Tổ chức y tế thế giới và phản ứng trước dịch bệnh một nghiên cứu cụ thể về đại dịch covid 19

HUE UNIVERSITY UNIVERSITY OF FOREIGN LANGUAGES AND INTERNATIONAL STUDIES INTERNATIONAL STUDIES DEPARTMENT GRADUATION RESEARCH PAPER THE WORLD HEALTH ORGANIZATION AND PANDEMIC RESPONSE: THE CASE OF THE COVID-19 PANDEMIC TRUONG PHUNG MINH Class: QTHK16 Student number: 19F7061020 Major: International Studies (American Studies) Supervisor: Dr Nguyen Thi Anh Thu HUE, MARCH 2023 ĐẠI HỌC HUẾ TRƯỜNG ĐẠI HỌC NGOẠI NGỮ VÀ QUỐC TẾ HỌC KHOA QUỐC TẾ HỌC KHOÁ LUẬN TỐT NGHIỆP ĐẠI HỌC TỔ CHỨC Y TẾ THẾ GIỚI VÀ PHẢN ỨNG TRƯỚC DỊCH BỆNH: MỘT NGHIÊN CỨU CỤ THỂ VỀ ĐẠI DỊCH COVID-19 Sinh viên: TRƯƠNG PHỤNG MINH Lớp: K16B Quốc tế học Mã sinh viên: 19F7061020 Chuyên ngành: Quốc tế học (Hoa Kì học) Cán hướng dẫn: TS Nguyễn Thị Anh Thư Huế, tháng năm 2023 Statement of Authorship I hereby certify that the authorship of the thesis titled “The World Health Organization and Pandemic Response: The Case of the Covid-19 Pandemic” is my own research This thesis does not contain any other documents except the references cited All references used are duly sourced and legally cited Truong Phung Minh Hue, March 20th, 2023 ii Abstract The Covid-19 pandemic is an epidemic affecting the respiratory system from a new strain of Corona virus that has spread across the globe since December 2019 During this pandemic, the World Health Organization (WHO) has made various efforts, from providing equipment, technical support and medicine, to issuing reliable specialist information and calling for international cooperation Despite these efforts, the WHO failed to develop a globally coordinated response to the Covid-19 pandemic The existing literature on the WHO’s failure in responding effectively to previous pandemics suggests three main explanations in terms of naming scheme, performance of staff, and lack of pandemic guidance Nonetheless, such explanations have empirical problems when it comes to the case of the Covid-19 pandemic This thesis provides theoretical explanations on why the WHO failed to develop a globally coordinated response to the Covid-19 pandemic by looking at their responses from three traditional approaches of International Relations (Realism, Liberalism, and Constructivism) Looking from the realist perspectives, the thesis argues that the WHO’s failure in developing a coordinated response to the Covid-19 pandemic was due to its soft approach to the Chinese government and weak actions in preventing responsibility-shifting and unequally vaccine distribution From a liberal approach, the thesis argues that the WHO’s effort in distributing vaccines was creating more dependence on vaccine supply, leading to inequity in vaccine distribution From a constructivist lens, the thesis shows that the ineffective statements by the WHO on mask wearing prevented them from setting good standards of behavior among the public The findings of the thesis contribute to the literature on the WHO’s pandemic response, especially offering theoretical explanations for the WHO’s failures in developing a globally coordinated response to the Covid-19 pandemic and pointing out the lessons learnt for the WHO in developing a more effective response to future pandemics iii Acknowledgements First of all, I would like to express my special respect and appreciation to my instructor, Ph.D Nguyen Thi Anh Thu for her dedication in assisting with precious constructive opinions in constructing this graduate thesis Without her guidance, this thesis would not have been done well and could not have been submitted on time Ms Thu is a very dedicated, enthusiastic teacher with a high level of expertise whom I am very fortunate to have had the opportunity to work with In addition, I would like to express my sincere gratitude to Ph.D Nguyen Thi Thanh Binh, who introduced me to such a wonderful instructor Besides, I would like to thank my mother & my classmates- Pham Thi Ai Thi & Nguyen Thi Bich Thuy for their explanations on real-life examples and act as spiritual helpers when I was stressed Finally, it is impossible to extend my special thanks to the International Studies Department for giving me the opportunity to try my hand at my graduation thesis, and it was a very valuable experience when I was at the university Because this is my first time doing such a high-level research project, thus errors can still happen Therefore, I hope readers can sympathize and give suggestions to improve this thesis Hopefully, the contents of this research can be a reference for future studies, as well as be a useful illustrative example in some courses at the International Studies Department and the Hue University of Foreign Languages and International Studies iv Table of Contents Statement of Authorship ii Abstract iii List of Abbreviations vii CHAPTER 1: INTRODUCTION 1.1 Research background 1.2 Research problem 1.3 Research Questions 1.4 Theoretical Framework 1.4.1 Realism 1.4.2 Liberalism 1.4.3 Constructivism 10 1.5 Research Method 11 1.5.1 Research Design 11 1.5.2 Data Collection 11 1.6 Thesis Outline 12 CHAPTER 2: LITERATURE REVIEW 14 2.1 Naming Scheme 14 2.2 Performance of Staff 15 2.3 Lack of Guidance 16 v CHAPTER 3: THEORETICAL EXPLANATION FOR THE WHO’S FAILURE IN