China, the WHO and the power grab that fuelled a pandemic

INSIGHT INVESTIGATION

In early 2020, the world missed its chance to stop Covid-19. Insight exposes how Beijing’s ten-year takeover of the global health watchdog sowed the seeds of disaster

The Sunday Times

After being heavily criticised by the World Health Organisation for its response to Sars in 2003, China decided it would not accept such public humiliation again. What followed was a concerted campaign over many years to seize power within the organisation.

A Sunday Times investigation raises serious concerns that the independence and leadership of the WHO were severely compromised by the time the first cases of a mysterious new coronavirus appeared in Wuhan in 2019 — with profound consequences for the course of the Covid-19 pandemic and the world.

Our investigation reveals:

● China secured WHO votes to install its chosen candidates as director-general.

● The WHO leadership prioritised China’s economic interests over halting the spread of the virus when Covid-19 first emerged.

A catastrophe in the making

Barely eight months after taking charge, the director-general of the WHO gave a speech that would prove extraordinarily prophetic. Tedros Adhanom Ghebreyesus warned that all nations were facing the ever-present threat that a new respiratory illness, such as the Spanish flu, might emerge and spread across the globe in weeks or months, killing millions.

It was why, the Ethiopian told the audience at his keynote speech in Dubai in February 2018, he had made it his daily priority since becoming the WHO’s chief to make sure he was up to date on the thousands of reports the health body received every month that might flag up signs of an outbreak.

The WHO, a Geneva-based United Nations agency with a £5 billion budget from 194 member states, was on a war footing. Tedros said it would act fast and decisively, because ignoring the signs of an outbreak could “be the difference between global spread of a deadly disease and rapid interruption of transmission”. So far this “new tighter focus” was working, he added.

Tedros Adhanom Ghebreyesus with Chinese premier Li Keqiang in 2017
Tedros Adhanom Ghebreyesus with Chinese premier Li Keqiang in 2017
GETTY IMAGES

So when the first alert of a mysterious respiratory illness in China, exactly as Tedros had described, was reported by health monitors in Taiwan at the end of December 2019, the health agency should have been prepared and ready for action.

In fact the WHO would receive considerable criticism for failing to help stop the spread of the Sars-CoV-2 virus in the opening weeks of the Covid-19 pandemic. Not only did the organisation fail to act but it also promulgated misinformation about the virus originating from China and even discouraged other nations from taking steps that might have contained the spread. For all his foresight, Tedros would be accused of being ineffective when the big test came.

The world paid a heavy price for the WHO’s inaction. As Tedros predicted, the virus has killed more than four million people, and there will be many more. The body that is charged with looking after the world’s health seriously malfunctioned in those opening weeks, when humanity most needed it to come to the rescue. Why?

Our investigation reveals today how a concerted campaign over many years by Beijing to grab power inside the WHO appears to have fatally compromised its ability to respond to the crisis. It raises serious concerns about the extent of Beijing’s influence over the WHO and its director-general, and how this undermined the organisation’s capacity — and willingness — to take the steps necessary to avert a global pandemic. Its leadership put China’s economic interests before public health concerns. The results have been nothing short of catastrophic.

Disinfection in a Chinese village in January 2020, when hospitals were being overwhelmed with Covid patients
Disinfection in a Chinese village in January 2020, when hospitals were being overwhelmed with Covid patients
CNSPHOTO/REUTERS

Beijing’s man

It is a story that stretches back many years before the Covid-19 crisis. After being strongly criticised by the health agency for attempting to cover up the 2003 Sars crisis, China set out to increase its influence over the WHO. By applying financial and diplomatic leverage over some of the world’s poorest nations, Beijing won a global power struggle to get its favoured candidates installed at the very top of the organisation.

As a result, years later, a body that was set up with the lofty goal of “attainment by all peoples of the highest possible level of health” has been co-opted into aiding the Chinese state’s campaign for global economic dominance. Its leadership began to speak differently, espousing statements and pursuing policies that were markedly convenient to China — even praising Beijing’s questionable allies such as North Korea, despite its appalling health and human rights record.

Beijing had been instrumental in installing Tedros as the £170,000-a-year head of the agency by pulling strings and calling in favours during the 2017 election for the job.

Tedros himself caused outrage by bestowing the role of WHO goodwill ambassador on Robert Mugabe, the notorious former Zimbabwean dictator, an appointment said to have had strong backing by the Chinese government, a long-standing close ally of the despot.

As hospitals became flooded with patients in Wuhan in January 2020, the health agency repeatedly relayed to the world the Chinese government’s false claims that there was no evidence the virus could pass between humans. It made a specific point of cautioning countries not to impose bans on travel to and from the virus hotspots — which meant many weeks were lost before countries independently decided to seal their borders. The WHO’s approach ensured that China’s short-term economic prospects were protected. Meanwhile, the virus was allowed to spread round the globe like wildfire.

More recently, we can reveal, a backroom deal negotiated between the WHO and China has seriously damaged the chances of the world getting to the bottom of one of the most important questions facing mankind today: the origin of the Covid-19 pandemic.

When the world’s nations gave Tedros the job of discovering how the virus first came to infect humans, his team struck an agreement in secret with China that emasculated the inquiry. It meant that the WHO’s “independent” mission — its fact-finding team travelled to Wuhan early this year to carry out an investigation — was, in the words of one expert, little more than a “shameful charade”. There may well be no second chance.

Legacy of Sars

The health agency’s reaction to Sars, the first pandemic crisis of the 21st century, had been very different. In many ways that lay at the root of the later difficulties that would come to a head with China.

The Sars outbreak started in November 2002, when a number of people in Guangdong province, southern China, began to fall ill with flu-like respiratory symptoms; by January 2003 infected patients were streaming into the region’s hospitals.

The Chinese government had immediately enforced its strict laws, which classified all new infectious diseases as a state secret before they were officially announced by the ministry of health. As a result, the WHO was kept largely in the dark about the outbreak until the son of one of its former employees emailed the agency in February 2003 with some alarming news. The message described a mysterious virus in Guangdong that had already killed 100 people but claimed the authorities were insisting “it was not allowed to be made known to the public”.

The cat was out of the bag, and after stern questions from the health agency China did share some limited information about the new virus the following day. However, government officials in Guangzhou, the city at the centre of the outbreak, were still maintaining that the illness was under control. This was untrue. Sars had already spread to other parts of China.

The Chinese were still anxious to play down the extent of the outbreak. At one stage 30 patients with the virus were said to have been driven round Beijing in ambulances, and 40 others were moved out of a hospital into a hotel to hide their existence from a visiting team of WHO scientists.

