WHO was warned lives were at risk over yanked report, emails show

An author of a withdrawn World Health Organization report into Italy's coronavirus response warned his bosses in May that people could die and the UN agency could suffer "catastrophic" reputational damage if it allowed political concerns to suppress the document, according to emails seen by The Associated Press.

The comprehensive report examined how the Italian government and health system reacted after the country became the epicentre of the European outbreak in late February, with real-time data and case studies of what worked and what didn't. It was aimed at helping other countries prepare as the virus spread globally.

The United Nations agency took it down a day after it was posted on its website, prompting the official who co-ordinated the work to appeal directly to WHO chief Tedros Adhanom Ghebreyesus on May 28 and warn that the report's disappearance was undermining WHO's credibility. He cautioned that any further attempts at censorship would compromise the agency's independence and its relations with donor nations that funded the research.

The handling of the report could cause a "scandal of huge proportion — in a delicate moment for the UN health agency with the forthcoming COVID-19 investigation," wrote Francesco Zambon, WHO's chief field co-ordinator for Italy and its regions during the pandemic.

Zambon's report had 'factual inaccuracies,' WHO says

In a statement Saturday, WHO said Zambon "expressed his views to many people and they were handled via appropriate channels."

The report, written by Zambon and a team of WHO public health experts and consultants, was posted on May 13 after it had received necessary approvals within the UN system, according to internal WHO documents seen by AP. The agency later said it was withdrawn because of "factual inaccuracies" that it has not detailed and denied that it received any pressure from the Italian government to remove it.

In the face of criticism that yanking the report deprived countries of data that could have helped them avoid Italy's fate, WHO said Monday that it has offered another "mechanism" to assess pandemic responses. But that wasn't rolled out until two months after the report was pulled.

Concerns over the missing report have grown in recent weeks, fuelling criticism of WHO's leadership of the global response to the pandemic that led the agency to agree to an independent probe of its performance.

The UN agency has been loath to publicly criticize countries that are top donors even when their policies could undermine public health.

During the initial stages of the outbreak in January, for example, WHO officials were privately frustrated by the lack of information being shared by China but publicly lauded the country for its transparency. As the pandemic gained pace in Europe, WHO scientists internally questioned Britain's policies — such as when it suggested it would pursue "herd immunity" — but publicly emphasized their support.

The missing report has cast a spotlight on preparedness in Italy, where Europe's deadliest outbreak unfolded. In the hard-hit province of Bergamo, prosecutors have seized on it as part of their investigation into what went wrong.

Paradoxically, the report isn't even particularly critical of the Italian government and credited officials for their efforts, praising at one point how they counteracted with data "sensational displays of disagreement in talk shows" that stirred anxiety.

Initial response 'improvised, chaotic and creative'

The text did note that the Italian Health Ministry hadn't updated its influenza pandemic preparedness plan since 2006. The 2006 plan was merely "reconfirmed" in 2016-17 without being updated and was "more theoretical than practical."

"Unprepared for such a flood of severely ill patients, the initial reaction of the hospitals was improvised, chaotic and creative," the report said. "It took some time before formal guidance became available."

Italy's state-run RAI television investigative Report program has published emails showing that a top WHO official, Raniero Guerra, who worked as a liaison with the Italian government during the pandemic, told Zambon to "correct" that Italy's preparedness plan had been "updated" in 2016, even though the 2016 version was identical to the 2006 one.

Guerra had been in charge of prevention in the Italian Health Ministry from 2014 to 2017, when the plan should have been overhauled. He himself wrote to the then-health minister saying the plan needed to be updated, according to a copy of his 2017 memo seen by AP.

WHO has said the Italian government "at no time" asked it to remove the report, which it now says it does not endorse. "The decision to remove the document from the website was taken by WHO's Regional Office for Europe due to factual inaccuracies," WHO said.

Zambon says the only inaccuracy was an out-of-date timeline of the virus in China that he corrected immediately and had new copies without it printed. WHO on Saturday defended retracting the report altogether.

"We are, of course, resolutely focused on saving lives, but published content needs to be accurate and based on proven methods," WHO said.