Powerful cyclone prompts millions to evacuate; Trump threatens WHO funding, US membership; Tracking the growing list of COVID-19 symptoms

Powerful cyclone prompts millions to evacuate; Trump threatens WHO funding, US membership; Tracking the growing list of COVID-19 symptoms

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The World staff

A scientist at India Meteorological Department Earth System Science Organization, points to a section of the screen showing the position of the Cyclone Amphan to media people inside his office in Kolkata, India, May 19, 2020.

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Rupak De Chowdhuri/Reuters

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Top of The World — our morning news round up written by editors at The World. Subscribe here.

A potentially devastating cyclone is expected to hit South Asia on Wednesday, leading India and Bangladesh to evacuate up to 3 million people from the storm’s path. Cyclone Amphan had been classified as the most powerful type of cyclone and the second such storm to be tracked in the region since 1999. Though it has been weakening slightly, it is still likely to bring dangerous wind, rain and flooding. 

Cyclone Amphan is coming in the midst of a pandemic, in which India and Bangladesh together have more than 125,000 confirmed coronavirus cases. Some evacuees fear catching the virus in emergency shelters with no room to maintain social distance. 

A recent study shows that major tropical cyclones have become more likely over the past 40 years. According to researchers: “A warming planet may be fueling the increase” in stronger, sustained winds.

Trump threatens WHO funding, US membership

US President Donald Trump has redoubled his criticism of the World Health Organization, threatening to permanently withdraw funding and reconsider US membership if the UN agency does not commit to “major substantive improvements” within the next 30 days. The ultimatum comes after the first day of a WHO global summit urging international cooperation. The Trump administration already put a 60-day hold on WHO funds in April. Withdrawing support and membership would weaken the agency in the middle of a worldwide fight to tackle the novel coronavirus pandemic. It would also leave the US with little influence over the body and less access to WHO resources. 

And: China accuses US of coronavirus smear campaign

Also: Trump says he’s taking hydroxychloroquine, prompting warning from health experts

Colombian airlines face controversy over pandemic loans

Governments worldwide — from Singapore to the Netherlands and the US — have devoted more than $85 billion to prop up airlines during the coronavirus pandemic. But airlines’ requests for aid are controversial in less rich Latin American economies, where millions live in poverty and public health systems are ill-equipped to respond to a large-scale health crisis. Many leaders in Latin America likely see air travel as a luxury and may be reluctant to extend help to airlines during the crisis.

And: Britain is at risk of ‘returning to 80s levels of unemployment’

Tracking the growing list of COVID-19 symptoms

When the novel coronavirus first emerged in China, the world was warned to watch out for two main symptoms: fever or a persistent cough. A lot has changed since then. Researchers are learning that symptoms of the coronavirus can vary depending on myriad factors, such as age and health status. The COVID Symptom Study is pulling together this growing list of the coronavirus symptoms. Since its app launched in March, it has crowdsourced symptoms from more than 3.5 million people in the UK, US and Sweden.

From The World: World faces risk of ‘vaccine nationalism’ in COVID-19 fight, says CEPI chair

And: Trump’s use of malaria drug likely to be welcomed in India

Mosques in Kenya offer virtual prayers for Ramadan

On a normal Friday during Ramadan, Ahmed Ali Mohamed would head to the mosque with his family and friends to break the fast. But with the pandemic, this year’s Ramadan experience is anything but normal for Muslims in Nairobi, Kenya. Eastleigh, a predominantly Muslim neighborhood in Nairobi where Mohamed’s mother and grandmother live, is currently under lockdown, and most mosques have closed. Instead, some mosques are offering virtual prayers via YouTube.

And: Eid al-Fitr 2020: Everything you need to know

Art, poetry and … zombies? Cultural legacies of the 1918 pandemic

Norwegian artist Edvard Munch’s “Self-Portrait with the Spanish Flu,” circa 1919. 

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Public domain/Wikimedia Commons

There seem to be few great works of art that keep the 1918 flu pandemic alive in cultural memory. But Elizabeth Outka, author of “Viral Modernism: The Influenza Pandemic and Interwar Literature,” says the 1918 pandemic’s influence is an undercurrent that runs through many works of the period.