RESPONDING TO THE COVID-19 PANDEMIC 19 3.1 WHO’s Failures in Developing a Coordinated Response to the Covid-19 Pandemic 20 3.2 Explaining the WHO’s Failures in Developing a Coordinated Response to the Covid-19 Pandemic 24 3.2.1 Realist Explanation 24 3.2.2 Liberal Explanation 27 3.2.3 Constructivist Explanation 28 CHAPTER IV: CONCLUSION & RECOMMENDATIONS 31 4.1 Conclusion 31 4.2 Recommendations 32 4.2.1 Lessons Learnt for the WHO from its Failure in Responding to the Covid19 Pandemic 32 4.2.2 Ways to Limit WHO’s Weaknesses in the Prevention of Covid-19 Pandemic 34 References 38 vi List of Abbreviations CDC Centers for Disease Control and Prevention Covid-19 Corona Virus Disease 2019 IHR International Health Regulations PHEIC Public Health Emergency of International Concern WHO World Health Organization vii CHAPTER 1: INTRODUCTION 1.1 Research background In the past 20 years, the WHO has made several declarations on public health emergencies It started with the emergence of Severe Acute Respiratory Syndrome (SARS-CoV hereafter) in 2002 This disease was found to be transmitted to humans by civets The danger of SARS-CoV was revealed when this virus cause pneumonia and many complications causing respiratory distress, heart, and liver failure that could lead to death, especially those with pre-existing medical conditions (as cited in Mayo Clinic, 2023) Ten years later, the world faced up with the Middle East Respiratory Syndrome (MERS-CoV hereafter) MERS-CoV has been identified and linked to human infections in dromedary camels in several states in the Middle East, Africa and South Asia (WHO, 2022) Recently, SARS-CoV-2 (Covid-19 hereafter) virus, which broke out in December 2020, has been known as the deadliest public health emergency in history Compared with previous virus strains, the Covid-19 virus is highly contagious and overwhelms SARS and MERS both in the number of infected people and in the spatial extent of the epidemic area (Hu et al., 2021, p.141) Due to this high contagion of the virus, Covid-19 has been classified as a cross-border pandemic The Covid-19 pandemic has brought about several public health issues According to statistics from the WHO Coronavirus (COVID-19) Dashboard, from 2019 to December, 2022, there have been more than million deaths due to Covid-19 infection (WHO, n.d).Those who survived Covid-19 are still adversely affected In addition to the consequences on physical health, the negative impact on psychological health is also a matter of concern Limiting contact and travel leads to reduced social interaction, economic decline, fear or phobia about the Covid-19 virus which disturb the human psyche For example, Covid-19 has a far-reaching impact on the labor market When the pandemic broke out, economic activities had to be halted, causing the economy to become stagnant It will therefore have a strong impact on global unemployment and underemployment Because of the negative effects and consequences of Covid-19 on human health and global economy the response to this pandemic requires a health effort from the community to the whole world To that, the international health organization World Health Organization (WHO hereafter) has captured the attention of the majority of the world’s public with its leadership role in providing information, medicine, and resources during the Covid-19 pandemic Second, according to the WHO Constitution, the mission of this organization is to “The objective of the World Health Organization shall be the attainment by all peoples of the highest possible level of health” (p.2) And to accomplish those goals, the WHO Constitution also mentions that the organization already has several key functions including (p.2&3): (1) Acting as a directing and coordinating body for international health work; (2) Providing appropriate technical support and aid at the request of governments, especially in case of emergency; (3) Providing information, advice and support in the medical field; (4) Supporting collaboration between scientific groups that contribute to the advancement of health The fact that the WHO clearly defines the above tasks shows WHO’s determination to help improve global health and human health day by day with the best quality Throughout history, pandemics have been viewed as a serious threat because of the loss of life and their sequela to the community Thus, the entire health sector, each CHAPTER IV: CONCLUSION & RECOMMENDATIONS 4.1 Conclusion Although the WHO is an international organization with many good ideas in promoting international relations during the Covid-19 pandemic, the analysis from International Relations theories shows that WHO’s leadership still has many gaps when it advocates international cooperation during the Covid-19 pandemic Three traditional International Relations theories (realism, liberalism and constructivism) suggest that its failures were due to WHO’s soft approach to the Chinese government and its weak actions in calling for responsibility-sharing and global coordination on vaccine distribution, WHO’s encouragement for heavy reliance for vaccines and creating opportunities for false standard of behavior to exist respectively These gaps make the WHO’s leadership to develop a globally coordinated