Welcome to hardtalk. Im stephen sackur. With nations across the world struggling to contain the coronavirus pandemic, there has never been a greater need for an internationally co ordinated response, and that is where the un agency the World Health Organization should come in. But right now, the who is itself at the centre of a political storm. President donald trump has withdrawn american funding, accusing the who of being china centric. My guest today is the who special envoy for covid 19, doctor david nabarro. Is his agency failing its biggest test . David nabarro in geneva, welcome to hardtalk. Thank you. Thank you very much, stephen. Let us start with an overview as a veteran of fighting disease from malaria to cholera to ebola, youve now become the who special envoy on covid 19. Are you more worried today than you were a month ago about the way it is spreading around the world 7 i was always anxious about this, ever since i first heard about it, and ive got increasingly anxious as the pandemic has gone on. You see, were beginning to get some sense that the outbreak can be controlled in europe and in the us, but thats as a result of very rigorous physical distancing through lockdown. My concern is that the virus hasnt gone away during these lockdowns and that as the lockdowns are released, if were not fully defended, that the outbreaks will build up again, and im really worried about whats happening in poor countries on two accounts. One is that they have really very weak Health Services compared with advanced countries, and, secondly, that the lockdowns that have had to be introduced in so many countries now are also having impacts on peoples food security, peoples nutrition and their increasing poverty. David, do you regard it as inevitable, as some have said, that, ultimately, pandemic will sweep through the most Vulnerable Countries of all im thinking perhaps of yemen, of the situation in northern syria, of pretty broken countries like venezuela will they all ultimately be hit hard by this pandemic . It certainly will be a threat to every country and every population in the world. So the only way were going to be able to get on top of it and get ahead of it is if every society everywhere is knowing about it and is able to interrupt transmission for themselves. A really important point is to stress that its not going to suddenly go away, its going to stay with us for the foreseeable future. So this capacity to defend against it and to learn how to live with the constant threat of the virus is going to be the key for the future of humanity. In that context, how disappointing is it to you that the World Health Organization right now, far from being the sort of spearhead of a global attempt to control the virus, right now, the World Health Organization is riven with political division. You have the United States withdrawing funding, you have other politicians criticising you, and you have, lets face it, a profound credibility problem. Well, first of all, i want to stress that the way in which this virus has been tackled is through the most extraordinary network of Public Health experts throughout the world. Now, the Public Health community sees the World Health Organization as its focal point. Weve all worked as either members of the World Health Organization or as part of networks of the World Health Organization, and for the Public Health community, theres absolutely no question the World Health Organization is our lead organisation. We dont have a problem with its credibility. If there are political leaders who have problems with the World Health Organization, thats for them to sort out. Remember, the who is governed by 194 Member States as theyre called, and the who personnel operate under that government structure. That is the bureaucratic sort of process behind the who. I just want to get down to brass tacks. There is a strong feeling in some quarters that the who colluded in a cover up of the beginnings of the outbreak of covid 19 in china. Is that the case . Oh, absolutely not. I would like to say it a second time absolutely not. If you are so sure, explain to me why we now have evidence that the chinese authorities covered up for weeks knowledge that they had that this was an extremely dangerous new virus that was being transferred from human to human, and the World Health Organization failed, for week upon week, to flag that up. Well, i mean, of course, what we will do in the World Health Organization, as always happens, is a very detailed and forensic examination of exactly what happened on what days, who knew what, who told who what, and that will be the right thing to do. When i was working on ebola in 2014, there were many accusations against different organisations of failure to act on time, and necessary investigations were done, but they were done after we got on top of the outbreak. What matters now and i want to stress this, stephen is that everybody everywhere focuses on the job that has to be done. We have a massive global emergency, and its absolutely essential that we all focus on that. For us to be distracted and asked to do an enquiry right in the middle of everybody working flat out to try to keep people together to do whats necessary to do with this virus is frankly inappropriate. I understand that, and it is a very important point you make, but nonetheless, it isntjust about investigations of the past. It is about ongoing credibility, because we all need to know that the who, when it works with national governments, is able to access all of the data, that governments are being transparent, are being honest about what is happening in their territory, and that, therefore, the who is a network which is sharing genuine information, and right now, we cant be sure of that. Weve just learned the