For example, the pandemic and World War I led to a renewed interest in spiritualism, a belief that humans could communicate with the dead through seances, mediums and objects like Ouija boards. Another surprising cultural byproduct of the pandemic? Zombies.

Also: Polish hit song on grieving ‘censored’, sparking protests

Morning meme

After searching for 32 years, a Chinese couple has finally been reunited with their son, who was abducted from a Xi’an hotel when he was just two years old. 

“I won’t let him leave me anymore,” cried his mom. https://t.co/OcXTs6jx4K

— Shanghaiist.com (@shanghaiist) May 19, 2020In case you missed itListen: World leaders convene to address coronavirus crisis response

Tedros Adhanom Ghebreyesus, director general of World Health Organization speaks at the virtual 73rd World Health Assembly following the coronavirus outbreak in Geneva, Switzerland, May 18, 2020.

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Christopher Black/WHO/handout via Reuters

It’s an unprecedented time and situation: “A microscopic virus has brought us to our knees,” said United Nations Secretary-General António Guterres at the start of the 73rd annual World Health Assembly on Monday. Leaders from around the world convened, for the first time virtually, for two days of meetings to address the world’s response to the global pandemic. And, Brazil, one of the world’s coronavirus epicenters, is now navigating the coronavirus crisis without a health minister after Nelson Taich resigned on Friday. Also, a principal in New Zealand has posted a catchy YouTube video as health advice for her students returning after lockdown encouraging them to stay out of each other’s “moist breath zone.”

Don’t forget to subscribe to The World’s Latest Edition podcast using your favorite podcast player: RadioPublicApple PodcastsStitcherSoundcloudRSS.

Study tracks growing list of COVID-19 symptoms in real time

Study tracks growing list of COVID-19 symptoms in real time

The COVID Symptom Study is pulling together this growing list of the coronavirus symptoms. Since its app launched in March, it has crowdsourced symptoms from more than 3.5 million people in the UK, US and Sweden.

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People walk on the banks of the river Seine after France began a gradual end to a nationwide lockdown due to the coronavirus disease (COVID-19) outbreak, in Paris, May 17, 2020.

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Gonzalo Fuentes/Reuters 

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When the novel coronavirus first emerged in China, the world was warned to watch out for two main symptoms: fever or a persistent cough.

A lot has changed since then.

The US Centers for Disease Control and Prevention now lists seven symptoms, and the World Health Organization includes even more, with a breakdown of which ones appears to be more or less common. On Monday, the United Kingdom also added loss of smell and taste to the growing list of symptoms.

Related: World faces risk of ‘vaccine nationalism’ in COVID-19 fight, says CEPI chair

Researchers are learning that symptoms of the coronavirus can vary depending on myriad factors, such as age and health status. And they’re seeing other conditions they hadn’t connected to the disease earlier on, including in children.

Although cases of the coronavirus in children are few and far between, doctors have recently observed a syndrome they say is probably linked to COVID-19. Some children have experienced a rare condition involving an overreaction of the immune system and requiring intensive care.

“I call on all clinicians worldwide to work with your national authorities and WHO to be on the alert and better understand this syndrome in children.”

Dr. Tedros Adhanom Ghebreyesus, WHO director-general

“I call on all clinicians worldwide to work with your national authorities and WHO to be on the alert and better understand this syndrome in children,” said WHO director-general Dr. Tedros Adhanom Ghebreyesus.

The COVID Symptom Study is pulling together this growing list of the coronavirus symptoms in real-time. Since its app launched in March, it has crowdsourced symptoms from more than 3.5 million people in the UK, US and Sweden.

Related: Under lockdown, mosques in Kenya offer virtual prayers for Ramadan

“There are a few other ones we’ve added recently like acute muscle pains, hives of the face and skin rashes,” said Dr. Timothy Spector, a professor of genetic epidemiology and a doctor at King’s College in London and co-director of the study. “We’ve also got chest pain, abdominal pain, shortness of breath, hoarse voice, confusion, diarrhea. Important ones are fatigue, anorexia and loss of smell and taste.”

That last one — loss of smell and taste — caught the group’s attention. Spector and others with the project had a study in the journal Nature last week showing that the loss of smell and taste was higher in those with a positive test result — around 65% reported it — compared to those with a negative test result — about 21.7%.

