Resign, Margaret Chan

Chan, the head of the U.N. World Health Organization (WHO), probably owes her job to her pedigree as a Communist Party quisling in Hong Kong‘s public health bureaucracy.* As Hong Kong’s Director of Health during the SARS outbreak, Chan’s public statements made her the object of widespread derision and ridicule. Later, Hong Kong’s Legislative Council commissioned a Select Committee to conduct an exhaustive study on the response of the government and its officials. The Select Committee’s Findings about Dr. Chan’s performance, which begin on page 252, are strikingly similar to what you’re about to see excerpted in this post, with respect to her slow response to the Ebola outbreak. The report concluded:

The Select Committee finds the performance of Dr Margaret CHAN not satisfactory in the handling of the SARS outbreak in the above aspects.

Chan’s boss and one other politician resigned, but Chan was promoted into the leadership of the World Health Organization.

In hindsight, you can’t help but wonder how Chan could have risen to a position of global responsibility, except for the reason already noted. Nor can you avoid the lesson for Hong Kong itself, where the Communist Party may soon succeed at smothering public debate and accountability for the failures of government officials and institutions.

It may have been inevitable that Chan’s ambitions would also promote her into the position of global laughingstock. In 2010, Chan earned this distinction when, after a stage-managed tour of some showpiece hospitals in Pyongyang and a clinic outside the capital, she called North Korea’s health care system “something that most other developing countries would envy,” and observed (really!) that North Korea shows “no signs of the obesity emerging in some parts of Asia.” When challenged by Amnesty International for these breathtakingly stupid observations, Chan’s minions doubled down on them.

Now, The Washington Post reports that under Chan’s leadership, the WHO was a weak link in the global response to the Ebola outbreak. This time, no one is laughing.

The WHO, an arm of the United Nations, is responsible for coordinating international action in a crisis like this, but it has suffered budget cuts, has lost many of its brightest minds and was slow to sound a global alarm on Ebola. Not until Aug. 8, 4 1 ? 2 months into the epidemic, did the organization declare a global emergency. Its Africa office, which oversees the region, initially did not welcome a robust role by the CDC in the response to the outbreak.

Previous Ebola outbreaks had been quickly throttled, but that experience proved misleading and officials did not grasp the potential scale of the disaster. Their imaginations were unequal to the virulence of the pathogen.

“In retrospect, we could have responded faster. Some of the criticism is appropriate,” acknowledged Richard Brennan, director of the WHO’s Department of Emergency Risk Management and Humanitarian Response. But he added, “While some of the criticism we accept, I think we also have to get things in perspective that this outbreak has a dynamic that’s unlike everything we’ve ever seen before and, I think, has caught everyone unawares.”

Lack of funding is not an excuse this time. When a public health organization is charged with responding to a crisis of this magnitude, its leaders must call the world to action and lead. Had the WHO timely recognized the crisis, the world would have followed WHO’s leadership. It was the leadership itself that was lacking. Worse, some WHO officials actually obstructed the CDC’s efforts to assess the outbreak, and to fill the leadership void the WHO had created.

… Americans can’t simply charge into a country and begin barking orders. The CDC must be invited. Even then it plays a supporting role to local officials and the World Health Organization.

Early in this outbreak, the CDC ran into bureaucratic resistance from the WHO’s regional office in Africa. The American officials wanted a greater leadership role in managing the outbreak response, including data collection and resource deployment. The CDC’s Frieden asked Keiji Fukuda, a former CDC official who is now the WHO’s assistant director-general for health security, to intervene. Fukuda flew to the WHO’s regional office in Congo and persuaded his colleagues to allow the CDC to play a larger role.

What did it take for Chan herself to act, at last?

In late July, with the epidemic roaring, Liu, the head of Doctors Without Borders (known internationally by its French name, Médecins Sans Frontières), requested a meeting with WHO Director-General Margaret Chan at the WHO’s Geneva headquarters. [….]

On July 30, she implored Chan to declare an international health emergency. Chan responded that she was being very pessimistic, Liu said.

Liu replied: “Dr. Chan, I’m not being pessimistic. I’m being realistic.”

Chan soon flew to West Africa to meet with the presidents of Guinea, Liberia and Sierra Leone, and announced a $100 million push to stop the outbreak.

On Aug. 8, the WHO declared a global health emergency.

Chan declined to comment for this article. The WHO’s Fukuda said that if anyone asks whether his organization did a perfect job, the answer will be, “Hell no.”

Eventually, even Ban Ki-Moon appointed someone else to carry out the responsibilities that Chan could not:

In a sign of ebbing confidence in the WHO’s ability to coordinate a response, U.N. Secretary General Ban Ki-moon on Aug. 12 appointed David Nabarro, 65, a longtime troubleshooter, as senior U.N. system coordinator for Ebola.

Dr. Chan ought to have been driven from office years ago. This is only the latest and most compelling reason why she should step down. The best thing that could be said of her earlier gaffes on North Korea is that they only relegated the people of one forgotten nation to sickness, hunger, and misery. But it is also true that they demonstrated a paucity of judgment and candor that foreshadowed her failure in this crisis.

By early September, there was still no agreement among the major global health organizations and governments on how to respond to the epidemic. Unlike other disaster responses, such as the one after the earthquake in Haiti in 2010, no major U.N. operation was in place. And despite a 20-page “road map” that the WHO had introduced, it was unclear how anyone would put it into effect.

“Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it,” Liu, of Doctors Without Borders, told the United Nations on Sept. 2. For the first time, she implored countries to deploy their military assets – something her organization had previously opposed for health emergencies.

During these critical days and weeks of what could be the greatest global health crisis since the Spanish Influenza — if not the Black Plague — humanity can’t afford to relegate a position of such critical responsibility to someone who either can’t see the truth, can’t tell it, or can’t act on it. Can anyone in the U.N., no matter how hard she fails, ever be held accountable? If so, this is the time to show it.

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* Update: This New York Times story, written before China re-nominated Chan, paints a different picture of her, not so much as a CCP quisling — even as someone who was willing to challenge the CCP on occasion — but as someone who is simply out of her depth. Today, however, Dr. Chan must be doubly indebted to the CCP for both her rescue from disgrace and for her renomination. Chan could be a deep-red Maoist for all I care, if only she were a competent one.

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Update 2: I see that Reuters (via The New York Times) and Bloomberg have also published news articles critical of Chan’s performance. Even in this less critical Times piece, Chan admits that WHO was not prepared.