China’s status as a major superpower clearly places it outside the “normal actions” of the World Health Organization, experts have warned, as the country’s coronavirus outbreak continues to spread.
The novel virus has been detected in nearly every province in China and in at least seven other countries, infecting more than 1,600 people and killing 54. The first cases in Europe were confirmed on Friday, with three in France.
Many experts expected the WHO to declare a global health crisis this week, which would see emergency measures put in place. But the organisation said it was “too early” to do so, in a decision that baffled many.
“The criteria for declaring a public health emergency of international concern have been met,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations.
But “not all WHO decisions are made based on the developments in the biological world,” he added.
As China rose up the ladder to become the world’s second-largest economy, Beijing’s appetite for greater recognition on the international stage grew. The government has worked to curry favour at global organisations like the International Monetary Fund and the United Nations.
Lobbying efforts have scaled up enough at the UN to prompt the US State Department to dispatch Mark Lambert, previously special envoy to North Korea, to counter “malign influence” from China.
“China has a strategy of taking on more prominent roles in intergovernmental organisations,” said Frances Eve, deputy director of research at Chinese Human Rights Defenders, an advocacy group chronicling China’s growing influence at the UN. “China is using these organisations to promote Chinese interests.”
Last May, persistence paid off when the WHO included traditional Chinese medicine in its influential compendium, which categorises thousands of diseases and medical diagnoses.
Under Chinese pressure, the WHO has also excluded the self-ruled democratic island of Taiwan from the World Health Assembly, and from receiving global health advice for the last three years.
China regards Taiwan a renegade province, though it has its own democratically-elected president and currency, and argues it has no right to participate in international organisations as a separate entity.
But Taiwanese leaders this week are again warning that the long-withheld WHO access is creating a loophole in the health security chain that creates risk for all of Asia.
“As the world’s second largest economy, China has a role on the global health stage that... puts it outside some of the normal actions taken by WHO,” said Laurie Garrett, member of the World Economic Forum’s global health security advisory board.
She added that she believed the WHO will come to "deeply regret" the decision not to declare a crisis.
“But it would be very wrong to imply that this is about money. Indeed China is a quite minor WHO donor, its paltry contributions utterly dwarfed by those from the US, UK and Gates Foundation,” Ms Garrett said.
While China contributes $19 million in membership dues to WHO, the majority of the agency’s budget (some 80 per cent) comes from voluntary commitments. China is not a big hitter - in 2018 the nation contributed $6.3 million compared to over $200 million from both the UK and US.
Several experts pointed out that this could lose China influence in the WHO, rather than build it.
“I don’t think there’s anything sinister happening,” said Prof Trudie Lang, director of the global health network at Oxford University. “The WHO does a really good job of trying to genuinely represent all member states.”
But the agency has also faced criticism for its unwavering praise of the way Chinese authorities have handled the outbreak.
“The health commission in Wuhan could have been quicker in response,” said Chen Xi, a professor at Yale School of Public Health.
Officials failed to share information soon enough, disclosing it only to the world on Dec 31, though the mystery disease had been known for weeks, missing a “golden time period” to implement robust emergency measures, he said.
Chinese government censors have also worked overtime to delete complaints posted online from patients displaying symptoms of a coronavirus infection who have been unable to receive treatment.
Pictures of people in long queues outside hospitals have also been deleted, as the ruling Communist Party seeks to control public knowledge of the situation.