ON MARCH 26, at the virtual G20 summit, Prime Minister Narendra Modi asked the world leaders to “reform and strengthen intergovernmental organisations like the World Health Organization”. India has neither openly criticised the WHO’s current leadership, nor has it condoned the organisation’s turning a blind eye to China’s handling of the Covid-19 pandemic. Modi’s statement is, however, a demand for a much-needed change within the WHO.
While American president Donald Trump has withdrawn funding to the WHO, and Australian Prime Minister Scott Morrison is urging world leaders to demand an investigation into the pandemic, Union Health Minister Dr Harsh Vardhan said: “The WHO is an important partner in India’s fight against Covid-19.” India rarely criticises an international body that it is a member of, or even a nation, outright, and in public. Usually, the opinion is conveyed quietly, and in person.
The WHO’s condoning, even shielding, of China’s opacity with relation to information regarding the pandemic may be difficult for the organisation to live down. However, to be fair, the WHO has not much choice but to accept statistics provided by member nations. At the G20 summit, there were suggestions that WHO officials should be given powers like the United Nations weapons inspectors, so they can enter countries and take stock of the situation themselves. Another suggestion was to mandate the organisation with new responsibilities like developing early warning systems for pandemics, and national and international responses to them.
India is a small contributor to the WHO, financially—$2 million in the last fiscal. But in terms of the work done together, the WHO and India need each other. The organisation has partnered well with India in malaria, tuberculosis and immunisation programmes—most notably smallpox and polio.
With Dr Soumya Swaminathan appointed as the WHO’s first chief scientist of the public health division, and India scheduled to take over as chair of its executive board (on a rotational basis, for a year), the country is keen for a meatier role in the organisation. India has been a strong advocate of changes in the UN, arguing that it does not reflect present-day realities and power equations. The WHO, one of the dozen specialised agencies of the UN, may have its own general assembly, but otherwise, has the same power structure as the UN, where the same top nations call the shots.
As one insider notes, the biggest contributors to the WHO are obviously the most influential, and often strike deals among themselves—a quid pro quo across the UN’s specialised agencies. Contributions to the WHO are also made outside of the programme budget, as funding for specific projects. Here, too, the bigger donors get a say in appointments and direction of the project. “The five primary powers and other major donors enjoy undue influence in the organisation in setting priorities and thus, these international organisations have difficulty in going against the interests of these countries,” says Dilip Sinha, India’s former ambassador to the UN. “China, in addition, has also, in the past, exerted influence through other unorthodox means.”
In this existing order, India’s position is a prudent one. Neither does pulling the carpet from beneath the WHO suit its purpose, nor does antagonising China. All other strategic reasons aside, India’s current headspace in the pharma market itself is dependent on a steady supply of active pharmaceutical ingredients (APIs) from China. Similarly, while trade in drugs is done directly between countries, a word of disapproval from the WHO could dent India’s pharma export business. “The WHO, for all its poor handling of this pandemic, has done phenomenal work across the world, and is held in esteem,” notes former diplomat G. Parthasarathy. “A crisis is no time to destabilise an institution, especially when there is no better solution to replace it with. However, once the pandemic is behind us, there will be a new world order with new power equations emerging. India needs to focus its energies towards that future.”
The question is whether the country is equipped for that. Around 70 per cent of the world’s vaccines are produced in India. Similarly, around two-thirds of the global production in generic drugs is from India. Yet, India’s dependency on China for the APIs takes the shine off India’s position as the pill box of the world. “We need to strengthen our pharma sector; we also need to attract medical research into India. These should be priority now,” says Parthasarathy.
Mohan Kumar, chairman of Research and Information Systems for Developing Countries, says: “Public health will outflank food and energy security now, and India’s role should be to become the net public health security provider for the world. We are already in a good position; we need to consolidate it. If we can develop the Covid-19 vaccine in time, we will get a huge heft in this sector.”