COVID-19 has now killed more than one million people worldwide, and more than 200,000 in the United States with no signs of letting up. In Europe, countries once thought to have the virus under control are seeing surges once again, spreading fears that a second wave of the deadly pandemic is on its way.
We’ve seen already that the virus doesn’t respect national borders, and global health experts have repeatedly called for international cooperation in response to the pandemic.
But in July, the Trump administration gave official notice that the U.S. intends to fully withdraw from the World Health Organization by the middle of 2021, in the meantime it will withhold funding and has begun to withdraw staff that were seconded from the U.S. Department of Health and Human Services.
The president has blamed the WHO for mishandling the pandemic. “So much death has been caused by their mistakes,” the president told reporters during a White House briefing in April. Critics, however, argue that the president is using a scapegoat, and that he’s relying on false evidence, like a non-existent article published in noted medical journal, The Lancet.
The WHO, an organization under the wider umbrella of the United Nations, has been tasked with coordinating international efforts to stop the spread of COVID-19. Pulling funding from the organization could do great damage and potentially prolong the ill-effects of the pandemic. The United States is currently responsible for the largest percentage of funding for the WHO with 22% of assessed dues. It also provides the largest amount of voluntary assets.
Corporations have been stepping up to fill the void. Google, Microsoft and Facebook are taking on larger shares of the burden for the organization which also provides guidelines for the treatment of illnesses like malaria and tuberculosis. But the role companies play in quasi-governmental bodies is also posing its own set of challenges.
Fortune sat down with WHO chief information officer, Bernardo Mariano Jr., at the Virtual Edition of the Global Manufacturing and Industrialisation Summit to discuss the crisis at hand and what the future of world health post-pandemic might look like. The conversation has been edited for length and clarity.
What does this pandemic highlight about the need for nations to cooperate across borders to prevent the spread of COVID-19 and other diseases?
Bernardo Mariano Jr.: The healthcare sector has been traditionally siloed, especially in developed countries. This pandemic is highlighting the need to have a better interoperable ecosystem, it’s also highlighting the need to cooperate across borders between countries and it’s showing that we need to rethink the digital transformational healthcare sector in such a way that we really leverage technology. Think about telehealth and telemedicine. What is stopping countries from using and leveraging telemedicine today? It is not a lack of technology.
So what needs to be done to help leverage cross-border telemedicine?
The private sector, public sector, governments, and international organizations need to come together to see what policies are needed to extract the maximum benefit and of course mitigate all of the issues associated with technology, be it privacy, be it ethics. Today in most countries a medical doctor, when he or she moves to another country it’s always very difficult to practice medicine in that country. If I go to a state I need to get the whole certification of that state to practice medicine, but then if a patient is not in that state I cannot practice telemedicine so those are some of the areas I believe that we can use COVID-19 to accelerate change in. We need to establish multi-state healthboards to help with contact tracing, for instance.
This is happening at a time when large swaths of the Western World seem to be retreating from cooperating on a global scale, what fears do you have about that?
The more divided we are, the more the virus will multiply and the more difficult it will be for us to get out of the pandemic. An outbreak in a faraway country doesn’t mean safety in your country. There’s no doubt that the COVID-19 pandemic is outlining the importance of global cooperation, because without that we’ll take two to four times longer to actually address the disease. It’s true that we can talk about vaccines but you still need access to them, and we live in a global world. A company in the Northern hemisphere or a developing country has branches in other countries and vice versa, so if we want the global economy to continue to progress the way it was progressing before the pandemic we cannot do that in isolation, we need that global cooperation.
The U.S. has said it will pull funding from the WHO, but you still get a significant amount of funding from U.S. tech magnates like Bill Gates, do you see U.S. tech playing a large role in the governing of the WHO in the future, and how do you navigate that?
We work with a holistic focus. And we do still work with the U.S. government, I mean we’ll work with any country willing to work with the WHO because the disease has no border and doesn’t understand differences in entities. So we’re really trying to use the convening power of WHO to bring all the parts together. All the sectors have a stake in the game because COVID-19 has shown that the fact that you’re a tech company or a transport company or in the hospitality industry doesn’t mean you’re safe from the impact of this pandemic.
The question here is how we bring all of the efforts together. I have to say here that we were very grateful to see the response from the tech sector, we had over 100 companies approaching us to offer pro-bono support for the pandemic in all sorts of areas. The fact that they all volunteered shows that they realize they need to bring what they can to the table to help address these issues.
You’ve commented before that predicting the weather shouldn’t be easier than predicting a deadly pandemic…
And it is surprising. We’re working on developing infrastructure by putting together what we’re calling a network of networks. We have a lot of different groups trying to drive the digital direction so we want to make sure that we bring all stakeholders: private sector, academia, NGOs, and governments together to discuss some of the key issues and some of the pain points that are not allowing us to progress fast enough. I understand that each sector may have its own interests, but that doesn’t mean that we can’t share the common goal to make sure that we’re better prepared for a pandemic. That we have the right technology, the right data and the right predictive models to minimize the impact on people’s lives and also the impact on the economy and social problems that we currently have with the pandemic.
So when do you start looking towards the future and potential pandemics beyond COVID-19?
We already started discussing that with a number of stakeholders and there are three topics that we’ve been discussing with developing partners such as The Gates Foundation and The Rockefeller Foundation. We’ve also discussed the topics with member states and we have a global strategy going forward.