But it may be confusing for people to know whether a loss of smell or taste has to do with something like spring allergies as opposed to COVID-19. One indicator is that a person has never experienced such symptoms before.

The reason symptoms vary so wildly may depend on how people’s immune systems respond to the virus, but scientists are still learning. Through the study, researchers are able to zoom out and track trends at a population level.

Related: Gorilla conservation’s latest threat: COVID-19 from tourists

Spector is also interested in how genetics comes into play as well as people’s guts, or microbiomes.

“In my career, I’ve never seen any disease that has such a variable effect in people and can affect nearly every part of the body as well.”

Dr. Timothy Spector, King’s College in London

“In my career, I’ve never seen any disease that has such a variable effect in people and can affect nearly every part of the body as well.”

Clusters of symptoms may be an indicator of the disease and its spread, according to Dr. Andrew Chan, an epidemiologist at Harvard’s T.H. Chan School of Public Health and lead researcher of the project. One example might be groups of people reporting a combination of abdominal pain, acute loss of smell and a stuffy nose.

The hope is that such knowledge and data could better identify outbreaks.

“Our understanding of the symptoms has changed as a result of the data we’re collecting,” he said. “That [data] has been returned to public health authorities as a way to better track where we’re actually seeing incidence.”

Related: Madagascar defends coronavirus herbal remedy 

The need to get a better, real-time clinical picture of COVID-19 is critical, said Eleanor Murray, an assistant professor of epidemiology at Boston University who wasn’t involved in the study.

Tracking self-reported symptoms in this way can help researchers identify symptoms that might not be on their radar, she said. But Murray cautioned that the study has limits: It only captures those who use the app.

“Who downloads that app, who uses that app, who has access to a smartphone?” she said, adding that the app may miss young children and the elderly.

The fact that more people may be primed to report symptoms that they’re more aware of now might also throw off the data somewhat, she said.

WHO chief promises review of coronavirus response, China defends its performance

WHO chief promises review of coronavirus response, China defends its performance

Director-General of the World Health Organization Tedros Adhanom Ghebreyesus attends a news conference in Geneva, Switzerland, February 2020.

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Denis Balibouse/Reuters/File Photo

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The head of the World Health Organization Tedros Adhanom Ghebreyesus said on Monday an independent evaluation of the global coronavirus response would be launched as soon as possible during a virtual meeting of the WHO’s decision-making body, the World Health Assembly.

Chinese President Xi Jinping, facing global criticism over his county’s response to the coronavirus outbreak, defended China’s handling of the crisis but also backed the WHO’s review.

US President Donald Trump has fiercely questioned the WHO’s performance during the pandemic and led international criticism of China’s handling of the early stages of the crisis.

Tedros, who has always promised a post-pandemic review, said it would come “at the earliest appropriate moment” and provide recommendations for future preparedness.

“We all have lessons to learn from the pandemic. Every country and every organisation must examine its response and learn from its experience. WHO is committed to transparency, accountability and continuous improvement,” Tedros said.

The review must encompass responsibility of “all actors in good faith,” he said.

“The risk remains high and we have a long road to travel,” Tedros added, saying preliminary tests in some countries showed that at most 20% of populations had contracted the disease but most places that less than 10%.

Related: Is 2020 an economic write-off?

A resolution drafted by the European Union called for an independent evaluation of the WHO’s performance and appeared to have won consensus backing among the health body’s 194 states.

China has previously opposed calls for a review of the origin and spread of the coronavirus, but Xi signalled Beijing would be amenable to an impartial evaluation of the global response once the pandemic is brought under control.

“This work needs a scientific and professional attitude, and needs to be led by the WHO. And the principles of objectivity and fairness need to be upheld,” he told the meeting via video.

Calling the pandemic the most serious global public health emergency since the end of World War Two, Xi said: “All along we have acted with openness and transparency and responsibility.”

Wildlife origins

A draft of the EU resolution made no mention of China.

WHO and most experts say the virus is believed to have emerged in a market selling wildlife in the central city of Wuhan late last year.

A draft text of the EU resolution urges Tedros to initiate an “impartial, independent and comprehensive evaluation” of the  response to COVID-19 under the WHO “at the earliest appropriate moment.”

Diplomats said the United States, which suspended its funding of the WHO during the crisis, was unlikely to block a consensus backing the resolution.

