世界衛生組織必須回答全世界的17個關鍵問題

“如果世界衛生組織還想保持信譽，就必須對這些問題進行公開詳細地問答”

杨建利  Aaron Rhodes

（原文刊登在美國雜誌《美國利益》，中譯稿：Anna Chen）

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鑒於圍繞世界衛生組織（以下簡稱“世衛組織”）應對Covid-19的持續爭議，我們在此提出需要世衛組織回答的關鍵問題，以便對世衛組織此方面的記錄形成客觀的評估。所有問題的提出均基於對中文資料和其他公開資源的原始資料的研究。

1. 世衛組織何時收到關於Covid-19的消息？

據親北京的《南華早報》 （該報的主人是馬雲，他是阿里巴巴的創始人，一名中國共產黨成員)報道，中國武漢 covid19的第一個確診病例出現2019年11月17日。但是根據世衛組織官方網站，它在12月31日才第一次收到來自中國的關於病毒爆发的報告。

(https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/)

請問在此之前，世衛組織是否收到或发現有關疫情的任何其他信息？如果是，世衛組織的如何應對的？中國當局在向世衛組織提交的第一份報告的內容是什麽？世衛組織能否公布中國首份報告?如果不能，為什麽不能？

2.世衛組織是否意識到中國對關於Covid-19的研究和信息的壓制?

2020年1月1日，中國給世衛組織遞交報告的第二天,武漢市衛健委下令第一家鑒定和測序病毒的公司停止測試，銷毀所有樣品，並對信息進行保密。兩天後，中央衛生當局向全國的檢測機構发布了一條類似的行政指令。對此，世衛組織是否了解? 如果世衛組織了解這些情況，那它對中國的掩蓋又作出了何種反應?

3.世衛組織是如何處置從台灣收到的關於Covid-19人際傳播風險的信息的?

眾所周知，2019年12月31日，台灣向世衛組織通報了這種新病毒的人傳人風險。(https://www.ft.com/content/2a70a02a-644a-11ea-a6cd-df28cc3c6a68)，

我們不太清楚的是，世衛組織在收到來自台灣的警示後做了什麽？世衛組織是否將這些預警傳達給了其他國家?

4.世衛組織在否認該病毒可以人傳人的同時，是否已經知道中國有醫生感染了Covid-19？

與中國政府一樣，在1月20日之前，世衛組織一直否認Covid-19在人與人之間傳播的說法。但在1月1日至1月11日之間，已經有至少7名中國醫生感染了該病毒(https://mp.weixin.qq.com/s/69pdSrjNH_4qN3RrQ-Yk0Q)

世衛組織應該知道醫生被感染是人際傳播的重要明顯指標。在此期間，世衛組織是否知道中國有醫生被感染？還是中國當局沒有通知世衛組織這些案例？

5.為什麽世衛組織在確認了泰國於2020年1月13日发生Covid-19病毒感染病例後，繼續否認該病毒可以人傳人?

世衛組織的官方時間線表(https://www.who.int/news-room/detail/08-04-2020-who.timeling--covid-19)記載，1月13日，“[世衛組織]官員確認了泰國的一例COVID-19病例，這是中國境外的首例有記錄病例。”

那麽，為什麽世衛組織在1月14日的新聞发布會上繼續聲稱沒有證據顯示病毒可以人傳人、在中國或泰國也沒有醫生感染病例?( https://news.un.org/zh/story/2020/01/1049182)

6.為什麽世衛組織沒有去武漢訪問最前線收治Covid-9病人的醫院？

1月20日和21日，在宣布武漢封城的前一天，世衛組織中國和西太平洋區域辦事處的專家對武漢進行了一次簡短的實地訪問（https://www.who.int/china/news/detail/22-01-2020-field-visit-wuhan-china-jan-2020） 。代表團參觀了武漢天河機場，中南醫院，湖北省疾病預防控制中心，包括中國疾病預防控制中心(CDC) BSL3實驗室。

請問為什麽代表團沒有去武漢中心醫院、金銀灘醫院、武漢肺炎醫院等這些最前線收治感染者的主要醫院?世衛組織是否向中國當局提出了進行此類訪問的要求?

