NEW YORK (Mainichi) -- Doctor Mariatu Kamara is passing through a room with patients at a health facility in Sierra Leone. Her patients are children. Their mothers are there, too. They are sitting or lying on hospital beds, located right beneath windows, while their personal belongings are placed in steel trolleys.
To increase safety, two washing points for hands are at the entrance to the room. All of the mothers have masks on, including Kamara, who is all covered up in a protective greenish gown. They are not smiling but observing the doctor with respect. The mothers are worried about the rest of their families left back at homes. They could get infected with Ebola while they are gone.
"In 2015, we admitted a woman in our facility. It was a mother who came with her two kids. They were all positive for Ebolavirus," said Kamara. Her cheerful voice started to tremble. "They got all admitted, but their situation was already critical. The mother survived, but she ended up losing the two kids several days later... Everyone was crying... How can a mother be going back home thinking of her dead babies?" said Kamara, who works with Medecins Sans Frontieres Hangha at a health facility in Kenema, in Sierra Leone, where over 3,955 people died during an Ebola outbreak from 2014 to 2016.
The number of novel diseases passing on from animals to humans, called zoonotic diseases, have been increasing according to reports. Pandemics like the current one look like global threats. Shouldn't there be a need for a swift multilateral action about them? But in the present circumstances, will the United Nations Security Council (UNSC) be ready to act, notably given the frosty relations between the U.S. and China?
Zoonotic diseases are not new. They killed many in the past. The Black Death, or the Great Plague, which took more than 75 million people from 1347-53 was spread by rats. The 1918-20 Spanish flu, which killed more than 50 million people worldwide, is believed to come from birds transferring it to horses, who spread it to humans during World War I. The Asian flu of 1957-58 killed 1.5 to 2 million people and the Hong Kong flu of 1968-69 killed at least 1 million people, both believed to come from birds.
Recent outbreaks, which the UN acted on, such as HIV/AIDS or Ebola, are also believed to have come from animals. In the 1920s the HIV disease was passed onto people as hunters were selling chimpanzee meat in a Kinshasa market in the Democratic Republic of the Congo (DRC). Ebola was discovered in 1976 in DRC and South Sudan and it is believed to be transmitted from bat meat.
In 2000, the UN adopted resolution 1308 addressing health issues of the HIV/AIDS pandemic, placing health as part of international security. The members stressed, "that the HIV/AIDS pandemic, if unchecked, may pose a risk to stability and security." In 2011, the UNSC passed resolution 1983 on the impacts of the HIV/AIDS epidemic in conflict situations.
In September 2014, an outbreak of Ebola was declared to be a "threat to international peace and security" in UNSC resolution 2177 for the first time. In 2018, the UNSC called for a ceasefire and cessation of hostilities over the second outbreak of Ebola in DRC in resolution 2439, expressing concerns on the "security situation in the areas affected by the Ebola outbreak."
Pandemics typically originate from animal influenza viruses, a new virus for which there is no immunity among humans. Whereas in the past the disease would have its impact limited to nearby villagers, globalization has accelerated the spread.
"Diseases don't have borders, they don't have passports..." said Tolbert Nyenswah, senior research associate at the Johns Hopkins Bloomberg School of Public Health and the former Deputy Minister of Health of Liberia for disease surveillance and epidemic control.
Some scientists and organizations emphasize that the need for coordinated multilateral actions may increase in the future as diseases, in particular the zoonotic ones, are rising, in their opinion.
According to the 2008 study "Global trends in infectious diseases," which analyzed 335 cases between 1990 to 2004, the emergence of infectious diseases has significantly increased between 1940 to 2004: with over 60% being traced back to animals, while the majority of these (71.8%) originating in wildlife. A study published by the Royal Society of London, which analyzed a novel 33-year dataset from 1980 to 2013, says that zoonotic disease outbreaks compromised 65% of the dataset, and are increasing globally in both total number and richness.
Why the increase? The interpretation by some, is that the safe boundary between animals and humans has been destroyed.