But it could “dissociate” itself from sections referring to intellectual property rights for drugs and vaccines, and to continued provision of services for sexual and reproductive health during the pandemic, they said.

UN Secretary-General Antonio Guterres called the WHO “irreplaceable.” South African President Cyril Ramaphosa said Africa affirms its “full support,” but assistance to the continent should include debt relief and help with diagnostics, drugs and medical supplies.

Barbados’ prime minister said Caribbean states need a restructuring of debt or a debt moratorium to “provide certainty to both borrower and lender” during the pandemic.

By Stephanie Nebehay and Emma Farge/Reuters

Chile’s ‘COVID-19 card’ sparks controversy over ‘uncertainty of evidence’ about immunity

Chile’s ‘COVID-19 card’ sparks controversy over ‘uncertainty of evidence’ about immunity

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The World staff

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A man wearing a protective face mask as a precaution against the spread of the coronavirus disease (COVID-19) rests in a public square in Valparaiso, Chile, April 27, 2020. 

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Chile is one of several countries trying to plan ahead for a return to normalcy amid the COVID-19 pandemic.

Its health ministry has pushed for the use of so-called “immunity passports” — an all-clear card of sorts issued to people who have already had the illness — so that parts of the population can return to work. 

Related: Countries herald lifting of coronavirus lockdowns, but UK says not yet

But scientists, doctors and researchers still lack much information about the coronavirus and how it works. Experts with the World Health Organization worry about moving too quickly and have advised against the use of such passport documentation to indicate immunity from COVID-19. 

Paula Daza, sub-secretary of Chile’s health ministry, told reporters on Sunday that while many uncertainties remain about the coronavirus pandemic, evidence points to a reduced risk after the first bout of the coronavirus.

“One of the things we know is that a person who has…lived through the disease is less likely to become ill again,” Daza said. She said certifying this status was the “goal of the COVID-19 card that is being prepared will soon be delivered” to patients.

WHO said that issuing certificates could inspire false confidence and increase the risk of spreading the virus. People who have recovered may ignore advice about taking precautions against the virus, the WHO said.

“There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection,” said WHO. 

Daza clarified on Sunday that the certificates Chile planned to issue did not certify immunity.

“It is very important, and I want to reiterate, that we have not talked about an immunity card,” she said.

But Chile’s top health official, Jaime Manalich, said early in April that those who have recovered from the coronavirus represented a population that was immune to it and incapable of transmitting it.

He said those with the medical discharge certificate would be “freed from all types of quarantine or restriction, specifically because they can help their communities enormously since they pose no risk.”

Daza did not specifically address the contradiction when asked by a reporter Sunday.

Chile has confirmed 14,885 cases of coronavirus since the outbreak began in the South American nation in early March, as well as 216 deaths.

Related: Kids in Spain venture outside for first time in weeks

Dr. Cristóbal Cuadrado is a professor of public health at the University of Chile who joined host Marco Werman from Santiago to discuss the idea behind the immunity passport concept — and why it sparked so much controversy. 

Marco Werman: Dr. Cuadrado, can you tell us what Chile has decided with regard to the immunity passports?

Dr. Cristóbal Cuadrado: There has been a lot of controversy regarding this issue in the last weeks. At the beginning, the Ministry of Health wanted to give this kind of immunity passport to any person that had acquired the disease in the last two weeks. So, any person that has been diagnosed and cleared from the disease was suspected to be immune, and therefore, given this kind of passport. Additionally, there was a discussion into if antibody testing should be added to the definition.

But the problem, as World Health Organization has mentioned, is that we don’t know if this rapid testing available now in the market really is able to detect effective antibodies on how long this potential immunity could last. So, I think there is a lot of controversy at this point in Chile, and also in other countries that are looking forward to move on these kinds of measures.

Right, and depending on how you feel about this idea, I suspect you may or may not agree with even whether to call it an “immunity passport.” The WHO has recommended against them because there is no evidence currently supporting immunity. The idea that if you’ve been infected once that you can’t be reinfected — we just don’t know. So, has the Chilean government addressed these concerns in any way?

