The Global Fight Against COVID-19

even almost non existent role of international organizations. Whole countries are making headlines for imposing and lifting social restrictions, but the who. The World Health Organization is having its funds cut off by President Donald Trump without international leadership. The UN is also struggling to do its job. What's the story behind all of this? What are these organizations supposed

to be doing? Who's filling them? Here to discuss this with me today is not er Musa Vizade Nonnor is an extraordinary geopolitical thinker who worked extremely closely as an advisor for many years with Secretary General Kofi a On of United Nations. He's held leadership positions in a wide range of global institutions around the world, and today he's leading a Macroadvisory Partners, a firm that provides strategies to businesses and governments around the world. Nonna, thank you very

much for joining me. I hugely appreciate it. I wanted to start with international organizations, and they're always an alphabet soup of acronyms, you know, from the better known like the UN to the WHO, the World Health Organization. Then we've got the International Monetary Fund, the World Bank. What are they supposed to be doing right now? We all have the sense that they're not doing exactly what they're supposed to do, But what are they supposed to do

in the first place? Thank you, No. I think the first thing to think about when considering the role of these organizations today is that they were set up, most of the ones in your alphabet soup exactly seventy five years ago as part of a world order that was supposed to in the aftermath of the Second World War establish a set of rules by which countries both would cooperate, regulate their disputes, and where there were common interests, work together.

And that's where WHO is one example in the air of global health. The IMF is institution. In the area of financial stability, and that was the purpose they were set up for. So if they're supposed to coordinate our efforts, how would they do that? In theory? Like, how would the WHO work on paper in a situation of global pandemic? What are they supposed to do for us? The key role for the WHO in a pandemic or in a crisis of a global health nature of any kind really

is to do two things. One is to provide technical assistance emergency advice to those countries most exposed and least able based on the strength of their own public health systems. And then also play a broader normative rule, what are the ways in which the world can cooperate better? Be

a catalyst for action, for alliances and for cooperation. And you'd really think we would need to cooperate in a pandemic because obviously the virus doesn't know borders and it's spreading everywhere, and yet we have this incredible patchwork of approaches all over the world. In principle, would the WHO give advice that countries would be bound to follow or would it just be suggestions? Sort of the way Donald Trump is chosen not to dictate to the States, but

it's rather allowed states to make their own determinations. Yeah, I mean, I think what we see in the response of something like the WHO. Remember again, these are inter governmental organizations with all the bureaucracy and all the rules around cooperation collaboration that you'd expect. But if you think about COVID nineteen, what we have seen and but COVID found in the international system as it arrived, particularly the

case of WHO is two key features. One is that WHO historically has been underfunded, underresourced, and over bureaucratic, as well as having a really quite contentious relationship with global pharma. So that's the underlying characteristic and reputation of WHO coming into this, even though in its leadership today and other ways in which it's responded, I think it's been actually

surprising a lot of people. In effectiveness the other key element here, and this is something those of us who grew up in the UN and elsewhere continue to harp on about, which perhaps sometimes seems like an excuse, but it is the reality that these organizations only work if the key actors in the world want them to work,

and want them to work as centers of collaboration. And in this case, what we found is that the pandemic comes to the world and finds a WHO not only underfunded, but caught between the most important rivalry in the world today, which is between the United States and China. And so it's not working. What is the WHO in fact trying to do right now that they're failing to do? Are they just not trying because, as you say, they're caught between China and the United States and being beaten up

to some degree by both. Well, I think what we're seeing actually is a bit of an X ray of the world as we find it today rather than the world that was imagined seventy five years ago or may have been imagined in A lot of the cooperation that was intended around this, which is that in the vacuum left by a WHO, which was underfunded and under mandated, stepped in a number of global philanthropies organizations, principally the Gates Foundation, but others as well, looking at the broader

global public health challenge and saying what can we do as independent private sector philanthropic actors with access to capital, reliance on science and IT bias for action and cooperation. And so what you're seeing when you ask yourself, what is the WHO doing today it is being asked to play a role in some ways convening, in other ways providing a sense of global legitimacy to these kinds of efforts which now increasingly are catalyzed by actors which were

not imagined when these global institutions were set up. And that is both a role that these independent private sector, often philanthropic organizations can play because they have access to capital and science, and also because they are not driven by national or nationalistic agendas, much as we see so much of the world powers operate today. This is fascinating and I want to ask you to dive down into it. What I hear you saying is perhaps there are no fault of its own or just in virtue of the