official figures from wuhan for the numbers killed by covid i9 were off by 50 . What else dont we know about the way this virus is working . Stephen, that is a super complex question to answer. I hope you will give me the time to answer it, and perhaps i have to ask you to repeat parts of it. Lets deal with the figures. I would like you just to check whats been happening in the uk in the recent past. We were told, i believe, over the last 2a hours, that the uk death estimates have had to increase because they found that they hadnt got all the deaths that were probably covid related in their figures because they were dealing with them primarily on the basis of nhs results, and then they found there were additional deaths from people in residential institutions. The same for other countries as well. Revision of death numbers during an outbreak is very common and viewers should not believe that just because death numbers have been revised, that means theres concealment. Secondly, the World Health Organization is not a Global International health inspectorate. Its a Brilliant Organisation that works in the way that it was set up to deal with information that is provided to it by individual members. It cannot compel governments to release information, it doesnt have the power, and thats the way in which weve always worked, and that, i presume, is the way were going to continue to work unless governments give us different rules to work by. I understand that point, and it is an important one, but let us not forget that your boss, doctor tedros, the head of the who, went to beijing, and in the course of his conversations with xijinping and others, he heaped praise upon the chinese response to covid i9. Now. Knowing what we know, do you deeply regret that . Can i interrupt you at this point . It is really important that your viewers understand exactly what doctor tedros was doing. He was praising the way in which the Chinese Government responded to the outbreak when they realised what was going on. They did the number of things that every other country should be doing. They informed their people what was happening, they reinforced public Health Services, they repurposed hospitals and they got the whole of government to focus on the need to stop movement out of wuhan, to stop the disease spreading elsewhere in the country. That was praised because it was the right thing to do. Other countries have done the same, particularly countries that were affected by sars in 2003. That was what doctor tedros was praising and he has encouraged other countries to read the report of what weve seen was happening in china during february and to apply those findings themselves. That was correct. As my view as a Public Health professional, that was the right thing to do. What do you say then to people and well talk about donald trump in a minute but people who actually have a lot of time for the who, who have even worked alongside it, people like david fidler, fellow in Global Health at the council on foreign relations, been a consultant to the who, who says, we have had a situation since the beginning of the year where it looks like the who doesnt want to exercise its authority when it came to its interventions with china. What do you say to that . Well, of course, the enquiries will be done. Those of us who are working on this right now believe that the World Health Organization has acted within the authorities that it has, and im going to continue to say that even if you push me to try not to say it. I also want to stress the following the World Health Organization has been very clear since the middle of january that there was a sense that this was a major and serious disease. Onjanuary 14, that concern was expressed in press briefings and other communications, and its been the same ever since. Take this virus seriously. Act quickly when youve got cases within your country. Do not. Do not behave as though its a mild disease, do not treat it like its flu. And that advice has been the drumbeat thats come from who since january. Understood, and well get to your advice to governments and people around the world injust a moment. Butjust one more point taiwan, the government of taiwan says that it sent information to you at the who in late december, describing their fear that human to human transmission of covid i9 we didnt call it that then, but what we now know as covid i9 was already happening. They say they got no response from you and there are many people concerned that because of your whos close relationship with the Chinese Government, that anything that came from taiwan was not taken seriously. Is that true . Well, thats not true, so let me just give you the facts as i understand them. And i want to stress, i was not working for who at the time, i started working as a special envoy initially at the end of january. Now, on december 31, china reported that it found a cluster of pneumonia like illness in wuhan, in hubei province. And that report went to the who. On the same day, authorities in taiwan wrote to who, saying, weve heard that there is an outbreak of atypical pneumonia in wuhan. Can you tell us anything about it . The who, as far as i understand, was not given any information from taiwan that was different from what they received from the government of china. So, there will of course be an investigation, and im sure there will be more to be found, but that is the information that i have, and so it doesnt indicate that who was given information by taiwan that it did not have from china. Well, you know as well as i do, doctor nabarro, that donald trump, for one, doesnt buy that. But lets look at the Bigger Picture of the relationship with the United States. Donald trump tweeted out, the who blew it. For some reason, theyre funded mostly