The use of this documentation is not clear any longer because the initial idea of the government was to produce this documentation so people could move freely and not be forced to stay at home, for example, when quarantines were in place in some cities. But just recently, a few days ago, they needed to step back on this and they stopped calling this an immunity passport. So, this is still something that is ongoing and probably we will hear from the Chilean government in the next week, how they are going to or plan to use this documentation if it’s not aiming to warrant immunity to the persons that are holding it.

So in a matter of a few weeks, the Chilean government contradicted itself on this. What kind of reaction has there been to the plan so far?

In the media, it has been very clear that there were profound differences with the ministry of health. For example, the Chilean Society of Immunology or the Chilean Society of Infectology were both calling for prudence on the implementation of these measures in the context of uncertainty of the evidence. And I think the message from the World Health Organization during the last week was also very, very influential for the decision of the government to step back on this decision.

Will it give people false confidence when we just don’t have full details on immunity to COVID-19?

Yeah, absolutely. I think that one of the main criticisms of this idea of the immunity passport is not to be transparent in the uncertainties behind the idea. So, I think you can implement something like this, but you need to be very, very transparent to the public. What we do know and what we don’t know. I think that is, of course, a point of contention, because the economy needs to start working again. But we need to do it in a way that we protect the population’s health as well.

This interview has been edited and condensed for clarity. Reuters contributed to this report. 

In fight against coronavirus, Ghana uses drones to speed up testing

In fight against coronavirus, Ghana uses drones to speed up testing

Ghana is the first African country to ease its lockdown in response to the coronavirus. The country is using drones to deliver samples collected in more than 1,000 health facilities across the country.

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María Elena Romero

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Lydia Emmanouilidou

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COVID-19 tests samples are being delivered from rural areas of Ghana to testing centers in urban areas using drone technology.

 

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Courtesy of Zipline

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This week, Ghana became the first African country to ease its nearly three-week lockdown against the coronavirus.

While large gatherings are still banned, and schools remain closed, some nonessential businesses were allowed to open in Accra and Kumasi, the two main metropolitan areas in the country. Ghana’s President Nana Akufo-Addo said his decision came about after increasing the country’s capacity to fight the pandemic, including aggressive contact tracing and expansion of testing. 

Ghana is using a unique approach to reduce the amount of time it takes to get COVID-19 test samples from remote rural areas to labs: drones. Instead of waiting for days for a batch of samples to be transported by truck, tests from rural areas can be delivered for analysis in less than an hour.

Related: COVID-19: The latest from The World 

The Ministry of Health expanded its partnership with Zipline, an American company that uses drones to deliver medical supplies. Zipline has set up a system to deliver samples collected in more than 1,000 health facilities across the country.

Zipline’s drones are automated, but they’re also being monitored and, when needed, controlled, by humans. On April 17, on Zipline’s first flight, 51 samples were flown from the Omenako drone distribution center to the Noguchi Memorial Institute for Medical Research in Accra, 45 miles away, in what could be the first time that drones have been used to deliver COVID-19 test samples. 

The COVID-19 test samples are packed in special red boxes using guidelines issued by the World Health Organization and then placed inside the belly of the drone. The drone is then put on a launcher, and it’s off to its destination for delivery.

Zipline’s drones are automated but they’re also being monitored and, when needed, controlled, by humans.

Credit:

Courtesy of Zipline

The delivery is contactless. Once at the testing facility, the drone opens up its belly and drops the box filled with samples using a parachute to ease the landing. A health care worker sprays the box down with disinfectant and takes it inside to be processed. 

For nearly a year, Zipline has been delivering vaccines and medications to hospitals around Ghana. It also operates in Rwanda, where it uses its drones to deliver blood samples.

Wilmot James, a visiting professor at Columbia University who has advised the African Centers for Disease Control and Prevention on biosecurity, has been following Zipline’s operations for years and says the company has a clean track safety record. But he stressed that biosafety is critical in this kind of work and the fact that there is an inherent risk to these types of operations. 

“In this particular instance, we’re dealing with samples that are pathogenic,” James said. “An Ebola sample is another one; you have to make sure that you have proper protocols around that.”

Zipline says they’ve done that in consultation with experts and WHO. 

Ghana conducted more than 68,000 tests during lockdown, and some18,000 testing samples remain outstanding. The country has only  67 ventilators available in its public hospitals for a population of almost 30 million.

