Will the Independent Panel for Pandemic Preparedness and Response restore the world’s trust in the fractured post COVID-19 global health system?

17 September 2020  – Mukesh Kapila

Some ten months after the first case was reported from Wuhan and, as the world COVID-19 meter clicks on relentlessly towards 30 million confirmed SARS-COV-2 infections,  the Independent Panel For Pandemic Preparedness and Response meets for the first time today.

It’s leisurely gestation has not matched the rapid evolution of the pandemic and it was almost still-born as the World Health Organization, China, and some poorly-performing nations tried to kick-it into the long grass. The initial argument was that it was not the time to conduct reviews because countries and institutions were too busy managing the emergency and could not be distracted. There would be time enough to learn lessons from “after-action reviews”.

However, it was quickly obvious that there would be no after-action phase as such: the wily coronavirus was becoming a feature of our lives and would require permanent action. Meanwhile, a fearful world, much frustrated by highly disruptive public health measures with immense social and economic impacts, had to find someone to blame. This was combined with deliberate misinformation, mischief-making, and even malice, and conspiracy theories around COVID-19 multiplied. These cost lives even as they squeezed WHO and its Director General Dr Tedros, impacting their influence and effectiveness at a crucial moment for the world.

Under such contentious circumstances it not unknown in national and international public affairs to seek investigations. But motivations are often mixed with some genuinely sincere in seeking honest answers and others seeking yet another opportunity to push  particular partisan perspectives. This was clearly evident in the virtually-conducted 73rd World Health Assembly in May that finally asked the WHO Director General to initiate  an “impartial, independent and comprehensive evaluation” to examine WHO actions as well as the adequacy of global disease control mechanisms such as the International Health Regulations.  However, the crucial question of an enquiry into the origins of the novel coronavirus and its initial handling by China was fudged. 

WHO appointed the former Liberian President Ellen Johnson Sirleaf and Helen Clark, the former New Zealand Prime Minister and UNDP Administrator, as co-chairs of the Independent Panel. They have, in turn, appointed 11 other diverse and distinguished members from a list nominated by governments (many of which are themselves deserving of critical scrutiny for their own COVID-19 responses).  WHO is also providing an ‘independent secretariat’ headed by one of its own former senior staff, Anders Nordstrom, who has been an acting director general of the Organization that is itself the focus of the scrutiny.  The secretariat – technically WHO employees – can, no doubt, control access to  all information that panelists get or not.

The personal integrity and competence of panel members or its secretariat are, prima facie,  not in doubt. But none of them are genuine outsiders to the global system that is under the microscope, and their route to panel membership has come via their good standing with their own governments.  Most of them also have direct or indirect links with the multilateral system including WHO and UN and could be viewed as architects or pillars or even beneficiaries of the same system that is seen – justified or not – as having let the world down badly in its hour of greatest need. How conflicted will be the panel? Not because they are not honest, caring people – which they undoubtedly are – but because they are too much of insiders with strong personal stakes in upholding the system they are seeking to examine with objectivity.

Robustly countering the concern that the panel may not be perceived as impartial and independent is crucial. If that is not done, the panel’s conclusions will be seen as a whitewash, and do little to change the broad public and political mood of cynicism and mistrust in global institutions and multilateral co-operation. 

Besides, previous WHO-commissioned ‘independent’ reviews, such as after its generally-acknowledged disastrous performance on Ebola in West Africa in 2014 have had mixed results.  There is general weariness with reviews that are selectively implemented because they fall foul of internal WHO or member-state politics. There are also parallel mechanisms such as the  Oversight and Advisory Committee for the WHO Health Emergencies Programme -purportedly also independent – set up after earlier criticism.  These risk tripping over each other.  Meanwhile, others have already moved on with their own enquiries such as The Lancet COVID-19 Commission which will produce their own reports.

Thus, the much-vaunted new Independent Panel enters a crowded space – and late. Nevertheless, it should be given the chance to succeed not least for the sake of a world that must be made more secure to face of future pandemics.

How could  the panel be seen as credible? Essentially, by how it conducts its business.  It has made a confidence-boosting start by affirming that it is financed only from  WHO’s assessed budget (i.e. by all governments) and will not accept additional contributions in cash or in kind. It has its own branded identity, website, and its secretariat will not be on WHO premises.

The panel should also set its own transparent rules for evidence-taking.  This could involve written submissions in response to a global call setting out the questions to which answers are sought and which should be supported by evidence. A representative list from those submitting could be invited to oral hearings. A list of those who will give oral evidence should be finalised before the hearings start but not published so as to reduce lobbying of those who will attend, and lobbying for attendance by those not invited. Oral hearings should be recorded but not broadcast live. This is to stop prejudicing subsequent ‘witnesses’ or generating premature public and media debates. The written submissions and the transcripts from the oral submissions  would be part of the official record to be published afterwards so that we can see the basis on which the panel made its conclusions.

The WHO Director General should see the draft report in confidence and offer any factual corrections, and make any responses. The panel report and WHO reaction can then be published together as a public document for discussion by the World Health Assembly and other stakeholders.  

WHO has done well in tackling COVID-19, despite its in-built constraints. That story deserves to be recognised more widely and the shortcomings tackled so that states can unite behind a strengthened WHO.  The panel could perform a great public service to enable that to happen, by not just behaving independently but also by being seen to be independent.

Published by Mukesh Kapila

See http://www.mukeshkapila.org

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