The emergence of the pandemic zika virus in the Americas in 2015 renewed the debate over whether a global agency like the UN had the right expertise and the political will to lead the fight to defeat it. The doubts were already well-founded: the UN’s inability to halt the Ebola epidemic in west Africa three years earlier sent the Ebola response far down the road to catastrophe. They were further compounded by similar troubles in Thailand and Saudi Arabia, both affected by the measles outbreak that has swept through the world, triggering several other global outbreaks.
Zika is a virus belonging to the same genus as influenza, malaria and the seasonal flu. It does not cause death in the vast majority of patients, but those who do become seriously ill can face long-term neurological effects. It also has been linked to severe birth defects. It was first discovered in Uganda in 1947, and the mosquito that carries it is endemic across much of Africa and Asia. Only 15 years ago, it was confined to tropical areas and remote Pacific islands. But the 2015 outbreak, which was linked to an outbreak of the microcephaly disorder in Brazil, prompted intervention from various governments and international organisations. In response, governments and, in particular, the US government organised a conference of state leaders in Washington to manage the attack and devise a response. The World Health Organisation played a key role in working with all those parties. But the WHO is a global body with a catch-all mandate, and response to an outbreak will inevitably vary from country to country. The result was that the responses differed dramatically, leading to a crisis of leadership and coordination.
Pandemic health emergencies are decided in part by political will. And little evidence exists that the political will exists to deal with health emergencies in an organised way, with UN leadership, for example. A broad-based international response is vital to prevent the spread of disease and fatal pandemics.
The international response was central to the response to the 2014 Ebola outbreak, which killed more than 11,000 people. The WHO, the Paris-based International Committee of the Red Cross and the public health charity Medecins Sans Frontieres (MSF) and other organisations played a central role in co-ordinating the response and aiding healthcare workers. There is no reason to believe they would not do so again if required to tackle another epidemic. Yet they still have significant political gaps to cross in order to encourage effective responses. In today’s world, the framework of national emergency governance is disintegrating, and global organisations are struggling to meet the challenge. A prolonged spell of such crises would constitute a serious threat to the global economy. No one wants such a spectre at the moment.
London has won the right to host the World Health Assembly, the UN’s governing body. It is keen to focus on other pressing crises, such as Trump’s US withdrawal from the Iran nuclear deal, rising unemployment and its looming strike on UK air travel. But health emergencies are not included. The UK has also lost its bid to host this year’s summit on antimicrobial resistance, which could establish principles for dealing with such crises.
UN negotiations on Ebola agreed that the world needed to learn to be more robust when threatened by diseases in remote or impoverished regions. It is time to act on that. More than that, there is a moral imperative to do so. The UK can build on its successful leadership role in both the global Ebola response and the US-led coalition fighting Isis to exert a leading influence on global health crises as well. The sooner the world develops a clearer understanding of Ebola, the sooner we can look to fight a disease such as Zika.