Trump’s WHO funding cut harms ‘fragile’ health systems, organization’s Africa head says

Trump's WHO funding cut harms 'fragile' health systems, organization's Africa head says

Dr. Michel Yao is WHO's program manager for emergency response for Africa. He spoke to The World's host Marco Werman about what it's like to deal with a pandemic and an epidemic at a time when WHO is overstretched.

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The World staff

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Lucy Martirosyan

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A health care worker who volunteered in the Ebola response decontaminates his colleague after he entered the house of a woman suspected of dying of Ebola, in the eastern Congolese town of Beni in the Democratic Republic of Congo, October 2019.

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Zohra Bensemra/Reuters

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There is a global backlash against US President Donald Trump’s decision to halt American funding for the World Health Organization. The move would slash about 10% of the organization’s operating budget during the coronavirus pandemic. 

Germany and China are denouncing the president’s plan, as are all the 55 member states of the African Union. 

WHO support is critical in many parts of Africa — including countries like the Democratic Republic of Congo, which is not only dealing with the coronavirus outbreak, but with Ebola. 

Dr. Michel Yao is WHO’s program manager for emergency response for Africa. He spoke to The World’s host Marco Werman about what it’s like to deal with a pandemic and an epidemic at a time when WHO is overstretched. 

Related: COVID-19: The latest from The World

Marco Werman: Dr. Yao, what do you make of Trump’s call to stop US donations to the WHO? 

Dr. Michel Yao: I think we acknowledge the support received from the US so far in many different public health interventions. And based on this support, we had many achievements. The comment that I can make is that it’s quite unfortunate that it’s happened at this moment where we need most of the members around us. We are appealing really for more solidarity and being together for this unprecedented crisis. 

Related: In Senegal, COVID-19 safety measures conflict with cultural traditions

We’re thinking a lot about the coronavirus, but I know at the beginning of this week, the DR Congo was hoping that it could declare itself Ebola-free. And yet, two people died from Ebola. That’s got to be really disappointing for health workers. What does it mean for the country’s ability to effectively deal with two epidemics at the same time? 

In a fragile health system, like the one we have in DR Congo, it means that the resources will be overstretched. You have to deal with Ebola — that is absorbing a lot of resources. If we want to control it, it’s going to require dedicated attention. At the same time, you have another disease that also spreads faster than Ebola. So, it will mean that the resources have to deal with two challenges, and there would be more of a stretch. So, there is a need for our different partners to remain on board and around. 

Related: As coronavirus spreads, poor communities in Kenya are left vulnerable

When the Ebola outbreak started in DR Congo in August of 2018 — so nearly two years ago — many people didn’t believe it was real. In fact, as you know, militias shot and killed health workers over it — colleagues of yours. How are people in DR Congo reacting to COVID-19? Are they taking it more seriously? 

It’s the same in DR Congo as well as in many countries. You see, this deadly virus has a lot of rumors. So, it’s like in many communicable diseases, it requires a lot of awareness. So, I think we learned a lot from Ebola that we need to share the right information. We need to also engage communities to be on board, to assign them tasks for them to own their response. And that’s what we are doing. Learning from Ebola, we are building on what we did. But these rumors are always there. 

Related: What the US can learn from West Africa to slow the spread of coronavirus

With your background, Dr. Yao, in emergency responses to epidemics, how does COVID-19 compare? Is it too soon to compare it to other outbreaks you’ve been through? 

COVID-19 is, I think from my experience, it’s one of the things that I’ve never seen, the way it affects many countries at the same time. So, you find all the worldwide resources absorbed by this outbreak, and it leaves less for support for the weakest. 

I’m in charge of emergency operations for WHO Africa. And in my experience, we deal with few countries. Major outbreaks never affect more than 10 countries at once. But this time, we have in our region — we cover 47 countries — we have 45 of them in crisis. So, this is what makes it totally different from what we saw in the past. 

This interview has been condensed and edited for clarity.

Madeleine Albright: ‘Globalization is not a four-letter word’

Madeleine Albright: ‘Globalization is not a four-letter word’

By
The World staff

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Joyce Hackel

Former Secretary of State Madeline Albright takes the stage during the Democratic National Convention in Philadelphia, Pennsylvania, July 26, 2016.

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Lucy Nicholson/Reuters

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Former Secretary of State Madeleine Albright spent years representing the US in multilateral institutions.  