7.世衛組織是否從中南醫院院長王行環博士處得到了關於Covid-19傳播的信息?

1月19日，在世衛組織代表團訪問的前一天，湖北省、武漢市衛健委領導來中南醫院考察安排接待世衛專家時，衛健委的官員要中南醫院人員“註意政治影響和說話方式”。王行環當即直接反駁說，“我一定會實話實說。你們難道忘記了沙士教訓了嗎？救人命是最大的政治，實事求是是最大的政治“。在世衛組織到中南醫院考察的頭天晚上，王行環還回絕了跟他相熟的省級領導要他註意政治影響的叮囑。他對這位領導說，”真正的政治站位是要站在人民的立場上，站在黨中央的全局高度立場上。”(http://www.rfi.fr/cn/%E6%94%BF%E6%B2%BB/20200413-%E6%8A%AB%E9%9C%B2%E6%AD%A6%E6%B1%89%E5%B0%81%E5%9F%8E%E5%89%8D%E5%86%85%E5%B9%95-%E6%9D%8E%E6%96%87%E4%BA%AE%E8%89%BE%E8%8A%AC%E4%B9%8B%E5%90%8E%E5%8F%88%E6%9C%89%E8%90%A7%E8%BE%89%E7%8E%8B%E8%A1%8C%E7%8E%AF)

8.世衛組織能否公布1月20日王行環博士告知其代表團的信息內容？

9.1月20日當周就发生了武漢大規模逃離，為什麽世衛組織要等到1月30日才宣布疫情為國際關註突发公共衛生事件，而3月11日才宣布為全球大流行?

BBC健康報道的記者詹姆斯·加拉格爾1月18日发表報告,“中國新病毒將導致數百人感染”(https://www.bbc.com/news/health.51148303)寫道:“中國出現神秘病毒，感染人數遠遠大於官方數據顯示,科學家們告訴BBC。目前已有60多例新冠狀病毒確診病例，但英國專家估計這個數字接近1700例。”

世衛組織代表團訪問武漢期間，急於躲避病毒的居民紛紛離開這座城市，前往中國的其他地區和世界各地。武漢市長周先旺在1月26日的新聞发布會上證實，上一周已有500多萬武漢居民離開。世衛組織代表團是否知道這次大規模逃離？如果知道，為什麽世衛組織要等到1月30日才宣布疫情為國際關註的突发公共衛生事件，而到3月11日才宣布為全球大流行？為什麽在1月22日至23日的世衛組織會議上沒有作出這樣的決定?

10.請問1月28日，世衛組織總幹事與習近平和中國其他高層領導人會晤時发生了什麽?

1月28日，由總幹事譚德賽率領的世衛組織高級代表團訪問北京，與中國領導人會晤，了解中國的抗議，並提供技術援助。譚德賽會見了中共中央總書記習近平和外交部長王毅，但沒有會見中國中央防疫領導小組的組長、國務院總理李克強。譚德賽是否要求與李克強總理會晤? 譚德賽在中國了解到了什麽？他的中國之行是政治之行的還是防疫專業之行?

鑒於中國對信息的壓制、未能控制住Covid-9疫情傳播，以及在報告Covid-9的性質方面的拖延，世衛組織總幹事為什麽還要讚揚中國的應對，甚至是“中國的制度”?

1月30日，在宣布疫情為國際關切的突发公共衛生事件的新聞发布會上，譚德賽盛讚“中共體制的優勢,”習近平的領導,中國的應對。“我從北京回來後已經多次說過，盡管中國政府采取了非常措施來控制疫情，盡管這些措施對中國人民造成了嚴重的社會和經濟影響，但還是值得祝賀的。”他接著指出，“中國发現疫情、隔離病毒、測序基因組並與世衛組織和全世界分享的速度之快令人印象深刻，難以言表。中國對透明度和支持其他國家的承諾也是如此。在許多方面，不誇張地說，中國實際上正在為應對疫情制定新的標準。” (https://www.who.int/docs/default-source/coronaviruse/transcripts/ihr-emergency-committee-for-pneumonia-due-to-the-novel-coronavirus-2019-ncov-press-briefing-transcript-30012020.pdf?sfvrsn=c9463ac1_2)

