4 September 2020
Summary
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- The World Health Organization (WHO) and Public Health England (PHE) have been widely criticised for their response to the Covid-19 pandemic. Serious questions have been asked regarding their competence. As a result, the US government has withdrawn its funding from WHO and the UK government has announced that Public Health England will be disbanded. This paper looks at what went wrong.
- WHO has been accused of being naive and credulous in its dealings with the Chinese government, and of giving the world a false sense of security about the virus in the early stages of the outbreak. It strongly opposed travel bans and the use of face masks, and has been accused of sidelining Taiwan for political reasons.
- Public Health England was criticised for failing to expand diagnostic testing, failing to expand contact tracing, discouraging the use of face masks, failing to share infection data with local authorities, and overcounting the number of deaths from Covid-19 in England.
- In theory, WHO and PHE prioritise infectious diseases, but both organisations have arguably spread themselves too thinly over a broad range of medical, political and social issues. This has led to a lack of focus: neither agency saw itself as having ‘one job’. Even during the Covid-19 pandemic, they often retreated into their comfort zone of discussing lifestyle issues, such as sugary drinks and vaping.
- The institutional failure of public health agencies does not easily lend itself to free-market solutions, but funding does not have to come from the state and there is room for an element of competition. WHO may be beyond reform, but its most important function of disease surveillance could be carried out by another agency. Member states and private philanthropists could fund a politically neutral global pandemic surveillance organisation, focused solely on viral and bacterial epidemics. Alternatively, an existing organisation could be beefed up to fill this role.
- Public Health England could be replaced with an agency that has full responsibility for planning and executing the nation’s response to viral and bacterial epidemics (see Epilogue). Its health promotion campaigns could be restored to the NHS, and local public health budgets could be supplied by the Department of Health. Academic work currently published by PHE, such as evidence reviews, could be outsourced to external authors and commissioned by the Department of Health.
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