way it's designed. The who hasn't been capable at this moment of providing effective global coordination or advice that major countries would listen to that vacuum I hear you're saying. The words that stuck in my mind were Gates Foundation. There are others too, but Bill Gates has gotten a huge amount of attention, positive and negative for what he's been trying to do. Tell us what he and the Gates Foundation are doing in fact, so we can try to make sense of whether the criticisms or the praise

are warranted. So I think the first thing I would say is when the history books are written about this a pandemic and the crisis for the world, there will be in amazement actually at the role of one foundation

and one man. And I think the important thing to remember is not just that Bill Gates stepped out now, but that he had already created institutions which had for some time been leading the world in developing vaccine, thinking about pandemic preparedness, thinking about immunization of children in the poorest parts of the world, and supporting something like the Global Fund against HIV, Tuberculosis and Malaria, which was something that Kofiana in fact established in the early two thousands

in response to the global HIV AI's pandemic. And there we saw actually perhaps the last time there was enough global cooperation and frankly enough global leadership that something like that could be stood up in the middle of a

crisis as a global response. With the Gates Foundation has done since, both with its support for the Global Fund, but also with entities such as GAVI and sepages to add to your alphabet soup is to establish and fund and convene partnerships where they are often the largest funder, but really are there to do something really important, which is to say, with the WH show not being able to play its role, with governments being either too domestically

focused or too nationalistic to cooperate, here are institutions that have the support of a key funder who is as I said, science based bias for action, access to capital, and can then drawin others in working together. And I think that's the world the pandemic also found. It found actually in these institutions that many people had really not heard of, at least the beginnings the foundations of the

kind of global response. And that's why when the WHO makes it announcement of a new alliance around both diagnostics, therapeutics and vaccines, the Gates Foundation is a very principal speaker. All of its entities had separate speaking roles. And why is this important? Oh, it's important because it shows you that a private sector of philosophic enterprise essentially has co led the global response to the pandemic. Yes, with Who, but frankly with a couple of governments. And that's been

the core of the response. What does that look like? Concretely, there's a press conference, lots of people are speaking, as you say, alongside the who it's a kind of kabuki theater. As you point out, who has speaking roles tells you where the power lies. But I still don't get what happens on a day to day basis. You know who's calling the shots and how are the shots being called.

I think what's been so interesting about this crisis, and you and I have talked about many other crises over the years, but but so interesting about this crisis is that it really took a handful of actors and leaders, a lot of governments obviously scrambling initially what to do, which measures to take, what kind of public health infrastructure

they had in place. But what we actually are talking about in the case of the response globally, because China has been hugely focused on its own domestic response yes on some international behaviors. The United States remains enormously focused on its domestic challenge. So globally the response really has been led by President Makhall of France, Chancellor mercle of Germany, and Bill Gates. So what happened was there were a number of ideas, and people were circulating proposals for global

cooperation and alliances between various institutions. But really what happened in the last two weeks was that a series of phone calls between Marcol Gates, Christina Geogeva at the IMA, really a handful of global leaders, a global response was designed and then executed, and then other parts of the global system, frankly were added afterwards, which is things like the WHO, which had less of a role in the design and more of role now in the fronting of it.

Global pharma obviously needs to play a role. But what was so interesting about this crisis is it really was the personal diplomacy. The personal relationship between Maco and Marcol, Christina Geo gave the IMF and the Gates Foundation, who ended up being principal drivers of the global response. So not are what you're just described is sort of astonishing

to me. You said that three people, the President of France, the Chancellor of Germany and Bill Gates co ordinated an international strategy on the phone with some facilitation from the head of the IMF, and then they basically told the WHO to appear and as you put it, front the plan that for international coordination that they'd come up with.

How literally do you mean that? I mean literally you're describing phone calls with Bill Gates on one side and Emmanuel Mark call on the other, or on Glimmercal on the other saying we think that this is the right coordinative strategy on the basis of this plan devised by

Gates Foundation supported entities. Is that what you're describing put it this way, There's no doubt that, of course other governments who are involved early on the European Commission, who in doctor Chedros has been very active daily in lots of calls. But the question these kinds of crises is who ends up seizing the talking stick and then holding it.

And in this case, amongst the many proposals that were out there, the various kinds of alliances, finding the path to have clarity to say, this is what we're going to know on diagnostics, this is what we're going to do on therapeutics, and this is what we're going to do on vaccines. What kind of institutions will be the vehicles for the focus of the global effort? And lo

and behold it is the Gates funded vehicles. Seppi gave into a certain extent the global fund that will be the main instruments, and having the force basically to seize the agenda and say this is where the global consensus will sit. That was despite dozens of leaders and dobens of actors involved in this. At the end of the day, it comes down to three or four people who have enough weight to bring enough of the rest of the consensus with them and who agree on the core mission.

