At what point is the only responsible course of action to disband the WHO?

Every time I hear something new about the World Health Organization it seems to just get worse and worse and worse. I'm beginning to think that the only responsible course of action at this point is to shut it down as a public health threat.

It no doubt has a lot of competent people working but it but it's errors and omissions seem at this point entirely inexcusable. Just one of today's additions to the WHO backstory is discovering that back in 2017 the New York Times reported claims and evidence that the man now in charge of the WHO had been responsible for covering up evidence of cholera epidemics as health minister of Ethiopia. And there's there this segment of an interview with RTHK in Hong Kong:

Bruce Aylward was described in February by the CBC as team lead on the WHO-China joint mission on COVID-19. Why is Taiwan of particular relevance here? They warned the WHO of human-to-human transmission in late December ... and the WHO didn't pass the information along:

The timing of that puts it a day after Li Wenliang in Wuhan sent out a warning that authorities in China tried to suppress - i.e. the timing of Taiwan's warning fits the data. The World Health Organization, by contrast, stated two weeks later that preliminary investigations found little evidence of human-to-human transmission.

Then there was the issue of travel bans - again something advised against by the WHO back in January. Now that it at least claims to have gotten things under control in the country - though its claim seems suspicious - even China is banning almost all foreigners from traveling into the country.

Then there's the issue of wet markets where the latest virus seems to have originated - as did the previous SARS virus. Is the WHO calling for those to be shut down and replaced with something more sanitary? Nope. Instead they're merely offering tips for working there1.

And then it comes to the issues of masks, this is what a WHO account still was saying on March 26:

That's not the same tone you'll see if you compare to certain other parts of the world, and it seems that by and large those parts of the world that have adopted universal mask-wearing have had better success dealing with the current problems.

The New York Times article cites a study finding that for the previous SARS virus mask-wearing as an intervention appeared to be more effective protection than washing your hands 10 times a day - though you certainly can (and probably should) do both.

It seems to me that the WHO's guidance re: masks (which is still both the official approach taken by both the CDC and the corresponding government agency in the country where I'm living) is - as described on the British Medical Journal's blog - "confusing".

There don't seem to be enough masks to go around, so you could also that one should safe available masks for those in the healthcare sector and then give secondary priority to those in jobs requiring contact with a lot of different people but that's not generally the argument being made. A previous New York Times article suggesting that this seemed to make authorities appear untrustworthy which might actually fuel hoarding of surgical and N95 masks.

Instead a better idea might be to encourage improvised masks. The Czech Republic has made masks mandatory in public and improvisation wherein people frequently sow their own masks seems to be the course that country has staten. The German Medical Association is also now advising people to wear makeshift masks at all times.

If governments start encouraging mask-wearing then they can also start to point people to ways to make more effective improvised masks. The South China Morning Post has published instructions on how to make masks that performed 80-90% as effectively as surgical masks in testing, for example, and other research exists as to the effectiveness of different materials you could use for homemade mask-making. (Based on additional research it also appears that it's possible to render N95 masks sanitary for reuse without loss of filtering ability but those masks remain harder to come by).

If the mask shortage can be addressed by adoption of improvised masks it may then prove possible to adopt the suggestion found in the article Rational use of face masks in the COVID-19 pandemic which was published a days back in The Lancet Respiratory Medicine:

Perhaps it would also be rational to recommend that people in quarantine wear face masks if they need to leave home for any reason, to prevent potential asymptomatic or presymptomatic transmission. In addition, vulnerable populations, such as older adults and those with underlying medical conditions, should wear face masks if available. Universal use of face masks could be considered if supplies permit.

To move to a point wherein mask-wearing becomes universal again goes against the WHO's recommendations. I'm hoping that the US begins to move towards a change in it's official advice - this Twitter-verified account says that a change in the CDC recommendation on mask wearing will happen within the next ten days. I'd like to see a better source for this but with the 2017-2019 head of the FDA tweeting like this back on March 18th and then saying this on video on a Wall Street Journal twitter account on March 25th I certainly wouldn't be shocked by such a change in advice. Former President Obama also tweeted a link to an article wherein mask-wearing was one of the suggestions made.

Thinking back through all the above, I see the WHO as an organization now headed by a man with a history of covering up epidemics and who seemed to be attempting to cover another up in January. It was that same organization that refused to disseminate the information previously received from Taiwan about human-to-human transmission and has shown itself to be childish in its attempts to avoid discussing Taiwan. Its advice in general in these circumstances appears to have been quite poor in general2 and in some ways possibly even counterproductive.

At what point are the only reasonable courses of action to either disband the WHO entirely, or instead to revoke the membership of the People's Republic of China and grant membership to the Republic of China (i.e. Taiwan) instead? I keep finding myself thinking back to the League of Nations formed following the First World War with the intention of stopping further such conflicts. It failed and then in the wake of the Second World War the United Nations - of which the World Health Organization is a member agency - was formed. What should you do when prominent international organizations seems highly ineffective?

  1. One reason that I don't want to target criticism too heavily on wet markets is that factory farming is another danger area↩︎

  2. I haven't even discussed here the problems in the data distributed by the World Health Organization. You'll find, for example, on Our World In Data, a section of the coronavirus information page entitled "Why we stopped relying on data from the World Health Organization" - they instead use data from the European CDC these days. ↩︎