Published in The Himalayan Times on 2nd April 2020

Is WHO our global health nanny?

Expecting the World Health Organisation (WHO) to be our universal nanny is unrealistic and dangerous, especially in times of crisis. WHO is a body that brings together global expertise, health intelligence and experience to all its member states. Every organisation essentially represents the nature of its membership and what its members want it to be. WHO is made by your governments. Countries must take WHO’s guidance as their core ‘plan minimum’ and add to it their wisdom.

Imagine the COVID-19 response without the WHO

Gripped by COVID-19, all eyes are on WHO for guidance on what to do and what not to do? All it takes is to imagine our response to the pandemic without the WHO. All said and done common perception is that this is an organisation owned by member states and would be the closest that we could get to neutral information. Many criticise WHO for being influenced by one powerful state or another. However, no one has developed an alternative body that would enjoy the reach or brand recognition of WHO while maintaining the entire range of health expertise from epidemics to road injuries. Governments quote the WHO, and follow its guidance and feedback data into it.  The network of collaborative centres that the WHO operates in partnerships with academia and government is an immense asset to the global pool of knowledge and capacity.

What started as a health crisis has very rapidly evolved into a societal crisis. Some countries have declared COVID-19 a national security crisis, some have termed it a national disaster, and others have termed it a war. It is essential in this context to understand the role of the WHO, lower our expectations of it and shift specific tasks and responsibilities to other actors.

Shift expectations away from WHO to other agencies

While the WHO teams around the globe churn out a range of information material on how to deal with COVID19, other actors need to take that information forward to their constituents. Take, for example, the WHO‘s social distancing guidelines. These ought to be taken up by organisations within countries, modified to the local context, translated into the local languages and amplified using channels that work best in that given context. Marinating in inaction, awaiting tailor-made guidance for every population segment for every country is a luxury we can not afford now. In the country context, line ministries need to step up their game and use their intelligence to customise the science coming out of the WHO and channel it to their captive audiences. Spoon-feeding is not an option in times of crisis. Similar to the WHO, as Ministries of Health are overwhelmed in responding to the COVID19, line ministries should not self-paralyse for lack of vetting of each communication piece from their Ministry of Health counterparts. There is neither time nor any human resources that can be spared for this. In multiplying and amplifying messages, mistakes might be made here and there, but they can be corrected. The risk of doing nothing is way higher than making a few mistakes.

Help WHO deliver on its core mandate

Every emergency coordination meeting I have attended at a country, regional or headquarters level invariably ends with one default recommendation- we must coordinate better. Pick any emergency response evaluation, and you will see the same outcome. While coordination during a crisis may hold some limited promise within sectors- e.g. UN country teams, International NGOs, and government ministries, it rarely works between industries. It is no different from how things function or don’t within a building of tenants or extended family- some will always go solo or only halfheartedly implement agreements. I have found this to be valid as emergencies draw out. In a COVID-19 global crisis, let us allow WHO to focus on giving the world its best technical intelligence and advice.  Let us not put it under the expectation of global babysitting. It is the time to encourage all other ministries, organisations, industrial bodies, and associations to study, digest and use the WHO‘s knowledge and advance it to their audiences as quickly as possible using their innate intelligence and experience.

Let us help the WHO focus on its core knowledge generation and dissemination business. It is time for each of us to step up to our duty of using WHO‘s output responsibly and proactively in beating the menace of COVID19.

About the Author

Dr Sunoor Verma is a former Cardiothoracic surgeon; his experience ranges from various emergency settings related to the Avian Flu, SARS, Tsunami, HIV/AIDS, Kosovo crisis, Macedonia armed conflict and the Sri Lanka conflict. His focus is Strategy, Risk and Crisis Communication and Strategic Partnerships in international development. He has advised WHO, UNICEF UNHCR, the European Centre for Minority Issues, Cambridge University, Boston University and the Hospitals of the University of Geneva. He balances his high-level policy work with advisory work to grassroots NGOs worldwide. He works out of the Lake Geneva region.

What should the roles of government, private sector and the general public be in terms of crisis communication?

Crisis communication is very different from regular communication. This is because the way people perceive threat, process information and react to information is very different from that of the regular scenario.

The other challenge we face in the globally connected media is that we are watching what is happening in developed countries. Suddenly our own expectations from our own governments become unrealistically high. But we have to realise our own context and manage our expectations in that context.

Governments need to see that people expect information quickly to make themselves and their close ones safe. Second, they want reliable information. Third, they want information they can turn into action for themselves so that they can take their safety into their own hands.

The people need reliable information from governments, and governments need collaboration and cooperation from the people. These two elements need to be in harmony. For that to happen, there needs to be a single source of information that is trusted. In the case of this epidemic, the official government mechanism and the World Health Organisation are the only two sources from where we take the information.

Then there’s the role of leaders in other sectors. Leaders do not only mean elected leaders. We are looking at leadership from all sectors — within the private sector, the faith sector, and within the community sector.

For example, if I am a shopkeeper in Kathmandu, I should not expect the government or WHO to come up with a protocol on how to maintain social distancing at the shop. Shopkeepers, or their associations, should decide how we manage social distancing at shops.