And there I think what you saw being the decisive factors was in Merkel, a chancellor with huge trust and social trust and political trust in her own system as scientists by training, with a pre existing strong relationship with Bill Gates, and in President Macon, a leader of Europe who always is more ambitious than both France and Europe, and between the three of them were able to say this is where the consensus needs to sit. Yes, we will now make the necessary phone calls to the other lead.

But that's how this was devised. We'll be back in just a moment. There is a form of critique of what's happening internationally, sometimes from the left, sometimes from the right, and they actually sound surprisingly similar at this point that says, okay, an unelected, multi multi billionaire. Bill Gates is calling the shots to a huge degree, is much or more than heads of state. And he's doing this because he has

amassed all of this capital. And you say, he's in his foundation are science based and biased for action, but he's also aligned at a very basic level with the international structure of capitalism. I mean, that's what he comes out of, that's who he knows, that's his world. And the critique is that this is not okay. And I always sort of dismissed this by saying, oh, come on, you know, that's not what really happening out there. And I think I'm starting to feel like I'm a little

naive and dismissing it. I mean, it sounds like what you're describing is actually a situation in which, in the phase of relatively weak international organizations, a hugely successful global capitalist is issuing strong suggestions that are then transformed into actually being policy. I mean, am I getting that right? That's sort of shocking to me. Look, I think you're identifying something that's a genuine challenge and a genuine difficulty

about the world we find ourselves. And you know, for those of us who grew up in places like the UN and elsewhere in the international system, the challenge was always that there was legitimacy but no efficacy, i e. The institutions because they had every country of the world as their members were broadly seen as global, legitimate, everyone had to vote in the General Assembly, etc. Etc. But

the effectiveness was always lacking. And I think what we have here is the opposite challenge, which is, yes, there is effectiveness, there's ability to harness these various resources that he has, but where does the legitimacy come from? And how can he be held accountable at all? And I think it's really important to pose that question and to

think about it now. The two things that I think are important for context is the reason Bill Gates and his foundations play the role they do today is because of an absence of more effective, who more effective global institutions in these areas, and so he has stepped in. They have stepped in as funders, as supporters, as conveners

of institutions. That absolutely we would have been much better off, so to speak, if you'd have global organizations with genuine global legitimacy and sense of accountability running these But that's not the world we're in and so he has stepped

into a vacuum. And I think one of the ways that we can look at whether this ultimately is a legitimate, an accountable solution to this global pandemic is whether something really important is achieved, and that is whether both the therapeutics and the vaccine are delivered as a global public good ie produced at scale, at speed, and delivered on an equity basis across the world at a cost that everyone can afford. That's the meaning of a global public good.

And I think that will be the real test of whether this solution not just was a bias for action, bias for science, but actually got us the right outcome. I appreciate the pragmatism of your answer, but I want to push back. I think that when you're talking about global governance, which is what we're talking about, legitimacy has at least two parts. It has who picked you? And it are you accountable to the people who picked you?

In this instance, nobody picked Bill Gates except in some general sense that the capitalist system throws off a handful of incredibly rich people who then can choose it to use their money how they wish, and it's great if they use it pro socially, so no one picked him, so in that sense, his role can't be legitimate. And the second component is is he accountable? And I don't think there is a way to hold somebody accountable under

those circumstances. If let's say none of the vaccines work out, or if they do work out but they end up disproportionately being given to richer countries, nothing's going to happen to Bill Gates, Makran or Merkel can be kicked out of office. I mean, that's the fundamental difference between an elected representative of the people and someone who just steps up and says here I am. So I'm skeptical of the idea that we can backload legitimacy by saying, well,

if it worked, it worked. I mean that is, you know, not to put too fine a point on it. Always one of the arguments for non democratic government while nothing else is working. Democracy is a mess. Let's just have one person in charge, so you know that to me is a genuine concern. Democracy is not perfect. It has all kinds of flaws, but it is usually thought to be at least I think it is better than the alternatives.

And this sounds like one of the alternatives. I would say a couple of things, because I think you are pointing to a really important demand of this. The one thing is to say that we should continue to be mindful and vigilant about the lack of both legitimacy and accountability.