Tough on China: former WHO director-general Gro Harlem Brundtland
Tough on China: former WHO director-general Gro Harlem Brundtland
PAUL HILTON/EPA/REX/SHUTTERSTOCK

China’s reluctance to disclose the duration, scale and evolution of the disease led Gro Harlem Brundtland, then the WHO director-general, to get tough. She was a former prime minister of Norway and not scared of ruffling feathers. “Brundtland was a very brave politician with a lot of legitimacy,” recalls Gian Luca Burci, a legal adviser to the WHO at the time. “She didn’t shy away from criticising China and basically saying, ‘We don’t believe you. You should come clean.’”

Brundtland put pressure on China and took the brave decision to issue strong advice against travelling to the affected areas, which included Hong Kong and Toronto as the virus spread.

“The WHO really stepped into a vacuum, and it really exerted its authority as an emergency manager,” Burci said. “I would say the unanimous perception is that the WHO played a central role and essential role in allowing Sars to be controlled in a matter of months.”

Brundtland publicly criticised China’s cover-up and said the outbreak might have been contained if the WHO had been alerted earlier. “Next time something strange and new comes anywhere in the world, let us come in as quickly as possible,” she urged.

The virus was brought under control in the early summer with only 8,000 cases and just under 800 deaths. The public ticking-off had been humiliating for Beijing. There was also an economic price for China: the health agency’s travel advice had contributed to an estimated $6 billion loss to the country’s GDP.

China began taking a keen interest in the WHO after the bruising it received over Sars. A senior source now working at the health agency has described how in 2005 Beijing was behind a group of countries that attempted to “limit” the authority of its director-general.

Their efforts led to new regulations for the WHO’s governance, which compel the director-general to consult an emergency committee — made up of international experts and often including a China representative — before he or she calls an international public health emergency or recommends travel restrictions.

A further opportunity for China to extend its influence within the agency presented itself a year later when Brundtland’s recently appointed successor as director-general, the Korean doctor Lee Jong-wook, suddenly died after undergoing brain surgery.

One of the leading candidates was Dr Margaret Chan, a Chinese national. She was a former Hong Kong health director who had been criticised during the Sars crisis for her supine attitude to mainland China. The Hong Kong legislative council found she had been too slow to respond to the Sars outbreak and too unquestioning of the misleading information from Beijing. Hong Kong suffered a higher Sars death rate than anywhere else in the world.

Chan had, nonetheless, moved to a new job with the WHO in Geneva, and when Jong-wook died, the Beijing government rallied behind her candidacy, ordering its embassies to lobby international friends to get behind her in the November 2006 election to choose a replacement.

Margaret Chan drew criticism as Hong Kong’s health chief for believing China’s claims about the 2002-04 Sars outbreak
Margaret Chan drew criticism as Hong Kong’s health chief for believing China’s claims about the 2002-04 Sars outbreak
FABRICE COFFRINI/AFP/GETTY IMAGES

Just five days before the vote, a summit was held in Beijing for leaders of the African nations. China pledged to cancel large amounts of their debts and double aid donations to the continent in a move that was openly acknowledged by state-backed analysts in the country as designed to secure backing for Chan.

It was an “extraordinarily aggressive campaign”, according to Professor Lawrence Gostin, the director of the WHO’s Collaborating Centre on Public Health Law and Human Rights. “[China] got burnt really badly during Sars,” he said, adding: “It wanted someone much more friendly and gentle if an outbreak came again.”

Chan won with two thirds of the votes in the final ballot. China had succeeded in getting its candidate to the top “precisely to avoid another humiliation”, according to a source working at the WHO at the time.

The African link

During her 10-year reign in the agency’s top job, Chan certainly gave the appearance that she was very grateful to China for propelling her into the role. In April 2010 she made a trip to North Korea, one of China’s neighbours and allies, and made the extraordinary claim the country’s health system was the “envy” of most developing nations.

A few months later a report by the human rights group Amnesty International described the shambolic state of North Korea’s “crumbling” health system. Hospitals at times lacked heat, power and medicines, the report said, and amputations were sometimes performed in candlelight without anaesthesia by doctors who were living on the poverty line because their wages were not paid.

Chan made a number of key appointments that appeared carefully calculated to please the Chinese government. In 2011 she made the Chinese soprano Peng Liyuan a WHO goodwill ambassador, praising the singer’s “world-famous voice” and “compassionate heart”. The other reason Chan might have selected Peng was not mentioned.

Peng is married to Xi Jinping, China’s president. She holds the rank of major-general in the People’s Liberation Army and wore her uniform to sing for the troops after they quashed the pro-democracy protests in Tiananmen Square. Chinese state censors have since attempted to erase these pictures from the internet.

Chan also chose to appoint China Central Television’s James Chau a goodwill ambassador. Later, during the 2020 pandemic, more than 100 UN-affiliated associations would write to the WHO calling for him to be removed from the role because he was a well-known propagandist for the Chinese government.

The biggest test for Chan was also the moment she drew the most criticism — and there was a Beijing link to this too. She took two months to declare an international emergency over the 2014 ebola outbreak despite repeated warnings from her own experts.

Leaked emails obtained by the Associated Press revealed that the delay was caused by WHO officials who did not want to upset the African countries hit by the outbreak and damage their economies. More than 1,000 people died during the delay.

One of the countries affected, Guinea, had struck a big mining rights deal that allowed a state-backed Chinese firm to excavate one of the world’s biggest untapped iron ore reserves. Fearing that the foreign investors might be scared away, Alpha Condé, then the country’s president, claimed that ebola was under control in Guinea in a speech at the WHO’s Geneva headquarters.

His lie went unchallenged. “Margaret Chan’s WHO was accused of being too close to Alpha Condé,” the senior source from the WHO said. In the end the UN took the highly unusual step of appointing David Nabarro, a British doctor, to co-ordinate the international effort on ebola because it was so concerned about the WHO’s failure to get to grips with the outbreak.

In 2017 Chan crowned her final year in office by welcoming Xi to Geneva. While he was there, she signed an agreement that committed the WHO to working alongside China on health as part of the country’s Belt and Road initiative. It was the first time any UN agency had signed up to the initiative, which seeks to extend Chinese influence and trade in more than 70 developing countries by financing infrastructure projects.

The initiative is highly controversial because its critics argue that China uses it to shackle countries, particularly in Africa, to “unsustainable debt” as a way of gaining access to the continent’s raw materials and buying political favours.

“I think health is too special to get into the really seedy politics that Belt and Road is part of, and I wouldn’t want the WHO to be associated with it,” Gostin argues. “The cost in terms of human rights and debt, and other adverse events for Africa, was a bridge too far.”

STN.WHO_TIMELINE1.15.08.21.R

Turning on the money taps

Under bright skies in the rolling parkland on the banks of Lake Geneva a large group of protesters with placards gathered outside the Palace of Nations for the 70th meeting of the World Health Assembly (WHA), the body with representatives from all UN member states that controls the WHO.