response to Covid-19 pandemic quickly fail Too much political interference on the part of China instead of caring about the health of all mankind has caused the world to fall into a state of tension This selfishness stems from the realism and nationalism that are so deeply entrenched in this country In addition, vaccineism is also a result of realism, where countries tend to prioritize the safety of their own people over the survival of the world However, the WHO has proved ineffective because this organization has not yet taken strong measures in calling for sharing responsibility for fighting the epidemic among countries, as well as have not acted effectively on the global distribution of vaccines From the liberal point of view, even though the WHO upholds the spirit of cooperation, its efforts in distributing vaccines ended up creating more reliance on governments for vaccine supplies through WHO’s COVAX mechanism This mechanism was created to give every country in the world equal access to vaccines, 31 but the WHO has not well managed on how to give and receive vaccines, leaving some countries in a passive position and dependent on international assistance, causing a lack of progress in those countries Moreover, Constructivism is one of the structural components of social norms and most of them create good standard of behaviors for people in society Even establishing disease prevention measures is always a top priority for countries and governments during pandemics; unfortunately, the WHO has manually broken its standards in the use of masks because of its false information This may affect the fight against the Covid-19 pandemic and create false principles and consciousness in the public to develop and survive In order to overcome its shortcomings, the WHO needs to reflect on its failures and weaknesses to improve its work and response to a pandemic so as not to repeat those mistakes in future pandemics The following part provides some recommendations on how the WHO can improve the effectiveness in responding the future pandemics 4.2 Recommendations 4.2.1 Lessons Learnt for the WHO from its Failure in Responding to the Covid-19 Pandemic Although certain successes have been achieved when being recognized worldwide for efforts in medical support and international cooperation during the outbreak of the Covid-19 pandemic, the WHO has shown a few limitations in its leadership in public health Certainly, an “invisible enemy”, like past pandemics or the recent Covid-19 pandemic, is always a challenge for the world in general and the WHO in particular to deal with No person, organization or system of government is perfect, and mistakes can still happen no matter how hard they try, especially in the context of the Covid-19 pandemic The fact that WHO learns from experience and draws 32 lessons from previous pandemics and the Covid-19 pandemic will be beneficial to the response to outbreaks caused by new mutations and future epidemics The first lesson is that WHO must put clarity in reporting everything it knows about the disease, with the priority of reporting the levels of the disease first Because during the Covid-19 pandemic, WHO deliberately concealed the epidemic situation just for the sake of defending China (maybe for some political purpose) The mistake in hiding and delaying the announcement of the extent of the Covid-19 pandemic caused the world to go through a difficult time in responding to the pandemic Not to mention there have been thousands, culminating in hundreds of thousands of cases and countless deaths worldwide due to WHO's negligence and some difficulties in researching methods to combat the pandemic due to lack of information about the epidemic The lack of clarity and transparency in epidemic prevention and control easily loses the trust of the international community and makes it easy for the WHO to lead into a dead end The second lesson is that WHO’s subjectivity can lead to misinformation and delays During the fight against Covid-19, WHO declared Covid-19 as a PHEIC too late just because the head of the organization like Tedros Adhanom Ghebreyesus said it was not serious enough to be declared a pandemic that has caused many of the consequences mentioned above As a major international health organization, WHO should have been at the forefront of being alert and up to date with all that is related to the pandemic However, this organization has caused obvious disappointment just because of its subjectivity and unnecessary disregard for the epidemic This could be a great lesson for the organization that one person in charge of the entire organization could make such an emotional statement The WHO remains an essential international organization to support world health, despite its successes and failures The WHO has always been an organization that accompanies the governments of countries around the globe But, in order to maintain 33 trust and position as a global organization, the WHO should still take steps to improve its limitations and shortcomings, as well as promoting their strengths to help and take care of the world’s health better In the next section, I will present some personal solutions to limit the shortcomings of the WHO and commented on the