在同一次記者會上，他說:“讓我澄清一點，這個聲明不是對中國的不信任投票。相反，世衛組織仍然相信中國有能力控制疫情”。他似乎覺得有必要再補充一句:“我再重覆一遍，讓我澄清一下。這個聲明不是對中國的不信任投票。相反。世衛組織繼續相信中國有能力控制疫情。”

鑒於上述列舉的事實，世衛組織秘書長為何作出這種虛假報告？如果當時世衛組織沒有意識到這些事實，那麽現在世衛組織是否仍然堅持譚德賽在新聞发布會上所說的？他現在還相信中國致力於“透明”嗎？為什麽譚德賽讚揚中國並順從中國？

11.請問為什麽譚德賽在1月30日不建議甚至反對對中國進行邊境和貿易限制？

在1月30日的會議上，譚德賽反覆強調，世衛組織不建議也確實反對對中國的旅行和貿易進行任何限制。鑒於上面列出的信息，特別是1月26日武漢市長承認有500多萬武漢居民逃離了這座城市，為什麽譚德賽反對限制中國的入境和貿易?現在世衛組織承認這一判斷是錯誤的嗎?

12.為什麽世衛組織在2月底仍繼續反對對中國貿易和入境進行限制?

經雙方商定，中國與世衛組織召集中外專家組成聯合調查團，對中國的疫情防控情況進行調查。從2月16日開始，聯合考察團先後訪問了北京、廣東、四川、湖北武漢，於2月24日結束。在離開中國前，聯合考察團的負責人Bruce Aylward博士（前世衛組織前助理總幹事和總幹事高級顧問），和國家衛生健康委員會COVID-19應對方案專家組組長梁萬年博士在北京舉行了新聞发布會。

(https://www.who.int/docs/default-source/coronaviruse/transcripts/joint-mission-press-conference-script-english-final.pdf?sfvrsn=51c90b9e_2)

在新聞发布會上，Aylward博士繼續反對對中國旅遊和貿易的限制。現在來看，世衛組織會認為這是明智的呢?

13.為什麽中國-世界衛生組織聯合調查團甚至沒有檢查武漢和其他地區的疫區？

在2月24日的新聞发布會上，《華盛頓郵報》北京主任安娜·菲菲爾德(Anna Fifield)問Aylward，「周末在武漢逗留後，他為什麽沒有被隔離。」Aylward說，他沒有去武漢任何“骯臟區”，那天早上他已經接受了冠狀病毒檢測。他隨即離開中國而並沒有被隔離14天。很明顯，Aylward所說的“骯臟區”是指感染區。

為什麽世衛組織負責研究和調查病毒暴发的專家沒有前往感染區?(世衛組織2020年1月20日至21日訪問武漢的代表團似乎也沒有去“骯臟區”。)參加這次任務的世衛組織專家是否可以自由選擇去哪里訪問、去哪家醫院進行研究，以及與哪些人——醫生、受感染者、死者家屬或街上的人——進行交談?還是完全由中國政府安排?

14.為什麽未去感染區考察的世衛組織官員Bruce Aylward博士對中國抗疫大加吹捧又回避真實的問題？

在同一場新聞发布會上，盡管沒有親眼看到中國武漢和其他地方的感染區，但Dr. Aylward卻對中國在控制病毒方面取得的成功大加讚賞。但當一名BBC記者問道，他認為掩蓋和信息審查在多大程度上導致了病毒的加速傳播時，他回答說：“坦白地說，我不知道，我沒有註意到這一點。我只是實話實說……”

這次記者招待會的目的之一是為全球防疫提出建議。那麽，為什麽肩負這一使命的專家不去研究某個國家或另一個國家所犯的錯誤呢?為什麽Aylward試圖回避這個問題？現在世衛組織認為他的做法合適嗎？

15.為什麽世衛組織直到3月11日才宣布Covid-19為全球大流行? 3月初，Dr. Aylward為什麽繼續宣稱Covid-19不是全球大流行?