The protest that day — May 22, 2017 — was against Tedros standing to replace Chan, who had served her final term. The demonstrators were highlighting human rights abuses by the Ethiopian regime, which was reported to have tortured dissidents, displaced villages and ordered police massacres of protesters. Until the previous year Tedros had been a minister in that Ethiopian government.

Tedros, a former epidemiologist then aged 52, had been the health and then foreign minister after joining the government in 2005. Last year David Steinman, a US economist nominated for the Nobel peace prize, called for Tedros to be personally prosecuted for genocide over his alleged involvement directing Ethiopia’s security forces. He denies any involvement in human rights abuses despite his lengthy period in government.

As foreign minister Tedros had formed a close relationship with China. He would often praise the Chinese leadership, which invested more money in Ethiopia than any other country did. In 2014 he wrote a joint article with the Chinese foreign minister in the state-controlled China Daily newspaper that waxed lyrical about the bond between the countries. “We are sincere friends, reliable partners and good brothers who share both happiness and adversity, each rejoicing in the successes the other has achieved,” they wrote.

The African Union countries had wanted their candidate to replace Chan as director-general. They had previously helped Chan get elected, and it was now their turn. As an African with close links to China, Tedros was the perfect candidate.

As the election approached, China had again turned on the money taps. A month before the vote, a multinational ministerial conference was held in Pretoria ostensibly with the aim of stepping up China-Africa co-operation in health. During the conference China agreed to offer a cataract surgery programme for free to the African countries.

Then, nine days before polling, Xi hosted an event in Beijing at which he pledged more than $100 billion in extra funding for its Belt and Road initiative — a large portion of which would be channelled into investment in developing countries. This included new investment in Kenya, Indonesia and Hungary.

David Nabarro witnessed at first hand the WHO leadership’s incompetence during the Ebola crisis
David Nabarro witnessed at first hand the WHO leadership’s incompetence during the Ebola crisis
FABRICE COFFRINI/AFP/GETTY IMAGES

Tedros’s main opponent was Nabarro, whose first-hand experience of the WHO leadership’s incompetence during the ebola crisis had convinced him of the need for reform. Nabarro was not alone in his concerns about the WHO, and he reportedly received support from the US, the UK and Canada. This appears to have been the first time the West had woken up to China’s creeping influence over the health agency.

The contest between the two men for the WHO director-generalship took place under new rules that had been introduced by Chan. Previously, the director-general had been chosen by the 34 members of the WHA executive board, but the new rules gave an equal vote to all the assembly’s 194 member states.

Critics of the rule change, such as J Michael Cole of the Canadian think tank the Macdonald-Laurier Institute, have pointed out that the WHO was essentially copying the electoral system that propped up the famously corrupt regime of the former Fifa president Sepp Blatter.

As with football’s governing body, tiny countries that might be susceptible to financial aid were given an equal vote to countries many times their size. Cole said tiny island countries such as those in the Pacific were “easy targets” for Chinese influence.

During the campaign Gostin, who was supporting Nabarro, accused Tedros of covering up three cholera outbreaks during his time as Ethiopia’s health minister. Tedros again strongly denied the allegations. Certainly the mud did not stick. With China’s help he won by 133 votes to Nabarro’s 50.

‘Model’ China

Within a month of taking over in July 2017, Tedros was on his way to China to emphasise the health agency’s continued commitment to the partnership under the Belt and Road initiative.

“China’s long experience and expertise in health systems and policies will be invaluable to achieving the WHO’s global priorities, especially in health crisis management,” he wrote in the China Daily. “China can share its lessons learnt and best practices with other countries, offering them models of success.”

Months later Tedros made an extraordinary announcement, seemingly without consulting colleagues. He had appointed Mugabe, the tyrannical Zimbabwean president, as a goodwill ambassador for the WHO. Diplomatic sources affiliated to the health agency have told us that the honouring of Mugabe was made at the behest of Beijing as a political payoff for the dictator’s years as a staunch ally of the Chinese government.

Xi has described Zimbabwe as China’s “all-weather friend”. In turn Mugabe called Xi “a God-sent person”. The Chinese government’s connection to Mugabe stretches back to the 1970s, when it helped fund his guerrilla war in Zimbabwe before he took power. More recently it ploughed cash into his regime when it was struggling under western sanctions.

It was an ill-judged move by Tedros. The Canadian prime minister, Justin Trudeau, described the announcement as a “bad April Fool’s joke”, Ireland’s health minister said it was “offensive and bizarre” and the UK prime minister’s office said it was “surprising and disappointing, particularly in light of the current US and EU sanctions against [Mugabe]”.

There was particular bemusement because Zimbabwe’s healthcare system had deteriorated so badly under Mugabe’s rule that he himself had sought treatment at a luxurious private hospital in Singapore rather than trust his own country’s doctors. A report by the group Physicians for Human Rights in 2009 gave examples of how Mugabe had damaged his own health system in his efforts to cling on to power.

The appointment was withdrawn just four days after Tedros announced it. But it did not stop him continuing to lavish praise on China’s leaders. Nine months later, on another trip to Beijing in July 2018, he described China’s health reforms as “a model for universal health coverage” and “a bulwark against health emergencies”. In other words, they would help to prevent a future pandemic.

One of the oddities of China’s influence within the WHO was that it managed to achieve it while paying little money towards the running of the organisation. In 2018-19 China gave the health agency $89 million, whereas the UK contributed $464 million and the US $853 million.

Tedros praised President Xi’s ‘rare leadership’ as Covid spread across the world in January 2020
Tedros praised President Xi’s ‘rare leadership’ as Covid spread across the world in January 2020
LI XUEREN/XINHUA/AP

Gostin described the vast shortfall as “galling”. He is critical of the way China instead uses its money to pay for health projects in deals it negotiates directly with individual countries. This gives Beijing more diplomatic and economic leverage with the countries themselves. “China’s foreign policy is extraordinarily mercantile and self-interested,” he said. “It’s all done on bilateral country negotiations, where [China] has got a ton of leverage.”

China has used this approach to take over other parts of the UN system. In June 2019 a Chinese candidate was elected head of the Food and Agricultural Organisation, after reports that Beijing had cancelled $78 million of Cameroon’s debt in exchange for the withdrawal from the race of a candidate from the country. It meant that, of the UN’s 15 specialised agencies, four were headed by Chinese nationals.

The cover-up begins

The main “bulwark” at the beginning of the Covid-19 pandemic was a wall of secrecy in China. On December 30, 2019, Dr Li Wenliang, an ophthalmologist at Wuhan Central Hospital, sent a message to medical colleagues in an online chat forum suggesting they wear protective clothing because he had seen several cases of a virus that appeared to be transmitted between humans like Sars.

Li was summoned for an inquisition by the authorities, with seven of his friends. They were investigated for ”spreading rumours” and warned against ”publishing fictitious discourse”. Li would later die from Covid-19.

