EDITORIAL

Why WHO?

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Science  24 Apr 2020:
Vol. 368, Issue 6489, pp. 341
DOI: 10.1126/science.abc3400

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PHOTO: CAMERON DAVIDSON

Pandemics are international. A virus doesn't respect borders between countries—or between states, as we are seeing with severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) in the United States. Unfortunately, too many world leaders want to treat the situation as a problem for their nation alone and not the world.

Science will rise to the challenge of coronavirus disease 2019 (COVID-19) and is doing so. The structures of the most important SARS-CoV-2 proteins are now known. Although we are still in the early stages of understanding human immunity to the virus, neutralizing antibodies are being identified. Clinical trials have begun on vaccines and drugs. There's no shortcut, but there's reason to think we can conquer this if we can get enough time and collaboration. Most world leaders don't seem focused on giving the scientific and biomedical communities these two things.

China didn't do well in all this. In February, I thought my editorial on how China's secrecy about the new coronavirus led to the loss of life was an “edgy” commentary. Now that piece doesn't seem so daring at all because it's clear that China's delays and secrecy cost lives. Sadly, other governments' delays in action and delivery of misinformation have been costly as well.

The United States needs to uphold two apparently conflicting ideas: China covered up the initial spread of the virus, and we can't solve this crisis without collaborating with China. The World Health Organization (WHO) has walked a very fine line of trying to manage the pandemic without offending China. Last week's decision by the United States to suspend support for the WHO is not only dangerous but could delay a resolution to the pandemic. As Science's news reporter Kai Kupferschmidt tweeted, “This is like suspending firefighters while they are trying to save your house from the flames, pending a review of whether the trucks arrived later than they should.”

The amount of money at stake in funding the WHO is a tiny fraction of the total of the other costs of the pandemic. The total annual budget of the WHO is less than $2.5 billion, which has been compared to the annual budget of one relatively large academic medical center in a major U.S. city. That's a small price to help the whole world manage this health crisis.

Furthermore, the time for assigning blame should be reserved for after—not during—the crisis. Plenty of politicians have had their differences with the WHO and the United Nations over the years. Is now a good time to air all of that? The U.S. administration passed on using the WHO's viral diagnostic test, but then the U.S. Centers for Disease Control and Prevention (CDC) bungled their own version, costing Americans at least a month in controlling viral spread. That doesn't exactly give the administration a strong case for bailing on the WHO.

Yes, China did a lot to create this problem. But the world can't solve this without cooperating with Chinese scientists. Most of the important papers that Science has published over the past 6 weeks have been from Chinese scientists or have included Chinese collaborators. And the United States has been happily selling its debt to China, educating their students, and letting them make most of our stuff for 40 years. If the United States has decided to change these policies, then doing so—and abruptly—would probably be impossible, especially in the midst of a global pandemic.

Nobody wants to continue social distancing forever (or thinks they can). Even the most pessimistic modelers of COVID-19 spread agree that this degree of behavioral change can't be sustained for many months. But the tools needed to get to the next phase in the United States are still not showing up: increased testing, staffing and gear for the hospitals with the greatest needs, and masks for everyone.

Courageous and confident world leaders believe that nations work best together through international institutions; this process has benefited the world for decades. Weak leaders believe in this but only if it benefits their country alone or even themselves. The WHO is not perfect, but it has helped put out many fires around the world for a long time.

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