在此次新聞发布會上，Dr. Aylward還說，“因為我們每天都停下來思考這種疾病，並做出決定，不管我們是否應該這樣做，病毒會乘機使感染的病例翻倍的增長。我們必須加快行動”。這表明他懂得快速反應至關重要。到3月4日，許多國家的病例數和死亡人數激增，病毒早已符合人際傳播、高致死率等全球大流行的標準。然而，3月4日，在接受《紐約時報》記者Donald McNeil采訪時，他仍說:“我們沒有全球性大流行。”(https://www.nytimes.com/2020/03/04/health/coronavirus-china-aylward.html)

16.世衛組織是否已經進行模型計算，來估計如果更早宣布Covid-19為國際關切公共衛生緊急事件、更早宣布其為全球大流行，可以挽救多少生命?

17.最後，世衛組織是否認為有責任協調所有受感染國家組成一個可信的、獨立的科學團隊，對Covid-19的起源進行調查?

新型冠狀病毒的起源一直是各國激烈爭論和指責的焦點。這是首要問題，全世界的公民都在關切。這個問題最終是一個科學問題，與世衛組織的使命相一致。世衛組織能夠履行它的職責嗎？

Can the WHO Deliver?

Key Questions for the World Health Organization

By Jianli Yang and Aaron Rhodes

If the WHO is to remain a credible organization, it must answer these questions—publicly and in detail.

https://www.the-american-interest.com/2020/04/23/key-questions-for-the-world-health-organization/?utm-access=newsletter

In view of ongoing controversies surrounding the World Health Organization’s response to COVID-19, we have isolated the most important questions that need to be answered in order to form an objective assessment of the organization’s record. These questions are formulated on the basis of research on Chinese and other open sources.

When did the WHO receive information about COVID-19?

According to the pro-Beijing South China Morning Post, owned by Jack Ma (owner of the firm Alibaba and a member of the Chinese Communist Party), the first case of COVID-19 in Wuhan, China, was confirmed on November 17, 2019. But according to the official website of the WHO, it first received a report from China about the virus outbreak on December 31.

Before that date, did the WHO receive or discover any other information about the outbreak? If so, what was the organization’s reaction? What did Chinese authorities say in their first report to the WHO? Can the public see that report? If not, why not?

Was the WHO aware of China’s suppression of research and information about COVID-19?

On January 1, 2020, the day after China’s report, Hubei province health authorities ordered the company that first identified and sequenced the virus to stop testing, destroy all samples, and keep information secret. According to press reports, two days later, central health authorities issued a similar official order to testing facilities across the country. If the WHO was aware of these things, how did it react to China’s cover up?

What did the WHO do with information received from Taiwan about the risk of human-to-human transmission of COVID-19?

It is now well-known that on December 31, Taiwan alerted the WHO about the risk of human-to-human transmission of the new virus. What is less known is what the WHO did upon receiving the alert from Taiwan. Did the organization pass on the concerns to other countries?

Was the WHO aware of Chinese doctors becoming infected with COVID-19, even as the organization denied that the disease could be transmitted between individuals?

Like the Chinese government, the WHO officially denied until January 20 that COVID-19 could be transmitted from human to human. But between January 1 and January 11, at least seven doctors contracted the virus. The WHO was presumably aware that infected doctors are the most telling indicator of human-to-human transmission. Was the WHO aware of doctors infected in China during this time? Or did Chinese authorities not inform the WHO of these cases?

Why did the WHO continue to deny human transmission after confirming a case of COVID-19 in Thailand on January 13, 2020?

The WHO official timeline records that on January 13,  “Officials confirm a case of COVID-19 in Thailand, the first recorded case outside of China.” Why then did the organization continue to claim at its January 14 press conference that there was no evidence showing human-to-human transmission, and no case of doctors infected in China or Thailand?

Why didn’t the WHO visit Wuhan hospitals where COVID-19 patients were being treated?