The following day — the last of the year — the Wuhan Municipal Health Commission publicly admitted for the first time that a number of people had been struck down with a similar illness in a bland public announcement reporting 27 cases of pneumonia-like infection.

What the statement did not say was that the illness had already been identified by the Chinese authorities as a new coronavirus — not unlike Sars — that appeared to be passing between humans. This crucial information — as well as any indication of the alarm already secretly felt by scientific and health officials in China — was withheld from the world.

However, earlier that day Taiwan had been closely monitoring reports in the Chinese media that might indicate a new medical phenomenon and it noted that an internal hospital alert had been reported in an obscure business publication. The Taiwanese authorities sent the WHO an email raising concerns about a number of “atypical pneumonia cases” in Wuhan that had been “isolated for treatment”. The only reason patients would need to be isolated was that Chinese hospitals feared the virus could pass between humans.

The health agency did not heed the Taiwanese warning. The island’s relations with the WHO were strained because of China’s claims of sovereignty over its territory.

In the months before the pandemic Beijing had used its influence to block the island from attending meetings of the WHA for a third year in a row. The UK and the US were among a number of nations that wanted Taiwan to be given access and had warned Tedros that the country’s absence “created serious gaps in the global health security system”.

Taiwan’s vice-president, Chen Chien-jen, an epidemiologist by training, would later accuse the WHO of brushing aside this early evidence it had provided on suspected human-to-human transmission and of failing to pass the early warning on to the world. In the weeks that followed, the island’s relationship with the WHO deteriorated further when Tedros wrongly claimed in public that it was behind a series of racist online attacks against him.

In the first two weeks of January desperate scenes were unfolding at Wuhan hospitals as patients with flu-like symptoms began to flood in. The mayhem and death were described by Dr Peng Zhiyong, the director of the intensive care unit in Wuhan University’s Zhongnan Hospital, several weeks later in an interview he gave to the Chinese media outlet Caixin Global.

Within four days of the arrival of the first patient, Peng said, all 16 intensive care beds were full and the situation was “dire”. More than 40 members of his team then contracted the disease from patients. Things were even worse at another hospital in the city, where two thirds of intensive care staff had reportedly been infected.

The doctors fought the epidemic in gruelling conditions. Some wore nappies inside their protective suits to avoid taking breaks. Peng said many patients were turned away because the hospitals could not cope. “Some patients even knelt down to beg me to accept [them]. But there was nothing I could do since all the beds were occupied,” he said. “I shed tears while I turned them down. I have run out of tears now.”

The doctors were in no doubt the virus was passing rapidly between humans. Few of Peng’s colleagues went home after their shifts, for fear they would infect their families.

Yet the Chinese authorities systematically tried to cover up the human spread by issuing diktats, suppressing whistleblowers and scrubbing social media. On January 3 a confidential notice was issued forbidding labs to publish details of the virus without authorisation. On January 6 the hashtag #WuhanSARS appeared online, but posts on Twitter were swiftly censored.

The authorities also withheld work that had been done to sequence the coronavirus’s genome, which had been completed by January 3 — a decision that delayed international scientists from developing tests for the virus.

It was the beginning of exactly the type of crisis that Tedros had warned of in his 2018 Dubai speech. He had been clear at the time that ignoring the signs of an outbreak could be the difference between containing a deadly disease and allowing it to spread.

But, at the beginning of the biggest pandemic for more than a hundred years, the health agency simply took the Chinese explanations about the outbreak at face value. On January 10 the WHO issued a statement saying: “From the currently available information, preliminary investigation suggests that there is no significant human-to-human transmission, and no infections among healthcare workers have occurred.”

Both statements were untrue, and the agency did not even attempt to couch its language in a way that would have made clear that these were merely claims made by China. Instead it was mindful of the need to avoid taking measures that might damage the Chinese economy. “WHO advises against the application of any travel or trade restrictions on China,” its statement went on.

However, staff at the Shanghai Public Health Clinical Centre laboratory were growing increasingly anxious about the need to develop tests for the virus in the hope they might be available before millions of people crisscrossed the country for the lunar new year celebrations later that month. So they took matters into their own hands and shared the genetic code they had sequenced on a US computer database called GenBank, which is available to scientists around the world. It was published on January 11. When the Chinese authorities learnt of the leak, the Shanghai lab was instantly closed for “rectification”. But China’s secret was out and the Wuhan Institute of Virology was forced to share its information on the coronavirus with the health agency.

By now some officials inside the WHO were becoming frustrated that their repeated requests for data from China were being rebuffed. Leaked recordings of one of the health agency’s meetings in the second week of January show that Dr Michael Ryan, the WHO’s Irish chief of emergencies, wanted to apply more pressure on China as he could see that the crisis was becoming a repeat of the 2003 Sars disaster.

Chinese authorities desperately tried to cover up the spread of the coronavirus
Chinese authorities desperately tried to cover up the spread of the coronavirus
NOEL CELIS/AFP/GETTY IMAGES

“This is exactly the same scenario — endlessly trying to get updates from China about what was going on,” he said in the recording obtained by the AP news agency. “The WHO barely got out of that one with its neck intact, given the issues that arose around transparency in southern China.”

Ryan appears to have been keen to raise the lack of co-operation by China in public, pointing out that the health agency had criticised Tanzania a few months earlier for withholding details of an ebola outbreak. “We have to be consistent,” Ryan said. “The danger now is that despite our good intent … especially if something does happen, there will be a lot of finger-pointing at the WHO.”

But such behind-the-scenes concerns did not alter the WHO’s public messaging. “WHO is reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the commitment to share information regularly,” it said in a statement on January 12. “At this stage there is no infection among healthcare workers, and no clear evidence of human-to-human transmission,” it added calmly.

Deadly delay

On the morning of January 13 the first case of an infection outside China was found in Thailand. That day Tedros announced that he was giving thought to whether he should call a meeting of the WHO emergency committee, which consists of about 20 international experts, including one from China.

The emergency body plays a key role in deciding whether the director-general should declare an infectious outbreak as a public health emergency of international concern (PHEIC). Meetings are held in confidence because PHEIC declarations can damage business, travel and tourism in an affected country, according to a source on the committee.

The growing outbreak in China could have been declared an emergency under the health agency’s criterion, which requires a crisis to be “an extraordinary event” that might cause “a public health risk to other states through the international spread of disease”.

But Tedros decided to wait, and nine more days passed before he even gathered the committee members for their advice. During this period he was talking directly on the phone about the outbreak to Ma Xiaowei, the Chinese minister of health, whom he had described warmly as his “brother” in a tweet on January 11.

