China, WHO, coronavirus and politics

Health diplomacy is new power in pandemic-ravaged world. Pro-Chinese policies of world’s premier health body and its boss are fuelling Beijing’s ambition to replace US as world's top superpower.
WHO Director General Tedros Adhanom Ghebreyesus with President Xi Jinping. (Photo | AFP)
WHO Director General Tedros Adhanom Ghebreyesus with President Xi Jinping. (Photo | AFP)

In late January, as China continued its viral descent into endless night, a textile businessman, Fang Bin, in Wuhan found a higher calling—the pursuit of truth. He became a citizen journalist and reported on the grisly drama playing out on the desolate streets of his contagion-blighted city and exposed the Chinese Communist Party’s propaganda jukebox that played the tune that all was well; in spite of the corpses piling up everywhere. Five days after Chinese President Xi Jinping’s speech on January 20, urging officials to “reinforce public opinion management”, Fang came across the grisly sight of city buses being turned into impromptu hearses bursting with the corpses of Covid-19 victims.

He posted videos of the macabre images—as health workers dressed in white protective gear loaded the bodies, he can be heard in the background counting “five, six, seven, eight... eight bodies in five minutes!” The government promptly took down the video. Fang disappeared. He has either become just another statistic in a Wuhan bus or could be languishing in the bowels of any of China’s infamous prisons for dissidents.

A few days after the whistle-blower's disappearance, the World Health Organisation’s (WHO) Director General Tedros Adhanom Ghebreyesus met with President Xi and Chinese ministers. His statement issued on January 28 explained, “We appreciate the seriousness with which China is taking this outbreak”. Presently cases worldwide have crossed the 5-million mark. At a press conference the next month, Dr Tedros continued to defend Beijing’s line in the face of international heat: “China targeted the epicentre by locking down Wuhan… and that helped in preventing cases from being exported to other provinces in China and the rest of the world.” Incidentally, WHO is responsible for collating the World Health Report, which surveys health concerns around the globe. An Australia-led coalition of 62 nations, including India, has called for an independent probe into the virus’s origins and the UN body WHO’s response to China’s role. 

A call for the resignation of Tedros by the has gathered one million signatures. The WHO’s reputation is in tatters. China needs WHO as much as Tedros needs Beijing. A global pariah by now after its deliberate bungling of the epidemic, President Xi is looking for an image makeover. Who better to give it a fresh coat of paint than Tedros, whom Beijing helped in 2017 to become the custodian of world health? China had successfully lobbied to appoint him as the successor to Margaret Chan, a Chinese-Canadian physician who enjoyed two terms as WHO Director General.

Global anger against China’s mishandling of the virus, prompted by the Communist Party’s deep distrust of transparency and inward-looking social ethos, has flared up into a geopolitical conflagration. This is not the first time the country is under fire for its poor treatment of epidemics. During the 2003 SARS outbreak, then WHO Director General Dr Gro Harlem Brundtland was shocked by its approach to containment through use of state force. WHO historically issued its first-ever travel advisory against visiting southern China. Dr Brundtland accused Beijing of a cover-up, media blackout and persecution of whistleblowers. Tedros’s championship of Beijing’s Covid-19 response is in stark contrast to his predecessor’s ethical stand against a government’s callousness towards the safety of its own people.

 Is Dr Tedros Adhanom Ghebreyesus a Chinese lackey? The circumstances are in the pudding. American political science professor Bradley Thayer and Lianchao Han, vice president of the Citizen Power Initiatives for China, have damned him in an article in Hill, a prestigious Washington-based politics and policy magazine. They wrote, “Because of his leadership, the world may have missed a critical window to halt the pandemic or mitigate its virulence.” Japanese Deputy Prime Minister Taro Aso mocked WHO as “the Chinese Health Organisation”.

As the pandemic’s scythe reaped its fatal harvest across China, Tedros sent senior advisor, pandemic expert and former assistant director general Dr Bruce Aylward to Wuhan in February. Aylward gloated, “If I had Covid-19, I’d want to be treated in China.” Tedros had slammed various countries for imposing travel bans on visitors from China, and accused Western countries such as the US and Australia of inciting “fear and stigma” and appealed to world governments to make “evidence-based and consistent decisions” on dealing with the contagion. Evidence was exactly the problem—the Chinese government’s body count was dubious at best. Ironically, WHO’s mandate is “Better Health for All, Everywhere”. 