"About 75% of diseases in humans are zoonotic, and we have been witnessing an increase of these type of diseases during the last 30-40 years due mainly to habitat loss," says Cyan Wang from the China Biodiversity Conversation and Green Development Foundation. "Population growth has caused the exponential expansion of humans to natural areas where people were not part of the ecosystem. This has brought humans, and in particular domestic animals in contact with wild reservoirs of new viruses increasing the risk of contagion."
The most significant demand for illegal wildlife is in China, Vietnam, and Thailand. Wet markets, where a lot of the illicit trade is happening, are known to be places where zoonosis can quickly spread with the presence of many animal species packed in poor hygienic conditions.
The nature of the illegal wildlife industry is compared by some to the lucrativeness of the drug trade, with people believing in medical myths or the need to portray a social status. According to Wang, for instance: each pangolin purchased for a few hundred yuan at the border of China or Vietnam can bring profits of over 10,000 yuan (US$1,404).
But, U.S.-China tensions are making things more difficult over the current COVID-19 pandemic.
COVID-19 is part of a group of coronaviruses that get their name from their round shape with a halo of spiky proteins, resembling a corona of the sun. Most of them are mild, but SARS-CoV (SARS), MERS-CoV (MERS), and SARS-CoV-2 (COVID-19), which are the names of the viruses, have attachments penetrating deeper into the lungs. SARS-CoV-2, is the virus that causes COVID-19, the disease.
SARS-CoV is claimed to have leaped onto humans from bats in 2003 in Guangdong, China. While MERS-CoV supposedly jumped onto humans from camels who got it from bats in 2012 in Saudi Arabia.
In November 2019, COVID-19, was discovered in Wuhan, China. As of June 30, 2020, there were 10,509,683 cases, with 510,926 confirmed deaths. It spread to 213 countries and some scientists claim it to be transmitted by bats.
Regardless of the COVID-19's enormous impact, the U.S. and China, permanent members with veto power, were in a dispute over a COVID-19 resolution for over 12 weeks. The goal of the resolution was to support the Secretary General's call on March 23 for a global ceasefire, aimed at easing the fight with COVID-19 in conflict situations.
"Relations between China and the U.S. at the UN are deteriorating very quickly now, but we had seen tensions rising before COVID-19," said Richard Gowan, the UN director of the International Crisis Group. The overall arduous dynamic of the UNSC dates back before the start of the COVID-19 pandemic.
The UNSC finally adopted the resolution on COVID-19 on July 1. But since the UNSC started considering the resolution, it took over three months. The UNSC did not act timely.
The U.S. was demanding for a long time that the resolution has to mention that the virus had originated in China. It also did not agree with referring to the World Health Organization (WHO) nor more broadly to "specialized health agencies." The U.S. believes that the WHO is biased toward China.
Instead, members ended up stating in the resolution that the UNSC "considers" UN General Assembly resolution 74/270, which acknowledges the "crucial role played" by the WHO, an expression of "global solidarity to fight the coronavirus disease 2019 (COVID-19)." The origin of the virus is not mentioned.
The U.S. also changed the wording on an already pre-approved paragraph, and changed the word "welcoming," to "recognizing the efforts and measures proposed by the Secretary General concerning the response to the potential impact of COVID-19."
In this context, the U.S., together with the UK, also brought into the UNSC the Hong Kong matter under an informal meeting under the name, "Any Other Business". It was the last nail in the coffin of irenicism in the UNSC. Internal affairs of the "Permanent Five" have never been discussed before in the UNSC.
"Chinese diplomats have traditionally been very wary of major confrontations with the U.S. in the UNSC. They have tended to let Russia lead in big fights over Syria, while working quite pragmatically behind the scenes with the U.S. on issues like North Korea," said Gowan.
COVID-19 and Hong Kong discussions created a new level of tension.
Unlike COVID-19, Ebola or HIV were not that politically contentious, according to Gowan, Ebola blew up in an area of a lower strategic concern to the Permanent Five, but COVID-19 blew up in China.
"The magnitude of COVID-19 is different. Ebola when it came, it happened in countries which already were under the UN watchdog..." said Robert Kayinamura, Counsellor of the Permanent Mission of Rwanda to the UN, who was part of the 2014 UNSC team during Ebola.
