JOHN DWYER. Trump, Xi and the WHO.

President Trump, always blaming someone to hide his own inadequacies, has vented his fury on both China and the WHO. The WHO, for one precious week, had accepted China’s advice that the novel respiratory infections were not transmitted from human to human.

So, in the middle of the most fatal epidemic since the Spanish flu, Trump will withhold the US’s annual WHO contribution of some $400 million. WHO’s crucial work is being crippled. Chronically cash strapped, WHO is currently owed some $200 million dollars by the US! Vale Bill Gates for his promise of $100 million’.

We are certain that COVID-19 did not originate, nor escape, from the Wuhan corona virus laboratory. This universally regarded centre of viral research receives grants from numerous sources, including the US National Institutes for Health (NIH). It is frequently visited by America scientists.

COVID-19’s mutations, allowing it to infect humans, cannot be generated in a laboratory. Mutations occur when the virus is challenged by an immune system. That struggle drives random viral experimentation for survival. In other words, a mutated virus is created within an animal.

We simply don’t know whether or not animals infected with the mutated virus were present in Wuhan’s ‘wet food’ marketing of exotic (‘wild’) animals.

Bat to pangolin to humans is highly probable. Pangolins can drive corona viruses to produce a molecule which cuts through a cell’s surface – allowing viral entry.

The vast majority of the thousands of wet markets, relied on by millions for their daily food, don’t sell exotic non-farmed animals. Although China has apparently banned the sale of live exotica, a number of reports suggest that their exports to Asian countries continues.

China’s provision of inaccurate information to the WHO, and its persecution of the first doctor to recognise this epidemic, were disgraceful. It is easy, in retrospect, to suggest that the WHO should have been more skeptical. However, relevant to Trump’s attack is the fact that, at the time China contacted the WHO, more than a dozen senior US Health officials were working at the WHO’s headquarters in Geneva. They would have been privy to the Chinese reports. What they did or did not report to the US government is not known.

I’ve had much experience of the WHO. My first interaction occurred in 1974. For a number of years, sub-Saharan Africa had experienced a crippling drought. The World Bank was willing to fund a dam on the Senegal River, which separates Mauritania from Senegal. Over time, it would lead to desalination of the river. Fresh water would be a blessing; but it could create problems by increasing the incidence of water-related infectious diseases, especially malaria and onchocerciasis (river blindness).

Infectious disease specialists and immunologists at Yale University (where I was working at the time), were asked by the WHO to visit and report on mitigation strategies. For a young clinician/scientist, this was a disturbing and challenging adventure. On our first day in Dakar, I was shocked to see, at the major hospital, a dozen or so children with massive temperatures, experiencing epileptic seizures as they died from cerebral malaria.

At the end of our fortnight, the head of our university’s immunology program at Yale, Byron Waxman, and I reported to WHO. We noted that there were no West African immunology laboratories to combat the likely threats to health which the dam could create. I was impressed by the expertise and dedication of the WHO staff, both locally and at its spartan Geneva headquarters which we visited on our way home. We were awarded a grant to set up a state-of-the-art laboratory in Dakar. I spent a month there during each of five years. The range of crucial health projects for these developing countries, initiated and implemented by WHO, was inspiring.

My next involvement, lasting ten years, commenced in 1985. For the previous two years, my life at Yale was dominated by the HIV/AIDS epidemic. In those tragic early days, when we knew so little, all our patients died. On my return home that year, I was shocked at the southern hemisphere’s complacency. Indeed, some governments were referring to the ‘Northern’ virus. Thailand was then the only HIV-affected Asian country. I found the Thai Red Cross and WHO struggling with a rapidly expanding infection amongst both the homosexual and heterosexual populations. One research program involved paying prostitutes to measure the size of their customer’s penises because standard western condoms were too big!

Visiting more Asian countries, I interacted more and more with the extraordinarily talented and dedicated Geneva WHO leadership team, implementing world-wide strategies to control HIV.

In 1990, I led a team of Australian scientists, sociologists and community representatives in establishing ‘The AIDS Society for Asia and the Pacific’. Enjoying a rewarding partnership with WHO and the New York-based ‘United Nations Development program, (UNDP), we held Conferences in many countries. I report this history to emphasise the invaluable contributions made by these international agencies towards improving world health and tackling public health crises. The thought that Trump’s withholding funding, in the middle of the worst epidemic in a century, could financially cripple a zillion crucial projects is truly obscene.

However, I regret that my most recent engagement with WHO has not been positive. It provides credence to the idea that China has disproportionate influence there. President Xi is fixated on having the world accept the wisdom and practice of ‘Traditional Chinese Medicine’. He is championing TCM to treat, and even cure, COVID–19 infections. His government is promoting and financing the use of TCM in over 80 countries. Australia’s bilateral trade agreement even includes support and expansion of the use of TCM here.

In 2019, WHO, despite its commitment to promote only evidence-based medicine, gave undeserved credibility by endorsing TCM. Leading scientific journals have been rightly critical – indeed outraged. Not only is TCM based on pre-scientific concepts, it is intimately involved in promoting the alleged medicinal properties of anatomical parts of exotic animals. The trade in such animals is largely driven by these nonsensical beliefs.

I explored this subject in P&I in October 2018. ‘Friends of Science in Medicine, which I co-founded in 2011 to promote evidence-based medicine, managed to persuade WHO to delete its website support for more than a hundred non-evidence-based claims for the efficacy of acupuncture. Since then, however, Chinese pressure has resulted in this backward step in WHO’s mission to provide effective health care to the world.

Disappointing as this might be, it must not detract from our support for so much of WHO’s invaluable work.

With Gratitude for Editorial assistance from Dr Peter Arnold
Professor John Dwyer, Immunologist and Emeritus Professor of Medicine at UNSW

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Professor John Dwyer, Immunologist and Emeritus Professor of Medicine at UNSW

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