by the us and yet they are, he says, very china centric. Hes pulled the 400 million or so that the us puts into who funds every year, you have, clearly, a fundamental problem now with the United States. As a veteran fighter of global disease, how do you respond to what donald trump has done . You know, ive worked in Global Health really for more than a0 years and ive worked in the international system, with who and other organisations for more than 17 years. The most significant supporter in terms of personnel, in terms of partnership and funding is the United States of america. Weve always had an absolutely superb relationship with the us. And we continue to have that relationship. Us experts participated in the mission to china. Us experts are embedded in whos Emergency Response programme. Us experts have been constantly working with who even recently, particularly those who are responsible for the control of communicable diseases. Its not true to say that who is anything other than very close to the United States of america, as it should be because it has so many superb experts on whom we and the world depend. But you have to recognise reality. Donald trump has declared that he doesnt believe in the credibility of your organisation today. Gordon brown described trumps move as self harm, an act of sabotage, many would see it as. Do you see in that way . I really do not want to use any words to criticise any president of any country that is part of the international system. The way in which the International Systems work is by consent and by cooperation. When youve got a giant emergency like we have at the moment, the most important requirement is that all leaders Work Together to make sure that the wellbeing of 7. 8 billion people is maximised. If one head of state decides that he wants to move away from that global consensus, thats not a problem just for the World Health Organisation, it is a problem for the world. And its a particularly serious problem if it is the leader of the organisation that provides the majority of funding to our system. Let us look forward then, if we may. Doctor tedros, your boss, said that the message to the world all governments had to be test, test, test. The truth is, some governments and im thinking south korea and germany have conducted mass testing which appears to have been very important to putting a lid on the curve of infections. They have had success. Other countries, including the united kingdom, have not tested in the same way and their curve has not yet come down in the same way. Are you ready to call out countries like the uk for a fundamental failure . The World Health Organisation is not able to call out countries and criticise them. Its not how it works. What the World Health Organisation does is it identifies approaches that look as though they have been successful. The approach that is most useful in dealing with this disease is to interrupt transmission. It is easy to interrupt transmission if you are able to test people to see if they have the virus. Many countries have made valiant efforts to upgrade their capacity to test. Its a tricky test to do. And those countries that have done so and distributed testing widely have been able to get on top of the disease. Im interested. Our challenge is poorer countries who are not able to rapidly upgrade testing. And for them we are doing Everything Possible to help them get access to tests. And also, if they cant get access to tests, explain how best to interrupt transmission on the basis of what we coal on the basis of what we call symptom based diagnosis. Im interested in your contention that it is absolutely not the whos role or responsibility to call nations out. But ive got two quick questions for you. Brief answers if you would. When we see china, it seems still happy to tolerate the so called wet markets in cities like wuhan, where live, wild animals are sold in marketplaces alongside other foodstuffs and we believe that may well be the way in which covid i9 transferred to the human population. Isnt it time for you and others at the top of the who to say this is not acceptable, it must stop . We cant say is not acceptable, it must stop. But we can say that all the evidence suggests that wet markets and the eating of bushmeat and similar practices are contributing to an increased risk of zoonotic disease and we really discourage that practice. Then we need to redesign the who, dont we, to give it more teeth, to give it real power, otherwise whats the point . Stephen, you might want to redesign the who, i might want to redesign the who, but the who is governed by the worlds nations. And they meet together regularly and they work out the mandates they want to give to the organisation. They will no doubt review whats happening as a result of this and decide whether they want to change the mandate. But at the moment, the who has been given the powers to advise and to provide guidance and to review, but it does not instruct. Will there be an easy exit from this . Im guessing your answer is no, but im also guessing that actually, you, in the course of this interview, have suggested that we have to think of this not in terms of weeks and months but maybe even years before a semblance of normality is restored to our global cultures and societies. Is it like that . There are countries that are showing us that there are ways to continue with social and Economic Activity despite the fact the virus is a continuing threat. We build on the experiences of those countries to establish guidance for the world. And that suggests that we can transition out of the present situation living with covid, provided we set up defences in communities everywhere and provided we have clear protocols for how we are going to react to outbreaks. This gets