A World War II refugee from Czechoslovakia, Albright became the first woman to serve as US secretary of state in 1997, appointed to the role by then-President Bill Clinton. Before that, she served as US ambassador to the United Nations.  

Related: Madeleine Albright thinks it’s time to set the alarm on fascism

In her newly published book, “Hell and Other Destinations: A 21st Century Memoir,” Albright reflects on life after her tenure in the State Department. But the former Secretary of State remains a beacon of American statecraft and advocate of multilateral diplomacy. And she said she is concerned about US President Donald Trump’s recent actions to halt funding to the World Health Organization. 

“I think it is the most counterproductive move he possibly could have made. Clearly, there were problems and problems the Chinese are going to have to answer for at some point,” Albright told The World. “But, having been at the UN, I can tell you there is no way to have your views taken seriously or call for reform if you’re not being supportive. And it’s definitely taking yourself out of a situation instead of really trying to deal with the problem. The UN is 75 years old. They do need some help in fixing these organizations, but we can’t do it from the outside.”

Related: Trump cuts WHO funding

Albright spoke with The World’s Marco Werman about Trump’s recent WHO decision and the impact on multilateralism. 

Marco Werman: What sort of reform do you think the WHO needs?

Sec. Madeleine Albright: The WHO did provide warnings, but I think that there are, obviously, issues in every organization about how they function internally, the bureaucratic aspects, their relationships. But we have to be at the table and we have to contribute and support it and not create additional problems by all of a sudden going around its back.

Related: Is coronavirus reshuffling the global power deck?  

I don’t want to do an audit of the WHO in the middle of a pandemic. But specifically, where do you think the reform should happen?

The United Nations, many of the organizations, are actually very dependent on getting intelligence from the outside. And that’s probably a good idea to try to sort out when and how they get their information. But it’s unfair just to accuse them of having screwed everything up and blaming them for something that we need to take some responsibility for, and the Chinese obviously do.

Related: Madeleine Albright: ‘Many of the best diplomats are women’ 

So as far as Trump’s announcement regarding funding for the WHO, do you see it as theater and an effort to scapegoat? And what message does it send to the rest of the world?

I think that it sends a very difficult message that the United States doesn’t have to cooperate with international organizations. That the president of the United States can go to the General Assembly session and talk only about how important our country is and sovereignty without understanding that in the 21st century there are issues that can only be handled by more than one country.

And obviously, disease knows no borders. Globalization is not a four-letter word. It is the interconnectedness of the world in the 21st century. He has not explained, frankly, what he is going to do, where he’s going to put money. Or is he going to go through some other organization? Just kind of standing up and saying, “I’m canceling” or “I’m not going to contribute” without explaining what is going to happen, I think, is a grandstand.

Related: Leon Panetta on coronavirus: ‘We’re paying the price’ of ignoring intelligence reports  

Multilateral diplomacy is all but dead. So what comes next on the world stage, in terms of power relations?

Americans don’t like the word multilateralism. It has too many syllables and it ends in an “-ism.” But it’s just about partnership and a recognition that you need partners in solving problems. Trade and aid are obviously tools. But in order for us to have a good trade policy, which I believe we need to do, there need to be people that are healthy enough to buy our things.

I’m very worried about what I’m reading that’s happening in the developing world, where the virus is also hitting. They don’t have anywhere near the health situation that they can distance from each other. And who do we expect to buy all the things that we’re exporting? How are we going to deal with supply chains? So there’s an awful lot that’s interconnected that requires some kind of an active cooperation. Given what’s going on in the 21st century, we are interdependent. There’s just no question.

Related: Pandemic threatens global stability, says Susan Rice  

Sec. Albright, it’s no secret you’re known for wearing brooches that convey historical moments that you’re living through. Do you have a broach for this moment?

I do, actually. It’s a V, and I’ll tell you where it comes from. I do also write about the fact that — I was just a child — but we spent World War II in London during the Blitz. My father was with the Czechoslovak government in exile and he spoke over BBC to Czechoslovakia. And every BBC broadcast would begin with a kettle drum and the notes from Beethoven’s Fifth, which is basically Morse code for victory. And so I have a V pin. We need a victory over the virus.

This interview has been edited and condensed for clarity.