government has not followed suit.
“I think it reduces the credibility of the WHO on this issue,” said Dr. Wilson, who has acted as a consultant to the WHO on the International Health Regulations, a legal instrument designed to ensure a consistent global response to acute public-health risks. “It’s unfortunate because, as we can see, it’s a bit of a Wild West out there."
Kelley Lee, a Simon Fraser University professor who holds a Canada Research Chair in global health policy, said part of the difficulty is that the WHO is delivering a “mixed message,” telling the rest of the world that travel restrictions are unhelpful while supporting a Chinese government that has effectively locked down Hubei province, home to 57 million people.
However, Dr. Lee said the WHO is performing well under extraordinarily difficult circumstances, especially when it comes to helping co-ordinate the work of scientists all over the world. About 400 are expected to participate in the two-day forum in Geneva beginning Tuesday.
“We haven’t really resourced WHO very well," Dr. Lee said. “It has limited staff and they’re incredibly busy right now and doing the best they can under unusual circumstances.”