Plagues bring out the best and worst in pharaohs, as they do in party secretaries, presidents, and directors of the World Health Organization. There’s nothing like a high-pressure crisis to test a leader’s mettle.

In the US, the pandemic has exposed a president who is inclined to blame others for America’s troubles and to claim personal credit for remedial action. In China, it has exposed the Chinese Communist Party as an equally narcissistic institution shielding its followers from ‘hostile foreign forces’ while advancing implausible solutions for the world’s problems. China’s party leadership denies culpability for the global pandemic while demanding a note of thanks simply for doing what it should.

Between them, leaders in China and the US are presenting problems for the one institution on earth designed specifically to manage communicable disease outbreaks, the World Health Organization. Covid-19 has exposed a leadership team in the WHO with little experience managing an outbreak of non-communicable narcissistic disorder in the world’s two most powerful countries.

To this point, the damage wrought by China’s leadership is far and away the more serious.

The WHO acceded a year ago to Chinese government pressure to acknowledge traditional Chinese medicine, since revealed ^[1] as a plausible source of the Covid-19 pandemic. At the time the coronavirus was leaping from animal to human hosts in Wuhan in October 2019, CCP General Secretary Xi Jinping was telling ^[2] a conference in Beijing that he applauded ‘efforts to promote [traditional Chinese medicine] internationally and fully develop its unique strength in preventing and treating diseases’. For some years he had been lobbying the WHO to recognise traditional Chinese medicine as a legitimate form of medical treatment. In May 2019, the WHO’s governing body bowed ^[1] to Beijing’s pressure.

Scientists and public health specialists were appalled. One was quoted ^[3] as saying that the WHO’s ‘failure to specifically condemn the use of traditional chinese medicine utilising wild animal parts is egregiously negligent and irresponsible’.

Second, late last year the WHO ignored questions ^[4] from Taiwanese health authorities alerting the agency to signs of human-to-human transmission in Wuhan at a time when Beijing was downplaying concerns over social transmission. The WHO is obliged by the terms of its agreement with China to deny Taiwan formal recognition, but there’s nothing in its agreements compelling the WHO to ban Taiwan’s participation in health matters or reject the specialist knowledge and expertise Taiwan can bring to the table. This is a further result of political lobbying from Beijing.

At that time, WHO Director-General Tedros Adhanom Ghebreyesus accused ^[5] the government of Taiwan of levelling racist slurs against him, an accusation fiercely denied by Taiwan but reinforced by an online army of trolls based in China, pretending to be Taiwanese nationals, ‘apologising’ for offending Tedros. Once again this suggests unhealthy collusion between the WHO leadership and Beijing.

By his actions, the director-general inflicted reputational damage on the WHO. Taiwan’s exceptionally low rate of infection and mortality in the Covid-19 pandemic has made Taiwan a poster child advertising the benefits of being excluded from the WHO and relying instead on alternative sources of information and analysis. The WHO doesn’t come out well when a country so clearly benefits from having nothing to do with it.

Third, the WHO was slow in sharing information about the Covid-19 pandemic and, as US President Donald Trump reminds us, it parlayed misinformation from China in its public communications. But Trump is wrong in attributing this to ‘China-centric’ behaviour on the agency’s part.

There was certainly misinformation coming out of China. Local officials in Wuhan delayed reporting evidence of human-to-human transmission to Beijing for some weeks after the earliest cases came to their attention, and they prevented reliable informants among health professionals from sharing what they knew. Authorities in Beijing remained silent for a further week after receiving confirmation of local human-to-human transmission in mid-January. Xi only went public on 20 January.

That was not the WHO’s doing. The agency may have been naive in taking China’s authorities at their word, but as an organisation made up of members, that’s how the WHO operates: it shares information offered by its member states. When they can manage it, individual member states are responsible for gathering and sharing information on domestic health issues. The WHO, on the other hand, is uniquely responsible for monitoring the point at which domestic public health issues become global ones.

A key question for the WHO is how it managed reporting on human-to-human transmission beyond China’s borders. On this pivotal question there’s little basis for the claim that the WHO showed undue caution on account of pressure from China.

In fact, it had other reasons to tread very carefully. Early in the spread of Covid-19, health experts at the WHO were keen to avoid coming across as unduly alarmist in their public statements because they had been roundly condemned a decade earlier by European and other Western countries for taking a more proactive stance during the 2009–10 H1N1 pandemic. When that pandemic failed to unfold on the scale the WHO anticipated, the agency was accused of crying wolf.

That earlier H1N1 controversy is referenced in recent WHO statements on Covid-19 as a kind of cautionary lesson framing its approach to the global spread of the new disease. Addressing a press conference ^[6] on 17 February 2020, WHO Executive Director Michael J. Ryan reminded all media present that WHO officials ‘need to be careful’ in handling information on Covid-19 in light of earlier public criticism over the H1N1 pandemic.

In this case, his caution was ill-advised, but it had nothing to do with China. In 2010 it was European agencies that blasted the WHO for sounding a false alarm on H1N1. The chair of the Council of Europe’s health committee was reported ^[7] as saying that the WHO’s early call was ‘one of the greatest medical scandals of the century’ resulting in the waste of US$18 billion on preventive measures and pharmaceuticals to little purpose. The emergency committee advising the WHO was alleged to have been ‘subject to undue commercial influence’ from the big pharmaceutical companies that profited from the WHO’s H1N1 call.

Senior staff at the WHO still bear the scars of that controversy and tread cautiously before making public statements about the global spread of infectious diseases, not because they are ‘China-centric’ but on account of trenchant Western media criticism endured in years past.

The fate of the WHO now lies in the hands of Washington and Beijing, the one threatening to cut off funds, the other willing as ever to trade favours for improper influence. Beijing’s influence over the organisation has little to do with funding. China is the world’s second largest economy and over the decades has been an enormous beneficiary of WHO programs. And yet in 2019 its financial contributions to the WHO were less than those of Norway or Australia, let alone the US or UK.

China’s political influence is out of all proportion to its financial contributions because it controls access to one-fifth of the world’s population—a critical factor in world health reports—and because it can marshal support among smaller nations across the UN system to secure strategic advantages throughout the UN system. Beijing’s favoured currency is trading in political favours, and it will go on minting favours indefinitely whether or not Trump follows through on this threat to withdraw funding.

It is up to other countries, including Australia, to expose the damage Beijing’s collective narcissism and Trump’s narcissistic personality disorder are visiting upon us all. We could start by pressuring the WHO to reverse its decision on traditional Chinese medicine, and to make way for Taiwan at the table, and we could continue working together to ensure that the WHO puts health ahead of politics whenever it confronts unreasonable demands from member states.

Trump is often likened ^[8] by his fervent followers to a latter-day Moses leading his people out of bondage to the promised land. But he is just another pharaoh lashing out to escape responsibility for his own actions.