According to the health agency’s official timeline of events, it first warned that the virus might be transmitted between people on January 14. It is certainly true that Maria Van Kerkhove, the American acting head of emerging diseases, acknowledged in a briefing that there might be some evidence of “limited human-to-human transmission, potentially among families”. But she was corrected by the WHO official Twitter account a few hours later: “Investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus.” A further five days would go by in which the WHO issued another denial about hospital staff in Wuhan contracting the virus.

Finally on January 19 the health agency’s regional office in the western Pacific announced clearly that the virus could pass between humans, albeit with the qualification that the transmission was “limited”.

By now the emergency situation in Wuhan was so desperate that the Chinese authorities were preparing to build the 1,000-bed Huoshenshan Hospital in just 10 days. The virus had spread to Beijing, and it was no longer credible to pretend it could not pass between humans.

Therefore, on January 20 — three weeks after Taiwan’s warning — China’s health ministry admitted that it did have evidence that medical staff had been infected. It meant the health agency could no longer delay. Tedros summoned a meeting of the emergency committee, which deliberated on January 22 and 23.

The number of known cases jumped from 314 to 581 during those two days and the virus had spread to 24 regions of China, killing 18 people. The true figures will have been many times greater because of underreporting by China. And the virus had now escaped the country’s borders: ten cases had been identified in four other countries.

For reasons that are unclear because of the secrecy of its meetings, the members of the emergency committee were split on what action to take after an update on the crisis was provided by the Chinese representative. The advice they gave Tedros was equivocal, and he decided to avoid taking the diplomatically fraught decision of imposing an international public health emergency on China.

In a press briefing on January 23 he reasoned that there was “an emergency in China … but it has not yet become a global health emergency”, adding that he wished to thank the country’s government for its “co-operation and transparency”.

The protection of Beijing’s interests continued the following day when the health agency issued a statement reiterating that countries should not impose travel restrictions on China, even though the situation in Wuhan had become so dire that the city had imposed a full lockdown, then unprecedented in modern times. Yet the inaction by the health body sent a clear signal to the world that this new coronavirus might not be as serious as was feared.

The calm ripples of this cool approach were felt in Britain a day later. Matt Hancock, the health minister, chaired the first meeting of the Cobra national security committee, which spent an hour discussing the virus before concluding that the risk to the UK public was “low”. Hancock had first been alerted to the unusual pneumonia-like cases on January 3 but the government had done little in the meantime to prepare for the potential arrival of the virus. Downing Street would later defend Boris Johnson’s decision to skip the Cobra meeting — the first of five the prime minister missed — by pointing out that the WHO had not considered the crisis sufficiently serious to declare a global emergency.

By Tuesday January 28 four weeks had passed since Taiwan raised the initial alarm and there was still no evidence of the fast and decisive action that Tedros had said was necessary to combat an outbreak in his Dubai speech. That day he met Xi, the Chinese president, in Beijing and emerged from the encounter full of praise for his hosts.

He said Xi had shown “rare leadership” and deserved “gratitude and respect” for acting to contain the outbreak at the epicentre. These “extraordinary steps” had prevented further spread of the virus, and this was why, he said, there were only “a few cases of human-to-human transmission outside China, which we are monitoring very closely”.

Tedros even claimed that China was “completely committed to transparency”, pointing out that it had shared the genomic sequence of the virus “immediately” — when in fact the lab that leaked the sequence had been punished by the country’s authorities for defying the censors.

If the words of Tedros’s speech suggested he and China had everything under control, nothing could have been further from the truth. The virus was spreading fast across the globe.

By this point a crucial four weeks had been lost because China had covered up the highly infectious nature of Sars-CoV-2 while the WHO had repeated its claims unquestioningly. The health agency had failed in its single most important job — to swiftly sound the alarm.

Professor Richard Ebright, of Rutgers University’s Waksman Institute of Microbiology in New Jersey, a fellow of the Infectious Disease Society of America, believes China’s influence over the WHO played “a decisive role” in the agency’s failure to act decisively at the start of the pandemic.

“Not only did it have a role; it has had a decisive role,” he said. “It was the only motivation. There was no scientific or medical or policy justification for the stance that the WHO took in January and February 2020. That was entirely premised on maintaining satisfactory ties to the Chinese government. So at every step of the way, the WHO promoted the position that was sought by the Chinese government … the WHO actively resisted and obstructed efforts by other nations to implement effective border controls that could have limited the spread or even contained the spread of the outbreak.”

He added: “It is impossible for me to believe that the officials in Geneva, who were making those statements, believed those statements accorded with the facts that were available to them at the time the statements were made.

“It’s hard not to see that the direct origin of that is the support of the Chinese government for Tedros’s election as director-general … This was a remarkably high return on [China’s] investment with the relatively small sums that were invested in supporting his election. It paid off on a grand scale for the Chinese government.”

David Fidler, a former WHO legal adviser, is scathing about Tedros’s “obsequious” praise for Xi and suspects that “the WHO knew China was not being transparent, particularly about information related to human-to-human transmission”. He added: “The praise that he heaped on China gave them no incentive to change their behaviour.”

Tedros finally declared an international public health emergency on January 30. By then the virus had been detected in 18 countries and was almost certainly lurking undetected in many others.

The WHO’s failure to act had blown the world’s only chance to contain the pandemic at source, Ebright believes. “Ironically, China’s success in curbing the spread and containing the spread by implementing appropriate border controls … tells us that, had this been done globally, in January, this outbreak could have been potentially contained,” he said.

“We can see what happened when Taiwan, cut off from WHA guidance and shunned by the WHO, made its own decisions and was largely Covid-free for 2020 and even through 2021. Had other nations implemented tight border restrictions by the middle of January, the situation would have been very different.”

A year later a report by an independent panel set up at the request of the WHA was critical of the delay in calling the emergency. The panel, led by the former New Zealand prime minister Helen Clark, said the health agency should have assumed human-to-human transmission and issued warnings as a precaution, given what was known about respiratory infections.

Even after the global emergency was declared, the travel advice remained the same. At a meeting of the WHO executive board in Geneva on February 3, Tedros claimed the spread of the virus outside China was “minimal and slow” and there was no need to introduce measures that “unnecessarily interfere with international travel and trade”.

This prompted an outburst from the appreciative Chinese delegate to the board. Li Song, an ambassador to the UN, leapt to his feet and denounced countries that were blocking the entry of travellers from Hubei, the province of which Wuhan is the capital. “All these measures are seriously against recommendation by the WHO,” he fumed.

In fact, while the health agency did later give advice that travellers should be screened to detect flu symptoms at airports, it never did explicitly support any restrictions on travel to and from China. By the end of March 2020 many countries across the world had ignored the health agency’s advice and instituted some form of travel ban.

Gostin believes China’s cover-up in January was “the singular important event in the course of the pandemic” because it blew the world’s “only shot” of containing the crisis at source.