Also, videos on how to wash hands from developed countries show people washing their hands for 30 seconds under running water. Where do we get running water in Nepal? Our reality is a mug of water. We need a video on how to wash our hands with a mug of water for 30 seconds. This is not something we expect the government or the WHO to come up with. There are so many creators, YouTube stars and influencers. They can make their 30-second video.

It should be clear there’s no individual exit from this. The only way we can exit from this is through collective action. So this is the first time, I think, we are facing a crisis where it does not matter whether you are rich or poor; literate or illiterate; male or female; Hindu or Muslim or Buddhist.

Your survival depends on your neighbour. This is a massive equaliser. So crisis communication needs to be mastered very quickly by leaders in all spheres of life.

How can the private sector, which has yet to come out in Nepal, address this crisis?

It is very important for the private sector to step up to see what the government is doing and immediately come up with offers of action and support. This is not the time to negotiate product placement, visibility, brand logo, etc. This is the time for the private sector to unite most effectively through their associations. That way, the interests are not competing within companies or brands. It’s an industry coming together.

For example, an industry of manufacturers comes together. See what the government is doing. See what the messaging is and think about how they can take the message forward into areas they influence. How they can multiply and amplify the message and make it more understandable for their constituents. They must also start thinking of scenarios in future planning. At the moment, we are all thinking about the crisis. We are not thinking after the crisis.

When the private sector starts helping out, the government will also probably ask the private sector for things they could do. For example, Airbus and Rolls Royce are presently not manufacturing aeroplanes or engines, but they are manufacturing ventilators.

Everywhere in the world, countries are following one model of lockdown to slow down the spread of novel coronavirus. How sustainable is that model, especially for a country like Nepal where people have to go out to work every day to eke out a living?

This is where multilateralism comes in. Countries, no matter how independent and how proud, this crisis reminds us we are not independent but we are interdependent. So when we are interdependent, we have to use each other’s strengths to understand who is working how and resolving the problems through which means, and pick from there.

This is where multilateralism, regionalism, regional cooperation all come in. You can see China has sent a medical team to Italy. Cuba has just sent 50 doctors to Italy as well. So we need to see our partners who can help us in what manner. And help is not just with financial aid but with ideas. We also have to realise that solutions will emerge as we move on.

The other thing that we should ask ourselves is what the other option to the model of lockdown there is. Let’s start with the one option we’ve seen working everywhere until we have another option. In the meantime, we develop solutions as they emerge or as the problem evolves. But I do not think we have the luxury of waiting.

Is this crisis forcing everybody, even those writing off multilateralism, to rethink it?

Multilateralism is criticised because it is a soft and favourite punching bag for everyone. Any organisation, in essence, reflects the members it has. The United Nations is what its members are and what its members want it to be. But it is an easy punching bag because it is not easy for a country to go and punch an individual member which is more affluent, bigger and more powerful. But the COVID-19 crisis is reminding us about the importance of the WHO with its vast networks of collaborators of laboratories around the world, sharing information, pooling data and working 24 hours a day. If this system of multilateralism was not there, you would not have the WHO. Then the question would be, whose information would you trust? Of course, the UN system has to reflect modern society. But it is very big, and it takes time to change. Member states have to also think about it.

You have the luxury of so many UN agencies in Nepal. These agencies have programmes around the countries. So here you have channels and expertise spread around the country from a multilateral organisation where you are a member, where you can demand help. The UN offices are open, and all the heads of the UN agencies are in their offices.

How do you think this crisis is going to end as people paint a gloomy picture?

This whole experience poses questions on how we function as a society and in governance. So people and governments have a choice — will they make decisions based on scientific evidence? The second choice is whether we are going to support the public health sector or not. You can see the delay in response to COVID-19 in the US is attributed by many to reduced funding of the public health sector in the last few years.

In terms of the gloomy picture, science tells us virus evolves. The whole idea of the lockdown is to delay how the virus moves from one person to another. Hopefully, several parameters will change until we manage to postpone this, such as heat and humidity and hopefully, infections go down. So I think the evolution would gradually become that of the flu. It might re-emerge in November or December when seasonal flu occurs, but most scientists feel the virus would have evolved or mutated by then. But I think we do not have the luxury of long-term scenario planning in a crisis like this. We need to start step by step based on the experience that is evident around us. China has managed to bring it under control, South Korea is doing quite well, and Taiwan and Singapore have done quite well.

If you look at countries that have done well, they have been very strong in crisis communication and supply chain management. I think many of these countries have outstanding relations with Nepal. I think the way forward is to seek their expertise and support. Nepal is a full-fledged member of the United Nations. There’s immense recognition of Nepal’s contribution to the peacekeeping forces. Nepal has helped the world. Now Nepal needs help; I think the world will stand to support Nepal.

About the Author

Sunoor Verma is a senior international development specialist in strategic planning, strategic and risk communications and strategic partnerships. His experience includes advisory work for the World Health Organisation, UNHCR, UNICEF, European Centre for Minority Issues, Cambridge University, University of Geneva and Boston University. Most recently, he consulted WHO-Geneva on developing their Risk Communication Strategy for Pandemic influenza.

Roshan S Nepal of The Himalayan Times caught up with Dr Sunoor to talk about the importance of crisis communication in this time of COVID-19 pandemic. Published on 24th March 2020 in The Himalayan Times English national daily newspaper Nepal.