I think the second part of my answer, and maybe that's where my pragmatism comes from, Noah, which perhaps isn't as democratically guided as you would think or want, is that this is a pragmatism that comes from having spent almost ten years of the UN in some of its best days in the last thirty years, and some of its worst, and looking at what actually is the consequence of these global institutions that may have the legitimacy that you're asking for, have some form of accountability, but I

think you can debate that, but have been so lacking in delivering what they actually were established to do, which is peace and security, development, poverty eradication, public health goods.

And if it is through these kinds of alliances, which by necessity are with individuals, institutions which have not been democratically establ published nor are democratically lad but can marshal both resources, science and technology to what will be determined democratically and legitimately as the global public good that we're

going after. Then I think absent evidence to the contrary that this is the best we can do in the world that we're in right now, we need to think about who has the firetruck, and, without stretching the metaphor too much, if it's the wrong guy holding the hose for a while, at least he's the guy who had the firetruck able to show up on time, and in time, hopefully we'll have other trucks around him and others can contribute to the solution so that it is not, as

you rightly point out, leverage simply to one unelectable, unaccountable individual and the foundation the mission that he has not.

Are you mentioned that the context for everything that we've been discussing is a global context, with the US and China essentially fighting each other the stage only verbally, but it's pretty significant, and it's one of the things that's hamstringing the international organizations, even though they were a little bit designed for the context of the Cold War, so in theory they ought to work better than they're working out. But that was a long time ago, we've both been obsessed.

I think it's not too strong a term with the US China relationship for a decade. Now, how do you see it going at this moment? So I think it's not an exaggeration to say that the relationship is at a critical stage with very few vectors in favor of

slowing this further free fall. You know, the crisis between United States and China is fundamentally of a shift in Washington from cheating China as a competitor to treating China as an adversary and in equally nationalistic shift in Beijing of a very different agenda for China and its role in its power and influence in the twenty first century. So you take that underlying structural change, and then you

think of all the dimensions. Be at sports, be a business, be a technology, be a capital, be at people, and yes, a pandemic comes along, Well, is that going to be an arena for cooperation? Of course it isn't. If your basic disposition is anything that's a win for China is a loss to us, than anything that who does that is helpful in any way to China is a loss for us. And that's how I think it's playing out.

I think we have to worry a lot about how once the pandemic has passed its emergency stage, what are we left with. I think we're left with even deeper divisions over, yes, the response to the pandemic, but we're also left with a mindset where, in a hundred different ways, every day, decisions are being made to further separate the

two economies and societies rather than keep them cooperating. Lots more for us to discuss here or not or I hope you will come back another time to talk about US China and what the world looks like now and what it will look like in the aftermath of the pandemic. Thank you so much for your time. I really appreciate it. Thanks,

thank you. Speaking to an honor, I got a feeling that I often get when I speak to him, namely that there's a whole subworld of how power actually operates that is opaque and invisible to even somebody who reads the newspapers carefully like I do and tries to figure out what's really going on. In Nater's picture, it's really the struggle between the United States and China that's weakening global institutions like the WHO, creating effectively an open space

where international leadership is supposed to be. And into that gap, he says, have come private foundations, and in particular the Gates Foundation, and in particular Bill Gates himself, looking alongside elected heads of state to try to coordinate a global response. Naer thinks that the proof is in the pudding, and that the legitimacy and accountability of this weird structure depends on whether, in fact we get a vaccine, we get good global health response, and if that vaccine is made

broadly available to the world. In other words, if coordination happens, we should just be glad that it's happening. From somewhere, I can't help but think that it's difficult to create any kind of legitimacy and impossible to create accountability when a central person to these global efforts is an unelected billionaire.

Certainly we have to be pragmatic about the world in which we live, but at the same time can also identify the structural problems that seem to be making the world function less well than it is designed to do. Now that we're onto the question of what international organizations can and cannot do in this global pandemic. We will continue to keep our eye on the story and we will come back to you as there are more developments in it. Until I speak to you next time, Be careful,

be safe, and be well. Deep Background is brought to you by Pushkin Industries. Our producer is Lydia Jane Cott, with research help from zoo Win. Mastering is by Jason Gambrell and Martin Gonzalez. Our showrunner is Sophie mckibbon. Our theme music is composed by Luis GERA special thanks to the Pushkin Brass, Malcolm Gladwell, Jacob Weissberg, and Mia Lobel. I'm Noah Feldman. I also write a regular column for Bloomberg Opinion, which you can find at Bloomberg dot com

slash Feldman. To discover Bloomberg's original slate of podcasts, go to Bloomberg dot com slash Podcasts. You can follow me on Twitter at Noah R. Feldman. This is Deep Background.