The Wuhan institute was meant to develop vaccines in advance of outbreaks
The Wuhan institute was meant to develop vaccines in advance of outbreaks
ROMAN PILIPEY/EPA

A flawed investigation

If the cordial relationship between Tedros and China had survived the opening months of the pandemic, the strength of their friendship would be tested once again in the early summer of 2020. It was over the very important, yet highly sensitive, issue of how and where the virus originated.

The Sars outbreak in 2003 is thought to have originated in bats in Yunnan province, southwest China, and to have been introduced into markets in the surrounding area through an intermediary host animal. Sars-CoV-2 is believed to have had similar beginnings because of its resemblance to other bat coronaviruses.

However, the caves in Yunnan province are more than a thousand miles from Wuhan, and no bats containing such viruses have ever been found near that city. If an intermediate animal, or indeed a human, had been infected by a bat in Yunnan, how could this very infectious virus be carried on such a long journey to Wuhan without causing a single noticeable outbreak along the way?

The Chinese had tested thousands of animals in Wuhan and the surrounding areas, but not one had come up positive for the virus. Chinese scientists had also rejected the suggestion that the virus entered through the Huanan seafood market in the city, which was connected to some of the cases in December 2019.

Extensive sample-testing at the market failed to show a link between any of the animals there and the virus. It was also clear that many of the early human cases had no link to the market, and the conclusion was that the market was a crowded environment in which the virus had spread, rather than the point of introduction into Wuhan.

But there was an elephant in the room. Coronaviruses found in the Yunnan bat caves, including the world’s closest known match to Sars-CoV-2, were being kept at the Wuhan Institute of Virology at the time of the outbreak. To many it seemed a remarkable coincidence that, of all the 600 cities in China, the virus began in Wuhan, the home of an institute that houses the world’s largest collection of coronaviruses from wild bats and has a team of scientists who often travel to those same Yunnan caves.

The scientists had been seeking out coronavirus-infected bats and then transporting the viruses back to the laboratory in Wuhan. There they carried out highly controversial “gain of function” experiments to make the viruses more infectious to humans. The work was designed to help develop vaccines to pre-empt a potential coronavirus outbreak, but many scientists had warned that one safety lapse could itself cause a deadly pandemic.

Only a tiny handful of labs in the world carried out such high-risk experiments, and in 2018 inspectors sent by the US embassy in Beijing to the Wuhan institute had flagged serious safety concerns there. A US diplomatic cable leaked to The Washington Post stated: “During interactions with scientists at the WIV laboratory, they noted the new lab has a serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory.”

There were therefore questions about whether the pandemic had been caused by a leak from the Wuhan institute or one of its researchers who had been infected in the bat caves and then accidentally carried the virus back to the city. It was certainly not inconceivable: the Sars virus had leaked from the National Institute of Virology lab in Beijing in 2004. Nine people were infected by the outbreak and one died.

There were serious concerns about what the Wuhan institute had been doing with the world’s closest known match to the Covid-19 virus, which was the strongest lead in the hunt for the pandemic’s origin. It had been found eight years ago by Wuhan scientists in an abandoned mine, where it had been linked to deaths caused by a coronavirus-type respiratory illness. But the significance of the deaths had been kept secret by the Chinese authorities until a Sunday Times investigation uncovered them in the summer of last year. The lab has refused to answer questions on whether it was experimenting on the virus in the run-up to the pandemic.

Indeed China had been reluctant to address many questions about the pandemic’s origins since January 2020, other than to issue blanket denials. It did not want the ignominy of being found culpable for the world’s worst pandemic for a century.

The subject had become politically charged. Donald Trump, then the US president, had weighed in and alleged China might be culpable. Right-wingers in America were calling for multibillion-dollar reparations from China if it was proved to have caused the pandemic.

So a demand for an investigation of the origins of the virus by the Australian prime minister, Scott Morrison, on April 22 was not welcomed in Beijing. Morrison called for the WHO to appoint independent investigators, akin to weapons inspectors, and urged the international community to back a plan to track down the virus’s origins in China. In the weeks that followed, China imposed trade sanctions on Australia’s beef and barley.

Morrison had started a hare running. It was important to find the origin of the virus but there was much resistance by China, leading to some tough negotiating behind the scenes at the WHA. Many countries wanted an investigation to start immediately, but Chinese diplomats managed to fight that off. In the end it was the EU countries that brokered a compromise. “There were negotiations over every word,” said a source in the WHO.

On May 19 the assembly agreed on a form of words for the inquiry. The resolution required the director-general of the WHO to work closely with member states to “identify the zoonotic source of the virus and the route of introduction to the human population”. There was no mention of the word “investigation” or the timescale.

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There are those such as Jamie Metzl, a former member of the Clinton administration and an adviser to the WHO, who believe Tedros’s hands were tied from the beginning by the resolution. He says it had strong backing from China because it authorised “a Chinese-controlled joint study into a single-origin hypothesis, namely, that of zoonosis in the wild, and that is what I call the original sin, because there was a broad public perception that there was a WHO-led investigation, and there was no investigation that was ever authorised”.

However, the wording did not say this specifically, and it was left to Tedros and his team to draw up the terms of the inquiry with the Chinese authorities between May and July, which they did without seeking the opinions of the member states. The two sides took the decision to jointly interpret the loose wording — referring to “scientific and collaborative field missions” — as a mandate for a “study” rather than a proper independent investigation.

“It was never an investigation. Investigations are something different,” said the WHO source with knowledge of the negotiations. “With a study it’s not that you go and look for some wrongdoing … You’re not looking backwards trying really to do a forensic audit of things and say, ‘Give me everything; show me everything.’ It doesn’t work like that.”

In July, Peter Ben Embarek, a WHO expert on infections that jump from animals to people, spent three weeks in China with a colleague horse-trading over the terms of reference of the “study”. Two weeks were spent in quarantine in a gloomy hotel on the outskirts of Beijing, and their requests to interview Chinese researchers on Zoom were largely rebuffed. “It was a real struggle to get this going while they were on the ground and really depressing,” said the WHO source.

WHO insiders say Beijing held the trump card in the negotiations as it could always simply refuse to allow any of the scientific team to enter the country. That is why Tedros was averse to criticising the country’s leadership publicly, the insiders claim in his defence.

Behind closed doors the health agency ruled out any work on a matter that might make Beijing jumpy: the question of a possible laboratory leak. The study would concentrate on the zoonotic source of the virus, which the WHO argued was its narrow remit from the original WHA resolution.

But the resolution was clearly wider than the health agency’s interpretation. Even a virus that had leaked from the lab would have had a zoonotic origin before, for example, it was taken back to Wuhan by researchers. The crucial point was the second part of the resolution, which clearly states that the director-general was charged with finding out how such an animal virus would be then transmitted to humans.

The terms of reference were finalised between the WHO and China on August 2 last year. Yet, according to the US government, they were not shared with the other countries until the beginning of November.