effectiveness of this organization in the prevention of the Covid-19 pandemic 4.2.2 Ways to Limit WHO’s Weaknesses in the Prevention of Covid-19 Pandemic Innovating and improving pandemic response is important for the smooth progress of pandemic prevention and the building of this organization's reputation and trust in the international community to enhance support between countries in the context of Covid-19 and subsequent pandemics The followings are some of the solutions that should be taken into consideration to limit WHO’s weakness in the containment of the Covid-19 pandemic First, the WHO needs to act to improve the health problems of people globally Improving human health aims to make people’s resistance to pandemics better Thus, the WHO can promote campaigns on water sanitation, food security, and sanitation for people of any country, with priority given to less developed countries like Africa Specifically, the WHO can improve its vaccination program, have different health insurance programs for people who are not yet economically Building a good health foundation will help people have less risk of facing underlying diseases, thereby reducing the incidence of Covid-19 virus and limiting pressure on the health system Second, the WHO needs to prioritize health over political concerns In fact, the WHO is already politically part of it, as it is an international organization and is under the direction of the United Nations However, as a health regulatory organization, the WHO must put more emphasis on global health in order to create its credibility in the world This obliges the WHO to be honest, transparent and accountable in its PHEIC 34 statement, based on sound scientific evidence Besides, the WHO should also name the pandemic correctly to avoid misleading and causing unnecessary crises Third, continue to use PHEIC as the highest warning level in addition to some additional criteria The WHO must evaluate and properly consider to what extent it will be called PHEIC, as it was previously unclear to what extent and how an issue could become a PHEIC as international confidence in the WHO began to diminish In addition, PHEIC claimants are responsible for their publication to the worldwide public if any deviation occurs Fourth, clearly assign tasks between the Headquarters as well as the WHO offices to help better work efficiency This will help to have the necessary communication from both sides to be able to clearly understand the information in each location to make the best decisions As for the Headquarters, it will play a directing role and provide quick support to subordinates With subordinates, they will be the ones to announce their activities to their superiors about actions to respond to urgent health problems and provide methods to limit the epidemic Moreover, a clear division of work will help the parties reduce the burden created by the workload Fifth, the WHO should continue to promote the use of expertise in the world by continuing to use medical forces, researchers and scientists This specialized force will help the WHO have different discussions before deciding as well as advise, find different solutions and actions to respond to the pandemic This also means enhancing international cooperation Sixth, the financial mobilization at the WHO is never superfluous Having an abundant budget will prevent WHO from being passive because of the main subsidy cut, as in the case of the US, which cut off funding to the WHO during the time of Covid-19 With the budget in hand, the WHO can deal with ongoing and emerging issues more effectively To get that funding, WHO needs to mobilize member 35 countries to jointly develop and set up funds, such as the COVID-19 Solidarity Response Fund Seventh, the inclusion of official information from the WHO on pandemic issues needs to be improved Because of the development of technology, unorthodox information about pandemics constantly appears and affects the public’s psychology The WHO needs to further strengthen the dissemination of correct and official information to television, social networks and other media to properly propagate effective and scientifically sound ways to combat the epidemic Eighth, the WHO should not make any country dependent on vaccine supplies from other countries or COVAX WHO needs to find a way to encourage and support to self-reliance in the production of Covid-19 vaccines in other countries based on the copyrights of previous vaccines Besides, the WHO must make COVAX a fair vaccine distribution mechanism for the whole world Nineth, the WHO needs to focus more on its specialized forces The WHO needs to find more doctors, health professionals, and scientists to add to its force With this approach, WHO can make its decisions more correctly, by consulting many experts from diverse fields in our team and avoiding making wrong decisions that affect the world In addition, it is essential that the WHO should focus on training the knowledge of its experts Based on the analysis in this thesis, this part provides basic suggestions for improvement that the WHO can to improve their performance should an outbreak occur Pandemic becomes inevitable in a globalized 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