The surprise announcement by the President of the United States, 11 days after demanded a 30-day investigation, to withdraw from the World Health Organization (WHO) represents yet another grotesque betrayal of the global community. This time thought, it is tantamount to murder. To freeze needed resources and then withdraw after making demands during a global public health pandemic to the world’s only public health agency is an affront to the world’s most needy and at risk people.
In an organization which must follow the dictates of it’s donors, the overall program of the WHO operates on a relative shoestring budget, which has been effectively frozen for nearly 40 years since the Reagan Administration’s freeze on UN agency funding in its battle over UNESCO in 1984. Since then, Republican Administrations have all too often frozen programming that was deemed “unacceptable” like HIV/AIDS prevention, which included the use of condoms.
As a specialized agency the United Nations, the WHO receives funds in two forms—assessed dues which around about $250 million in a $4.9 billion dollar annual budget and the remainder is another $400 million in special and special programs supported by the US and other countries, like Polio eradication. These are voluntary gifts. As such are subject the whims and values of the donor at any given time.
However in the face of an international public health emergency, like COVID-19, new funds must always be raised to support the necessary expansion of pharmaceutical support, epidemiology, technical assistance and capacity building with essential supplies and staff upgrades in country. It is a balancing act on a good and a nightmare in the face of the US freeze.
Since the beginning in 1948 as a part of the re-creation of the world order after World War II, the need for a global public health monitor was needed to augment and support peacemaking efforts around the world. Since the beginning, because the United States was the leader of the new world order, it became clear that without good pubic health and hygiene and global supports for the creation of public health entities at country level, a nation could not hope to attain a quality of life for its citizens on par with the world.
Hence, WHO became the international public health agency charged with evaluating country health planning, providing technical public health guidelines and measures, and supporting capacity building through expert staffing in countries and education for pubic health professionals in national health departments, as well as, supporting and international health monitoring network development, and the upbuilding of health emergency preparedness systems. It is a large agenda.
This work is done with the overt understanding that WHO is merely a servant of Member State governments and an adherent of each country’s national sovereignty. Therefore, having no intelligence or investigative arm, WHO must rely on the transparency and honesty of nations to present their public health data for review annually, or immediately in the face of a public health emergency. However, WHO cannot enter a country to investigate a disease outbreak unless and when invited to do so by the Member State.
With the 194 Member States and another 40 organizations and entities being part of the global health community, and the United States being a “power hitter” supporting up to 22% of the WHO’s annual expenditures, the demands for “transparency” are nothing new and always the subject of conversation and policy within the WHO.
Curiously the complaint of a “China bias” in not inconsistent with decades of US charges, which have also included “Russia bias” under Reagan and bias again “pro-life” during the Bush Administration. In 2003-2004 with SARS, the WHO did call out the People’s Republic of China on the need for transparency and more robust disclosure about SARS and its risks. In that sphere the US directly supported the Wuhan Infectious Disease facility through the NIH as laboratory to explore viral outbreak ands and merging pathogens overseas.
The US has benefited from such conflicts in its international geopolitical posturing, but has never supported with facts for its claims of bias. However with the US seemingly abdicating its leadership in the global arena, space has been left for several states to impose their influence on multilateral international organizations, like the UN and WHO. By and large, the Member States have learned that the way to trust is the way of openness and transparency, but it is always an uneasy situation.
While it appears to the Administration has delayed, obscured, obfuscates and otherwise slows the payments of needed resources, withdrawal from the WHO sends a poor message to the world. As to the loss of the United States’ trust in WHO, that is another matter. Today there are hundreds of US citizens staffing professional posts within the Geneva-based organization, as well as, around the world.
There is also the overt and active participation of the US Centers for Disease Control and Prevention (CDC) which been responsible is assisting the world through WHO in establishing similar institutions in countries around the world as part of its global disease surveillance strategy. It was the reliance on that strategy that has surfaced the fact that the US DID KNOW about COV-19 as early as mid-December; yet the Administration failed to respond to public health alarms brought by the Assistant Secretary for Health and the CDC as well as the head of Health and Human Services.
Nonetheless, WHO is a critical symbol of hope. For the many millions in the developing world who have limited or no benefits and guarantees of health care, public health interventions and the desperately needed resources and supplies to meet the demands of public health emergencies of international concern (declared by WHO on January 30, 2020), the situation becomes dire. The withdrawal from WHO and global health reads as a death threat to millions, while the US government officially seems to have abandoned human decency and the long-held guarantee of all people to the right to health.