Why the world needs to adopt common manual for fighting pandemics

Covid-19 highlights the risks of every nation going it alone

SEOUL • Life for South Koreans, as with many people around the world, has been turned upside down because of Covid-19. The country has been virtually shut down for the past six weeks. A nationwide campaign of social distancing is in full swing: meetings are cancelled, businesses closed, and many people work from home. Online lectures for universities and cyber sermons for churches are part of this surreal new world.

As more and more countries activate emergency plans and impose varying degrees of lockdowns, many questions remain unanswered : We still do not know the exact cause or nature of this disease. Nor do we know for sure when the crisis will be over or vaccines available. Some are questions of science and best left to those with the necessary expertise. But the uncertainty that is causing so much fear and anxiety worldwide is also the result of gaps in the global health crisis management system, a matter that government policymakers and international institutions can and should address if we are to do better with the next outbreak.

Currently, there is no handy global health crisis manual for governments to turn to. The dearth of a systematic approach means that every government is on its own, with the result that some do better than others. In an inter-connected world, however, the impact of poor decisions by a single government is likely to be felt collectively.

Granted, health protection is inherently a national issue, to be taken care of by the respective national health authorities. But a crisis of this severity and magnitude cannot be overcome without close coordination and cooperation among states in a systematic and multi-dimensional manner.

To understand why that is the case, consider the present legal framework in the light of the pandemic and government responses. Some measures stand up to the test better than others.

Take, for instance, the quarantine of foreign nationals arriving at airports, a key first barrier against imported infections. The World Health Organisation (WHO) 2005 International Health Regulations (IHR 2005), the only international convention on the global health issue, permits quarantines and non-intrusive medical examination at ports of entry in global health crisis situations.

Should quarantines escalate into detention, a different set of legal rules comes into the equation. The 1963 Vienna Convention of Consular Relations (Article 36) requires that the detainee has access to help from the consular mission representing his country.

Trade rules kick in when governments impose export restrictions on medical items or daily hygiene essentials such as face masks. If it is characterised as a national emergency measure, it could be justified under the security exceptions of the General Agreement on Tariffs and Trade and free trade agreements. Many governments have slapped on bans, citing national shortages. However, the hasty manner in which these measures were imposed, sometimes with scant evidence in a non-transparent manner, has aggravated the sense of crisis in managing this global outbreak.

What about restrictions of regular flights or landings? The Convention on International Civil Aviation of 1944 allows for disease prevention measures (Article 14) and, if necessary, a "state of national emergency" exception (Article 89) for such orders. A state can also request a diversion of an incoming aircraft to another airport for landing under IHR 2005, but only if the flight's technical safety is ensured.

Again, the issue here is not so much one of legality as one of necessity and transparency. One could reasonably ask if some of the abruptly imposed bans directed at specific countries were warranted. The last thing anyone needs in the throes of a global health crisis is the politicisation of flight bans, with the target countries accusing others of racism and other hostile intentions.

Perhaps the best example of the thorny problems thrown up by Covid-19 is to be found in the sorry saga of unwanted contagion-bearing cruise ships. For governments around the world, the dilemma is essentially this - how to prevent foreign patients stuck on these vessels from overwhelming their health system while also finding a way of keeping their own citizens safe from a coronavirus that seems to flourish in these floating petri dishes.

The traditional legal approach of seeing the issue as a matter of overlapping jurisdiction involving the country in which the port is located and the ship's flag country has not worked well in the present circumstances; both parties would prefer to steer clear of the problem. The result: A hotchpotch of diverse and unsatisfactory responses.

Medical staff putting on protective gear last Friday before treating Covid-19 patients at the Erasme Hospital in Brussels. The adoption of a road map for the global community is vital because there will be another outbreak in the future, perhaps more
Medical staff putting on protective gear last Friday before treating Covid-19 patients at the Erasme Hospital in Brussels. The adoption of a road map for the global community is vital because there will be another outbreak in the future, perhaps more devastating than Covid-19, says the writer. PHOTO: AGENCE FRANCE-PRESSE

Japan, for instance, placed the Diamond Princess in quarantine while it was docked in Yokohama, during which time the virus spread among those on board.

If the Japanese kept the troubled vessel at arm's length, Pacific islands such as Samoa and Tonga rejected outright cruise ships headed their way for fear of having the disease reach their shores.

On March 19, some 2,700 people were allowed to disembark from the Ruby Princess docked in Sydney, despite cases of Covid-19 on board. This resulted in almost 200 cases spread across Australia.

Late last week, the Artania, a cruise ship registered in the Bahamas and run by a German tour operator, was finally allowed to dock in Fremantle in Western Australia after a stand-off with the state government. As suspected infections grew, the latter relented; it helped that the federal government stepped in to arrange travel home for healthy passengers and hospital care for those who tested positive for the virus.

What is clear from these examples is that decisions are made on a case-by-case, state-by-state basis. Left to the discretion of individual countries, predictability and consistency go out the window. Minus agreement on a set of commonly agreed international guidelines, the primacy of national self interest reigns unchecked and the temptation is for countries to go for quick and easy solutions.

In a pandemic, when national interests collide, mutual escalation of restrictions is almost certain. Furthermore, a pandemic could be the match that ignites saturating nationalistic vapours ablaze.

Can't the WHO do something about this? Since the start of the outbreak, the WHO has been working very hard. But its main focus has been case confirmation and data collection, and provision of statistics and health recommendations to governments; all very important no doubt, but they fall short of what is needed for a leading role in a global undertaking that entails multi-dimensional legal and policy aspects.

Furthermore, the WHO has come under fire for being too slow in declaring a pandemic in the face of growing evidence worldwide. At one level, it may seem a fight over labels. But it is more than that when seen in the context of transparency in WHO operations.

Transparency is required not just for the number of confirmed cases and patients; transparency is equally important for setting out with greater clarity definitions, the process of what measures to take and how to execute them in the event of a pandemic.

In an interconnected world, the defence against a global pandemic is reliant on its weakest link, and for that to hold, it is crucial that every country understands and agrees to what needs doing and what to avoid. Once the Covid-19 pandemic is contained, a concerted effort needs to be made by all countries to prepare and adopt global health emergency plans, drawing on the lessons learnt from the present crisis. The adoption of a road map for the global community is vital because there will be another outbreak in the future, perhaps more devastating than Covid-19. Millions of lives are at stake.

• Jaemin Lee is professor of law at Seoul National University.

A version of this article appeared in the print edition of The Straits Times on March 30, 2020, with the headline 'Why the world needs to adopt common manual for fighting pandemics'. Print Edition | Subscribe