The discipline of public health inherently prioritises the collective good over individual freedomby Elizabeth Pisani / February 28, 2020 / Leave a comment
When the World Health Organisation Director-General Tedros Adhanom Ghebreyesus declared Covid-19 a public health emergency of international concern, he urged countries not to restrict travel or trade with China. “It is a time for solidarity, not stigma,” he said, just two days after British Airways and other airlines announced they were suspending all direct flights to the Chinese mainland. He also repeated a clarion cry for transparency (“facts, not fear; science, not rumours”).
Meanwhile, out of the other side of Tedros’s mouth came praise for China’s response to the coronavirus, which began with suppression of reports of the outbreak, including those posted on social media by the unjustly vilified whistleblowing doctor Li Wenliang, who later died of the disease. When facts could no longer be written off as rumours, there followed the virtual shut-down of a city of 11m people, and draconian travel restrictions nationwide.
Tedros has taken flack for his apparently contradictory stance: calls for transparency and solidarity on the one hand, praise for Beijing’s authoritarian response on the other (roadblocks around major cities; potentially exposed people frog-marched to testing). Chinese social media is awash with images of him as the dog of President Xi Jinping. But his position highlights something we in the global health mafia do not admit: the discipline of public health inherently prioritises the collective good over individual freedom. Authoritarian regimes trample on individuals, but can also be good for public health.
Public and private welfare are not necessarily in conflict, and in the long run too much trampling is bad for everyone. But at the start of an outbreak, when resources are scarce and knowledge scarcer still, the authorities are never going to have the luxury of engaging in broad community consultations that might lead to a fair balance of interests. Their first concern is bound to be to avoid unnecessary public panic (the charitable view) and/or (more realistically) to save face and avoid damage to the economy. Hence the counterproductive early cover-up. When they can no longer close their eyes to the possibility that a new pathogen poses a real threat, however, those rare governments that care about the public good and have the clout to impose their will tend to do so rather rapidly. They’ll do…