That was when Garrett Grigsby, the US representative on the WHO executive board, immediately raised objections that the terms were “not negotiated in a transparent way with all WHO member states” and appeared to be “inconsistent” with the mandate. The complaints were ignored.

When asked why other nations had not been consulted about the terms, a WHO spokesman said: “In general, terms of reference for in-country scientific studies are not discussed by member states.”

By then the team of scientists had already been selected for the study. The health agency had deliberately chosen zoonotic experts rather than scientists who might be qualified to examine laboratory leaks. The team consisted of 34 scientists, and the agreement reached with Beijing was that it would include 17 members from China, who would mostly be employed by the Chinese state.

The team turned out to contain a majority of Chinese nationals because the health agency chose Li Jian — one of its technical officers, who is from China — among its 17. Gostin says allowing so many Chinese scientists to be part of the WHO team “undermined the credibility and objectivity” of the inquiry.

Furthermore, China was given a veto over the choice of the non-Chinese experts. When the US put forward three scientists, including a laboratory expert, they were all rejected by the WHO without even a phone call. The only US representative chosen by the WHO was Peter Daszak, a New Yorker originally from Dukinfield, near Manchester.

Daszak was a controversial choice. He had been working with the Wuhan Institute of Virology on hunting down coronaviruses for more than 15 years and he headed the EcoHealth Alliance charity, which had redirected large grants from the US government to the Wuhan lab to fund some of its controversial coronavirus work.

The institute’s lead virologist, Shi Zhengli — nicknamed “Bat Woman” — described Daszak as her “collaborator” in an email to this newspaper that summer. However, the health agency regarded this conflict of interest as an irrelevance because it had already ruled out the possibility that the team would follow any lines of inquiry into the Wuhan institute.

A capable communicator, Daszak had already been vocal with his view that the virus first infected humans directly from an animal — possibly in one of China’s crammed live markets. He had even secretly orchestrated a statement rejecting the “conspiracy” theory that the virus did not have a natural origin, which was signed by 27 scientists and published by the medical journal The Lancet in February 2020. When his role in organising the letter was revealed this year, Daszak stepped down from a UN-backed Lancet commission that was separately looking into the origins of the virus, and the medical periodical retrospectively published a detailed disclosure document on his work in China.

Peter Daszak had been hunting viruses with the Wuhan Institute of Virology for 15 years
Peter Daszak had been hunting viruses with the Wuhan Institute of Virology for 15 years
ALY SONG/REUTERS

The stakes were high for Daszak when the WHO chose him for the joint mission in late summer 2020. If it was concluded that the virus passed naturally from animals to humans, it would vindicate much of his life’s work. However, all that work would be seriously undermined if the pandemic had begun at the laboratory he was so closely associated with.

Metzl, who has been campaigning for a proper investigation of the origins of the virus, believes Daszak’s selection was “simply outrageous”. He said: “So his entire career is … in large part based on his collaboration with the Wuhan Institute of Virology. So he’s the last person who should be on a committee that is examining the possibility of whether experiments that his organisation may have supported played a role in sparking this global pandemic.”

Ebright added: “Shameful terms of reference were negotiated between WHO and China. Terms of reference that in essence ended up being the Chinese position without any change. Again it is hard not to see this as a repayment, or as a return on investment on the support the Chinese government provided for [Tedros’s] election.”

The centrepiece of the first phase of the WHO study was the long-awaited field trip to Wuhan, which finally began on January 14. It had been delayed by the Chinese government for reasons that were opaque: a year had passed since the original outbreak by the time the international scientists were allowed to set foot in the city where the first known Covid-19 cases were recorded.

According to the American magazine Vanity Fair, it was in the weeks before the trip that the US State Department had acquired its explosive — and hotly disputed — intelligence that three researchers from the Wuhan institute had fallen ill.

The researchers were alleged to be connected to the laboratory’s “gain of function” experiments on coronaviruses and appeared to have been taken to hospital with Covid-19-type pneumonia symptoms in November 2019. The timing of the cases is significant: this is exactly the time the outbreak is believed to have started and, if the intelligence is true, it would be a smoking gun in favour of the laboratory theory.

It is not clear when this information was conveyed to the WHO, but Tedros surprisingly decided to move the goalposts at about that time. According to WHO sources close to him, he agreed with China that the international team would now be allowed to briefly visit the Wuhan institute — while fully aware that the scientists that had been chosen were not qualified to assess the potential of a laboratory leak.

The Chinese had not acceded to every request by the health agency. They refused entry to a WHO communications officer who would have acted as spokesperson for the joint mission. The result was that the team’s most media-savvy communicator, Daszak, became the default spokesman for the group.

While the joint mission was in quarantine in a Wuhan hotel on January 15 this year, the US government publicly released its information about the researchers’ illnesses and raised concerns about the experiments that had been carried out at the laboratory on the closest known match to the Covid-19 virus. The US further claimed that the Wuhan institute had been engaged in secret projects with China’s military, including laboratory animal experiments, since 2017.

“For more than a year, the Chinese Communist Party has systematically prevented a transparent and thorough investigation of the Covid-19 pandemic’s origin, choosing instead to devote enormous resources to deceit and disinformation,” said the statement by the US State Department. “Nearly two million people have died. Their families deserve to know the truth.”

Joe Biden was due to be inaugurated as president in five days, and there was no sign that he would deviate from this hard line. It raised the stakes for the WHO team even higher.

Playing politics

As it was, the team’s visit to the Wuhan Institute of Virology lasted only a few hours. It was a smoggy day, and Daszak was filming the press pack outside the institute for his regular Twitter update. He would later claim that the joint mission had asked “tough” questions of the director and senior staff. “And the answers we got were consistent with everything that’s been put out there,” he said.

What actually happened was that the scientists asked a string of questions and appeared to take the answers from senior figures from the Wuhan institute at face value without seeking evidential proof.

Professor Thea Fischer, a Danish virologist who was part of the team, has described how she felt impolite asking direct questions. In an interview for a virology podcast she said the team concluded that it was not obvious that anything untoward had been “going on” but admitted: “This was based on questioning and not us coming with swabs or testing, or serology follow-up, or looking into lab logs, because it was not a lab audit.”

Before the trip there had been widespread disquiet in scientific circles about why the institute had, on September 12, 2019, taken offline a database that itemised its collection of 22,000 virus samples and sequences. The institute claimed it had taken the database down because it had feared hacking attacks, but it was a notable coincidence that it happened just before the pandemic is thought to have started.

Yet the joint mission team did not even demand access to the database. Daszak later explained that he had told the team there was no need to request the information as his charity had done a lot of work with the institute. “We do basically know what’s in those databases,” he said. They appear to have accepted his word and moved on.