On January 20 and 21, a day before the Wuhan lockdown was declared, WHO experts from its China and Western Pacific regional offices conducted a brief field visit to Wuhan.) The delegation visited the Wuhan Tianhe Airport, Zhongnan Hospital, the Hubei provincial Center for Disease Control (CDC), including the BSL3 laboratory in China’s CDC. Why did the delegation not visit Wuhan Central Hospital, Jinyintan Hospital, or Wuhan Pneumonia Hospital—that is, the main hospitals treating infected patients? Did the WHO request such visits?

Did the WHO receive information from Zhongnan Hospital head Dr. Wang Xinghuan about the spread of COVID-19? 

On January 19, the day before the WHO delegation’s visit, top Wuhan public authorities came to inspect Zhongnan Hospital, and instructed the hospital administrators and professionals to be “mindful of political implications about what you are going to say to WHO.” The hospital head Dr. Wang Xinghuan responded that, “I must tell them the truth. Have we learned any lesson from SARS? Saving lives is the biggest politics, so is telling the truth.” That night, worried that Wang would reveal what he knew, the city government sent an official “friend” to talk to him. Wang told the “friend” that political integrity “requires us to stand with the people, which is good for the Party’s overall image.” Can the WHO reveal what Dr. Wang told the delegation on January 20?

Given of the massive evacuation from Wuhan on the week of January 20, why did the WHO wait until January 30 to declare the outbreak a public health emergency of international concern (PHEIC)?    

BBC health reporter James Gallagher’s January 18 report begins: “The number of people already infected by the mystery virus emerging in China is far greater than official figures suggest, scientists have told the BBC. There have been more than 60 confirmed cases of the new coronavirus, but UK experts estimate a figure nearer 1,700.”

During the WHO delegation’s visit in Wuhan, residents desperate to avoid the virus were scrambling to leave the city for destinations in China and throughout the world. Wuhan Mayor Zhou Xianwang confirmed at a January 26 press conference that more than five million Wuhan residents had left in past week. Was the WHO delegation aware of this mass evacuation? Why was a PHEIC declaration not made at the WHO’s meeting on January 22-23?

What took place when the WHO’s Director-General met with Communist Party General Secretary Xi Jinping and other top Chinese leaders on January 28?

On January 28, a senior WHO delegation led by Director General Tedros Adhanom Ghebreyesus traveled to Beijing to meet China’s leadership, learn more about China’s response, and offer technical assistance. 

Tedros met with Xi Jinping and Foreign Minister Wang Yi, but did not meet with the official head of the Chinese government’s response, Premier Li Keqiang. Did Tedros request a meeting with Li? What did Tedros learn in China? Was his trip political or professional in nature?

Given China’s suppression of information, failure to contain the COVID-19 epidemic, and delays in reporting on the nature of COVID-19, why did the WHO’s Director-General praise the Chinese response and, indeed, the “Chinese system”?

In the January 30, at the WHO news conference to declare the outbreak a PHEIC, Tedros hailed “the advantage of the CCP system,” Xi Jinping’s leadership, and China’s responses: “As I have said repeatedly since my return from Beijing, the Chinese government is to be congratulated for the extraordinary measures it has taken to contain the outbreak, despite the severe social and economic impact those measures are having on the Chinese people.” He went on to note that

“the speed with which China detected the outbreak, isolated the virus, sequenced the genome, and shared it with WHO and the world are very impressive, and beyond words. So is China’s commitment to transparency and to supporting other countries. In many ways, China is actually setting a new standard for outbreak response, and it’s not an exaggeration.”

At the same conference, he said, “Let me be clear. This declaration is not a vote of no confidence in China. On the contrary, WHO continues to have the confidence in China’s capacity to control the outbreak.” He seemed to feel the need to add later: “I’ll repeat this. Let me be clear. This declaration is not a vote of no confidence in China. On the contrary. WHO continues to have confidence in China’s capacity to control the outbreak.”  

Given the facts laid out above, why did the WHO’s Director-General make such false claims? If the WHO was unaware of these facts at the time, does it now still stand by what Tedros said at the news conference? Does he still believe China was committed to “transparency”? Why did Tedros praise and defer to China?

Why didn’t Tedros recommend restricting Chinese travel and trade on January 30?