Its DG even endorsed Beijing’s claims that the virus is not contagious between humans. WHO tweeted on January 14, “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China.” It took over 120,000 confirmed cases and around 4,400 deaths in 114 countries for the health organisation to label the crisis a pandemic on March 11.

When Beijing claimed in March that no more coronavirus cases have been reported for the first time since Wuhan, Tedros was ecstatic. “This is an amazing achievement, which gives us all reassurance that the coronavirus can be beaten,” he crowed. There have been fresh outbreaks but going by precedent, the numbers do not seem credible. In the second week of May, China reported 17 new coronavirus cases, while 11 million residents of Wuhan underwent vigorous testing. After China’s National Health Commission zeroed in on five new coronavirus cases in Jilin Province two weeks ago, the city remains in lockdown. 

Covid-19 tests being conducted in Wuhan, China
Covid-19 tests being conducted in Wuhan, China

Tedros, an Ethiopian citizen and former health and foreign minister, has a shady past in public life. He is not a medical doctor, nor does he have experience in meeting global health crises. Tedros continues to hold a senior position in the Tigray People’s Liberation Front, which has earned a black mark in the Global Terrorism Database. He is also the first African to head WHO—China has deep business and political links in that continent. As soon as he came to power, Tedros selected Zimbabwe dictator Robert Mugabe as WHO’s goodwill ambassador. Singed by international outrage, Tedros cancelled the appointment a few days later.

China had supported Mugabe’s leadership of Zimbabwe’s independence struggle. The despot was a frequent flyer to China; in January, President Xi had assured him, “China will never forget its old friends.” This time, it did. Perhaps Tedros needs China more than ever now. The day after his election, he promised to back the “One China” principle that recognises the government in Beijing as the legitimate Chinese government, which claims that democratic Taiwan is part of the country. Since 1971 when it joined the UN, China has being blocking Taiwan’s WHO membership. Kept out of WHO, Taiwan is forced to depend on heavily censored Chinese data, which is often delayed for weeks. 

WHO has inexplicably argued that masks do not protect people in spite of research showing their efficacy rate at over 90 percent. China’s medical diplomacy is in stark contrast with the treatment of its own people and is meant to shore up its eroding global image. China despatched doctors to Italy, Iraq and Iran, ventilators to France and PPEs to Cambodia and the Philippines. The equipment was not so different from other Chinese products, which are known across the world for cheap price and poor quality. Italy found Chinese masks not up to international standards. The Netherlands recalled its order of 600,000 masks from China. Spain junked around 50,000 made-in-China testing kits whose accuracy rate proved to be just 30 percent. The Slovak government found the 1.2 million Chinese antibody tests it had bought from China of poor quality. So did the Czech Republic, which purchased 300,000 quick tests from China—one-third were defective. Turkey too was dissatisfied. In the face of such criticism, Tedros has remained schtum on a critical aspect of healthcare—quality. 

What has happened to the world’s once-most trusted and credible health organisation, which was founded in 1945, spearheaded the global effort against smallpox, polio, HIV, malaria and tuberculosis, and has 194 member states? Tedros presides over a gargantuan organisation with 150 offices worldwide and around 7,000 employees. A glimpse into WHO’s workings offers startling insights. The organisation is funded by member states and private contributors like the Bill and Melinda Gates Foundation. With recovery of dues at an all time low, Chinese largesse is its lifeline. After President Donald Trump put the brakes on funding to WHO—the US is the biggest donor with $400-500 million a year in 2018-19 or 15 percent of its total budget—Beijing will be adding an additional $30 million to its current contribution of $86 million. In April, China promised WHO an extra $20 million.

The organisation is caught in the spindrift of Beijing’s expansionist plans. Margaret Chan had notoriously applauded pro-Beijing North Korea’s healthcare system as the “envy” of “other developing countries”. She praised Syrian dictator Bashar Assad as “a president who is working for his people and his country”—he is known for employing poison gas attacks against his own people. Chan brought Xi Jinping to the WHO headquarters, the first such visit by any Chinese leader.

An ancient Chinese proverb goes, “Be not afraid of growing slowly.” The US’s vacuum in global leadership has strengthened China’s control over the United Nations. Chinese politicians and officials head many important UN bodies that oversee food and agriculture, telecommunication, development, climate change and inequality issues. China is in a unique position to be the top superpower of the 21st century. Countries like Britain, Germany and France, which rely on American military protection, are also economically close to China. President Trump’s strident rhetoric isn’t helping. His isolationism, mutual distrust with Europe and his own government, questionable acquiescence to Russia and trade war have left space open to Beijing to step in.