Even WHO sources acknowledge that the lab visit was cursory. “They walk through the door, they talk to people and they walk out,” the source said. “I think they were there for about two hours. And it was better than nothing, but it was close to nothing.”

The team toured hospitals, a communicable disease centre, a propaganda museum and the empty Wuhan seafood market. When it finished in early February this year, it decided to conduct a straw poll of all the international and Chinese members on the relative likelihood of four theories on how the virus originated.

On the ground the Chinese were 17-strong as originally intended but the team were down to 14 as three of their experts were having to keep in contact remotely from outside China.

The ranking of possible theories took place in a Wuhan conference centre on February 8, with the two sets of scientists sitting in rows of chairs facing each other. They were given five options to categorise each theory, in a sliding scale from “very likely” to “likely”, “possible”, “unlikely” and “extremely unlikely”.

WHO investigators at the Huanan seafood market in January this year
WHO investigators at the Huanan seafood market in January this year
GETTY IMAGES

It is not known how many people favoured each theory, but the results were announced at a press conference in Wuhan on February 9. The favoured theory, which was backed as “likely” to “very likely”, was that the virus spread from a bat into another host animal, possibly through intensive farming, and was then passed on to humans.

In a sense this was a leap of faith, as the joint mission had found no evidence of such an intermediary animal or any clues as to how it might have travelled the huge distance to Wuhan. It was just that the scientists believed that this was the way these outbreaks had happened in the past. But then laboratory leaks had happened too.

The decision was perhaps unsurprising, given this was a team that had been specifically picked to concentrate solely on the natural animal causes of the pandemic. In addition, the joint mission’s Chinese contingent were under pressure from their government to dismiss any suggestion of culpability.

Therefore the joint mission found the idea that a virus could have leaked from an institution in Wuhan “extremely unlikely” and unworthy of further investigation. Even the theory that the virus might have entered China on frozen food was ranked higher and classed as “possible”. The Chinese scientists had been pushing this theory and claimed to have evidence of a small number of cases in which the virus had been reintroduced to China on frozen food packaging.

The implausibility of the theory was later highlighted when the team’s more detailed report was released. But the joint mission’s “possible” verdict had given the theory a semblance of credibility, which was welcomed in Beijing because it suggested the virus might have originated outside its borders.

Sources close to Tedros say he was taken by surprise when Embarek, the mission’s joint leader, dismissed the lab leak theory at the press conference. “That was the first time when we realised back in Geneva that there was an agreement among the totality of terminology that did not feel grounded in science, specifically this relative weighting of hypotheses,” said the source.

The WHO insiders admit that the team was not even qualified to make that judgment. They point out that the health agency has a specialist “lab audit team”, which, for example, regularly checks Russian and American smallpox labs. “And that group had not fed into the choice of the team,” the source said. “Nor had any of those people gone [to Wuhan], because we weren’t able to negotiate something like that in the terms of reference.”

A second WHO source was even more damning. “These guys should have not gone into the labs at all. They had not been given proper access to these labs. They didn’t have expertise. They didn’t have a mandate,” they said. “And then they came out with this ‘extremely unlikely’ thing. We were all surprised. I was listening and I had no idea why they would say that. I think it was a little bit naive, honestly.”

Last week, Emabarek gave an extraordinary interview for a Danish television documentary in which he disclosed that the joint mission had been forced to rule out a lab leak because of pressure from Beijing. He said the final report had been vetted by the Chinese government employees and the team were only allowed to mention the theory if they agreed that they would not pursue it further.

Embarek said it was possible that a laboratory employee may have been infected while collecting samples from bats in the wild. “We consider that hypothesis a likely one,” he added. This was not what the team had told the world.

It is still not clear why Tedros organised for the team to visit the laboratory in his last-minute negotiations. But the director-general was under pressure after the joint mission’s press conference in February. He was only too aware the new US president held more sway among America’s international allies than Trump. While Biden had reversed his predecessor’s decision to stop funding the health agency, he was not backing down on the confrontation with China over the origin investigation.

With the WHO’s credibility on the line, Tedros decided to take a diplomatic approach to the joint mission’s findings. He called a press conference to praise the team for its work while making clear that “all hypotheses remain open and require further analysis and studies”.

When the joint mission produced its report in March, it was clear that there had been a lack of rigour in the team’s reasoning for ruling out the Wuhan laboratory as a possible source.

It made two main arguments. The first was that there “was no record of viruses closely related to Sars-CoV-2 in any laboratory before December 2019”. Yet it had not been given access to the Wuhan institute’s virus database. Second, it observed that staff at the institute had claimed nobody at the lab had been ill with respiratory symptoms. But the WHO joint mission had not been given access to research staff or their personnel records.

The report prompted a further joint statement by the US and 13 allies, including Britain, Australia and Japan, which expressed concerns about its findings and alleged the scientists’ work had been hampered by significant delays and “lacked access to complete, original data and samples”.

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The bigger picture was that the WHO study was in disarray. Whether by design or opportunism, China had triumphed. Beijing had never wanted an investigation of the origin of the virus and had used all its considerable influence at the WHO to make sure it was watered down.

“This outbreak was serious enough to potentially damage China’s image, its legitimacy, its interests, its ambitions and the image it was trying to project internationally,” said Fidler, the former lawyer for the health agency. “So that political dynamic led China to control and decide the way in which these investigations were going to happen. And that’s made nobody outside China happy.”

In late May Biden ordered the CIA to redouble its efforts to investigate how the outbreak started, “including whether it emerged from human contact with an infected animal or from a laboratory accident”. When it reports in a few weeks’ time, more may be revealed about the reliability or otherwise of the intelligence on the Wuhan institute.

But China was ready to pull up the drawbridge. When, on July 22, the WHO proposed a new phase two of the investigation, which would include an audit of the Wuhan labs, it was quickly rejected by China. The country’s top health officials held a press conference in Beijing to say the results of the joint team’s work should be accepted and the next phase should look at whether the pandemic had begun in a country outside China.

It means that unless China can be somehow compelled to open itself up to more thorough investigation, which appears unlikely, the world may never get to the bottom of what caused the great pandemic of the 21st century, which has killed four million people and counting.

In preparing this article, we asked to interview the health agency’s staff who were part of the investigation as well as Tedros. The WHO press office declined our request. Margaret Chan did not respond to a request for comment.

A WHO spokesperson said this newspaper’s article rehashed old events and contained “falsehoods and baseless claims”. The agency argues that the director general treats China like any other country as a matter of principle.

“WHO’s top priority is ending the acute stage of the Covid-19 pandemic and we are supporting countries to implement comprehensive, evidence based responses, based on the consistent use of public health measures and the equitable use of life-saving tools including vaccines,” the spokesperson added.

Meanwhile, Tedros is likely to stand for re-election when his term ends next year and, if he does, will no doubt again seek backing from China.

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