At January 30 conference, Tedros repeatedly stressed that the WHO did not recommend—and indeed opposed—any restrictions on Chinese travel and trade. Given the above information, and especially the Wuhan Mayor’s admission on January 26 that more than five million Wuhan residents had escaped the city, why was Tedros opposed restrictions on Chinese travel and trade? Does the WHO now admit that this judgment was incorrect?

Why did the WHO continue to oppose restrictions on Chinese trade and travel through the end of February?

As agreed by the two sides, China and the WHO convened Chinese and foreign experts to form a joint mission to investigate epidemic prevention and control in China. Starting on February 16, the joint mission visited Beijing, Guangdong, Sichuan, and Wuhan of Hubei province successively, ending on February 24.

The team leaders of the joint mission—Dr. Bruce Aylward, former WHO Assistant Director-General and senior advisor to the Director-General, and Dr. Liang Wannian, head of the Expert Panel on COVID-19 Response of China’s National Health Commission—held a press conference in Beijing before Aylward left China. At the press conference, Aylward continued to oppose restrictions on Chinese travel and trade. In retrospect, does the WHO think this was sensible？ 

Why didn’t the joint China-WHO mission inspect the infected areas of Wuhan?

At the end of the February 24 press conference, Washington Post Beijing bureau chief Anna Fifield asked the WHO’s Dr. Aylward why he was not in quarantine after staying in Wuhan over the weekend. Aylward said he didn’t go to any “dirty” areas in Wuhan and that he had been tested for the coronavirus that morning. He left China immediately without quarantining himself for 14 days. It is obvious that by “dirty areas,” Aylward meant infectious areas. 

Why did the WHO experts on the mission to study and investigate the viral outbreak not go the infected area? (The WHO delegation visiting Wuhan on January 20-21, 2020, also does not seem to have gone to “dirty areas.”) Did the WHO experts on the mission have freedom to choose where they went, what hospitals they studied, and what people to talk to—doctors, the infected, relatives of the deceased, or people on streets for that matter? Or was the mission itinerary and agenda dictated by the Chinese authorities?

Why did the WHO’s Dr. Aylward lavish praise on China’s putative success in containing COVID-19?

At the same press conference, and without having personally seen infected areas of Wuhan and other places in China, Aylward lavished praise on the government’s success in containing the virus. But when a BBC reporter asked him to what extent he thought a cover up and censorship played a role in allowing the virus to accelerate at the rate that it did, he replied, “I don’t know, frankly, didn’t look at that. I'm just being completely honest. . . .”

One purpose of the press conference was to make recommendations for a global response. Why, then, did an expert charged with that task not consider whether China or any country had made mistakes? Why did Aylward try to avoid that question? Does the WHO now think this approach was appropriate?

Why did the WHO wait until March 11 to declare COVID-19 a global pandemic? Why did Dr. Aylward continue to minimize the scope and threat of COVID-19?

At the press conference, Dr. Aylward also said, “Because every day we stopped to think about this disease and make decisions, should we do it or not, this virus will take advantage and almost double the number of cases. We have to move fast.” This shows that he understood the vital importance of speed. By March 4, as the number of cases and death toll soared in many countries, it had long met the criteria of transmission between people, high fatality rates, and worldwide spread.  Yet on March 4, in an interview with New York Times reporter Donald McNeil, he said, “We don’t have a global pandemic.” 

Has the WHO run models to estimate how many lives could have been saved if it had acted more quickly to declare COVID-19, respectively, a public health emergency of international concern and a global pandemic?

Finally, does the WHO believe it has a duty to coordinate all affected countries to form a credible, independent scientific team to conduct an investigation into the origin of COVID-19?

The origin of the novel coronavirus has been at the center of a maelstrom of debate of accusations between countries. This is a first-order of question, and one that concerns all the citizens of the world. The question is ultimately a scientific one, and consistent with the organization’s mandate. Can the WHO deliver?

Jianli Yang is founder and president of Citizen Power Initiatives for China. 

Aaron Rhodes is president of the Forum for Religious Freedom-Europe, human rights editor of Dissident Magazine, and the author of The Debasement of Human Rights (Encounter Books, 2018).