The inability to approve the resolution weakened the UN's international standing. The Secretary-General has been waiting for the UNSC support of his call, being the legislative body. The deputy spokesperson of the Secretary General said on June 17 that the lack of international unity "has been frustrating" and "made our (the UN) ability to deal with the pandemic on a worldwide scale much more difficult."
But according to some in the field, the failure or success rate of resolutions in getting ceasefires into place has very little to do if the UNSC passes the vexed resolution.
"From the field end that completely overlooks all the myriad of factors which make leaders in war decide or not to stop. The calculus in their minds is not what the Council says or doesn't say," said Martin Griffith, the UN Special Envoy to Yemen. "This is a massive issue. But it's not a New York issue," he said.
As stated by some sources, while the rest of the UNSC members were waiting, the U.S. and China finally settled their discussions on June 29 after extensive negotiations. The resolution was put to a vote on June 30.
"We worked intensively for three months to arrive to this text which reflects fragile compromise between several Council members. We still await instructions but hope that the capital will give us the green light," said Dmitry Polyanskiy, Ambassador and the First Deputy Representative of the Russian Mission to the UN, to the Mainichi newspaper on June 30.
"Our collective efforts to reach agreement on this issue were put on pause for more than a month while the U.S. was not agreeing to compromise proposals and tried to introduce language provocative to China and WHO. Finally, a compromise seems to have been reached which made the resolution considerably watered-down," said a UNSC diplomat to the Mainichi newspaper.
"There are different things and ways we have tried," said Sven Jurgenson, Ambassador of Estonia to the UN.
Gowan believes the problem lied with the hardline leaderships in Washington and Beijing, and with U.S. Secretary of State Mike Pompeo in particular. The UN diplomats negotiated in good faith.
Is history repeating itself, and in some way resembling the UNSC paralysis over the Cold War? Or, might it resemble the Thucydides Trap, a reference to the U.S. and China said by the Secretary General, which was about the rise of Athens instilling fear in Sparta, making the war inevitable?
"Now I believe the war is not inevitable ... But if we want to avoid wars in the future, we need to invest in making relations functional in the present," said the Secretary General on June 25.
"The Security Council has been frozen between 1945 and 1990 because of the Cold War, and the last thing that we want now is seeing that happening again," said the French Ambassador, Nicolas de Riviere, who is together with Tunisia, one of the two drafters of the resolution, and who was mediating the U.S. and China. "We definitely need a stable platform that performs its duties and mandate. Importing bilateral disputes in the Security Council would be a disaster."
According to the Security Council Report, in 2019, the number of formal Council decisions was at its lowest since 1991, adopting 67 decisions (resolutions and presidential statements), saying the numbers suggest the difficult and restrained dynamics among the P5.
"This is just another chapter in a long-term set of disagreements between the U.S. and China which has been stoked by President (Donald) Trump," said Robert Yates, a Director of the Global Health Program at the Chatham House, an independent policy institute based in London.
"The geopolitical battles between the U.S. and China are not good for the world. We do not have to be best friends. But still, we definitely need to be collaborating on global solutions," said Joan Kaufman, a lecturer of Global Health at Harvard Medical School, to the Mainichi newspaper.
The question is, how long the dysfunctional relationship will last, and how many UN resolutions will be forgone?
"The whole debate over COVID-19 in the Council has made it clear how bad relations between some of the big powers are at the UN, and in particular how worsening tensions between China and the U.S. could weaken the UN in the years ahead," said Gowan.
UN resolutions can go a long way. The resolutions can help people like Doctor Kamara, who, working with her sick patients, knows how scary epidemics can be. She says that some patients came to her too late, when their Ebola infection were already severe. Many were already vomiting, and had blood coming out of their eyes, ears, or nose. Soon, their internal organs start bleeding. People are scared of dying.
In the future, the possibility of new viruses spreading more often will require a united multilateral response. Diplomats shall think of people like Doctor Kamara, who does not think about geopolitics but is risking her life to save her country.
(By Lenka White, United Nations correspondent)