The US leads in the world in coronavirus cases. Its economy is predicted to shrink by one-fourth and recession looms. Europe’s supply chains have been devastated. UK economy faces a cash crunch. Russia’s Vladimir Putin is on shaky ground after oil prices plummeted and as Covid-19 cripples its economy. Should Russia, in spite of Putin’s public criticism, tilt towards China, the borders of Western Europe will move closer to China giving NATO the jitters.

At this point, Bejing seems poised to come out ahead since the worst of the contagion is now behind it—even if it isn’t, China’s ruthless control over information and willingness to imperil its population will give it a clean bill of health, thanks to followers like Tedros. Slowly shops are starting to reopen, factories have started work and people are stepping out of homes. The predictions that the US companies will pull out of China to India and Vietnam seem distant (see box)—the most recent US-China Business Council survey found that 97 percent of foreign companies in China were profitable, and 87 percent had no plans to relocate. 

A global geopolitical realignment and carving new economic borders are in the offing. China’s medical diplomacy seems to be working with a little hand from functionaries like Tedros who help propagate China’s story as the only victor over the virus—“China’s signature strength, efficiency and speed in this fight has been widely acclaimed,” declared Foreign Ministry spokesman Zhao Lijian. President Xi phoned Italian Prime Minister Giuseppe Conte to show his desire to establish a “Health Silk Road” as part of China’s global One Belt One Road (OBOR) initiative—a sort of Chinese Marco Polo in reverse monopolising world medical trade. Serbian President Aleksandar Vucic declared that “the only country that can help us is China.”

The dragon’s main competitor to dominate the 21st century could be India, which controls the other half of the pharmaceutical resource universe. The relationship is complicated;  on one hand China has opened its doors to Indian drug companies while escalating border conflicts. It has massively slashed prices of generic cancer drugs, too. The Chinese propaganda machine is one of the best in the world. The Chinese film Dying to Survive, a dark comedy about smuggling cheap cancer drugs from India to China, is a made-in-China fantasy of cross-border drug terrorism, which creates at home the image of India as the traditional devil. In this situation, the India-China pharma paradigm is changing in unexpected ways. Both are the world’s top generic drug producers.

A poster of 2017 Chinese action filmWolf Warrior II 
A poster of 2017 Chinese action filmWolf Warrior II 

Money and more money drives business and economies. India has benefited from the US-China trade war on pricing. Beijing threw open its financial frontiers to Indian drug companies well before Covid-19 hit Wuhan. Last year, Cipla unveiled plans for a joint venture with Chinese pharma company Jiangsu Acebright Pharmaceutical, which will hold only 20 percent. Both Sun Pharma and Aurobindo Pharma formed joint ventures with Chinese firms; significantly most of these deals were to manufacture respiratory equipment. Dr. Reddy’s Laboratories will launch around 70 products over time and intends to build a new plant. Ironically, Indian drugs are rarely seen in China because they are generic. In the cut-throat world of big pharma, the Chinese are offering whopping  90 percent discounts to bidders for supply contracts. The IT brain drain could be outpaced by the pharma brain drain: China is wooing Indian drug formulation experts with 300 percent pay raises.

Karin von Hippel, Director General of the Royal United Services Institute, recently told The Atlantic monthly that “some kind of reckoning with China” is likely. She said, “Some countries will emerge from this trying to cling to China… but most others are likely to try to decouple.” China manufactures most of the active pharmaceutical ingredients of antibiotics—its share of the US antibiotics market exceeds 95 percent. Even masks have been weaponised in the Age of Coronavirus; Washington’s failure in generating enough test kits contrasts with China’s mask charm offensive. Alibaba co-founder Jack Ma will be sending massive numbers of testing kits and masks to the US, and 20,000 test kits and 100,000 masks to all 54 African countries.

If technology, IT and AI were the icons that defined 20th century progress,  Covid-19 has taken Health Power to the top of the 21st. A new geopolitical equation that engages the existing growth engines fuelled by China’s captive domestic labour supply and R&D  could see a new Leviathan in play. Life is cheap in both China and India, where poverty and mortality hide beneath the glitter of progress. The crucial difference is that India is a democracy. As the Wuhan containment operation revealed, China’s total disregard for human rights  combined with an aggressive global PR effort will burnish Beijing’s image as the proactive leader who put its house, or rather hospital in order, while other powers suffered. In this context, WHO is not a pawn. It is the whole game.

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