So there are three topics: One of them is a disease surveillance system both at the global and national level to try to create an environment of modeling that is better than the weather forecast today, because there are outbreaks in some part of the world pretty much everyday and some of them are easy to control and others are not, like Ebola. The other one is the network of networks, we want to make sure we create a mechanism that allows for interoperability of systems, concepts, and policies that would bring all the players together. The last one is accelerating the transformation of the healthcare sector through telehealth and telemedicine.
We have to change our culture because we didn’t interact with the private sector previously and we never thought that we could sit at the same table as them, we looked at them as having a conflict of interest. But we established a framework of engagement with non state actors that allows us to actually have that engagement without compromising our own values.
It’s interesting because there is a serious economic interest here, COVID-19 has been terrible for the global economy…Have you noticed this increase in private sector companies wanting to work with you for those reasons?
Yes, there are always different interests. We work to make sure that we advance policies and support governments, and a private sector company will work to make sure that they make revenue. They can support pro bono engagement to a point, but there will be a point where they say ‘Look if I continue like that I’ll be run out of business.’ The question is, how can you find that equilibrium where the private sector delivers what they deliver with good governance while still protecting the interests of the company. This pandemic is ruining the food industry, the transport industry, the hospitality industry, they’re all impacted, all of them. So, we need to share the responsibility to preserve the ecosystem that the world exists in.
Also, remember one thing, after World War II, we created systems to prevent another world war. We built systems to make sure there were negotiations and discussions to prevent escalation of war because that was such a terrible experience. But we are also having a terrible experience with the pandemic, so we need to start thinking about having to prepare the world for the virus, not just war and i think we need to invest more into that.
The World Wars shifted the global order immensely, bringing us into this current era. Now, it feels like that era of global cooperation is winding down, but is the pandemic enough to retain global status quo?
What I’m saying is that we need to quickly adapt to new realities. The world needs to shift and adapt to these new challenges and not just be tethered to these old problems. The healthcare sector and investment in health, has long been ignored. We need to refocus our attention to investing in health, because while we never thought that the virus would put us in the situation where we are today, we’re here.
There’s such a difference between the creation of the UN and an organization that includes major companies like Google and Facebook So do you imagine that the way power is structured is shifting away from governments and into these giant tech companies?
It is. I mean Facebook has 2.7 billion users in the world across different geographies and social structures and they have the power to influence. These are the new realities, and the world needs to adjust as we move. We have this health risk, this virus, that is creating such a huge problem, and we need to be coordinated, cooperative, and united in solidarity, that’s the only way to address this. We need to invest in this and make sure that the world is much more prepared and that it is not just on the shoulders of the WHO or the UN or governments. It’s on all of us: the private sector, public sector, academia, all of us. We need every sector of society to act as a whistleblower if something isn’t working very well. We need the WHO and the UN to make sure that countries don’t keep reinventing the wheel and can learn from each other and can come together and say what was created in one country can be used in another, we have to strike that balance. It’s easier said than done but we need to do it.
How do we combat the spread of misinformation around COVID-19?
We have a new science being born called infodemiology. We have frontline workers and healthcare professionals fighting the epidemic, but we have another fight on our hands; information. It’s as deadly as the epidemic and we need to strengthen this science. We’ve brought in a number of specialists and we recognize that this is a key characteristic in any disease outbreak. We know much more than we knew six months ago and we’ll know much more six months from now. The question is how can this knowledge be quickly reached by people who need to know it in order to make sure that lives are saved and also that social and economic impact is minimized.
What’s the dream outcome of this tech community coming together?
What the whole world is trying to do right now is to get back to normal: The normal that we know, where we can travel, where I can shake your hand, where I can go to my mother who is living in Mozambique and hug her without fearing that I’m transmitting a disease. It’s all about using technology to accelerate therapeutics, and a vaccine is one of them. A number of companies have approached us to look at for instance the digitalization of immunization, so how can we digitize immunization records as we go through the process of a vaccine or medicine so we come away from the physical immunization card. Today the only international immunization card that exists today is a yellow vaccine card.
We should come out of COVID-19 with some good, accelerated practices that will allow healthcare professionals to conduct treatments with someone across a border. Because look at the European Union for instance, you had Spain and Italy with health systems on the brink of collapse during the earliest stage of the pandemic, and you had other countries nearby that weren’t in the same stage. Can you imagine the power of telemedicine in that scenario?
The United States has said they’re withdrawing funding from the World Health Organization. Do you see the U.S. playing a diminished role here?
I don’t think the United States will ever play a diminished role. Of course if you look at the situation over a short period of time that might be the impression, but we are here for a long period and I think the U.S. has been a leader in many forms and has been an excellent partner. The U.S. is the mother of WHO, and there will be a time where we’ll come back and say “okay fine, we’ve got over the critical phase and now we have huge challenges to address and multinational political issues so let’s get back to better prepare for the future.” I think we’re all learning lessons as we move.
And at that point we might have a different administration that’s a little more friendly to the WHO…
We will see and figure out what needs to change, all national governments will have to do a post-mortem analysis of how we acted, how we behaved, how we reacted and what we can do better. That includes the WHO, that includes the U.S., EU, and countries in Africa. I think the WHO is open to any recommendations for improvement because the bottom line is that we want to see a better world and better health for all. We will have the space and time to transgress some of the differences or issues that are perhaps today not the top priority. The top priority today is to address the virus.
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