In yet another example of brash finger-pointing, President Trump called out China last week as the reason to terminate U.S. membership in and funding of the World Health Organization. The president cited WHO’s supposed too-warm relationship with China, which he said delayed the global response to the pandemic.
While political maneuvering and isolationism has often been part of the president’s approach, it is a particularly consequential move in a pandemic. Sure, the WHO response has had shortcomings (I’ve written about the topic often), but pulling U.S. funding and membership from the world’s primary global public health organization cuts off our nation from crucial research, coordination, and collaboration in the middle of the biggest global health crisis of a century. It makes the world less safe, and it makes Americans less safe.
Let’s leave aside for now important questions about whether the president has the authority to take this action. His announcement lays bare a deep ignorance of how infectious diseases work (they transcend borders), how global health is tied to national security (we are only as safe from an epidemic and its fallouts as our weakest neighbor), and what the WHO actually accomplishes around the world (a lot).
The president’s decision, in symbolism and in practicality, will have a profound impact not only on the health of people around the world but on how global leadership is reshaped in the wake of this pandemic.
First, the president’s move distracts and weakens the WHO when the U.S. and the world most need it to be effective. In the WHO’s past budget period, the U.S., as its largest donor, provided about 15% of the organization’s funding, or about $450 million. The WHO relies on this funding and that of its other member states to provide public health leadership, technical expertise, and scientific support to countries around the world. While all countries benefit from this expertise, most low- and middle-income countries (LMICs) rely heavily on the WHO.
Many of these countries count on the WHO’s expertise to conduct testing and disease surveillance, collect data, and acquire necessary medical supplies. They rely on the WHO for technical and scientific advice. The current demands on the WHO are extraordinary and the organization is already facing large gaps in funding. The withdrawal of U.S. support may cripple WHO’s ability to meet these growing and urgent demands.
Let me be crystal clear what this means: Hampering the WHO now means that even more people will die around the world during this pandemic.
A global pandemic requires a strong, coordinated international response. Covid-19 transcends borders — an outbreak anywhere can quickly become an outbreak everywhere. The cases in the U.S. were initially imported from Europe and China. As the disease outbreak continues, Latin America, South Asia, and other parts of the world will see larger outbreaks and can become the sources for more cases in the U.S. We can’t wall off our country from the rest of the world forever.
While the president said that the funding he pulled from the WHO would be redirected to other global health organizations, none has the expertise, capacity for coordination, and leverage as the WHO.
Pulling out of the WHO will also hamper critical parts of the scientific response to the virus. As we muddle our way through the pandemic, the U.S. — and the rest of the world — are waiting for science to come to the rescue through better diagnostics, therapies, and ultimately a vaccine.
Science is a global enterprise. It was a Chinese scientist’s publication of the viral genome of SARS-CoV-2 that led a German scientist to develop a test that the WHO then helped distribute to 126 countries. This is science in the 21st century.
The WHO is running the world’s largest clinical trial of therapies for Covid-19 with scientists around the world. The agency is also coordinating vaccine trials by building a global coalition of scientists, clinicians, and developers. For many scientists, the WHO remains a central place for sharing samples, coordinating approaches, and working together to build the best evidence base.
Is the U.S. better off not having a seat at the table and helping shape these efforts? Do the American people benefit from being left out from the global scientific effort to combat Covid-19? Here’s the bottom line: While the scientific enterprise will continue, this decision leaves Americans less able to shape and benefit from its potentially lifesaving results.
More fallout from the president’s action is that is further removes the U.S. from its role as a global leader and opens new doors for nations looking to gain more influence on the international stage. The WHO has 194 member states, including China and most European nations. The message that President Trump’s decision sends to the world is that American leadership cannot be counted on during crises and that the U.S. is an unreliable partner.
Some countries may step in to at least partially fill the funding gap, which will also allow them to exert more influence over the global architecture for how we fight common public health challenges. We know which country has the means to do so. So, in spite of the rhetoric, the biggest beneficiary of the president’s move will almost surely be China.
To be sure, the WHO’s performance during the Covid-19 outbreak has not been perfect. But many of the critiques — that the organization did not stand up to China, for example — are based on policies that the U.S. has advocated for, such as limiting WHO’s ability to encroach on national sovereignty. The WHO can no more force its way into China then it could force its way into the U.S.
If our goal is a more effective and less political WHO, the U.S. could enable that by engaging and reforming the organization. But rather than doing that and instead taking America’s marbles and going home, President Trump has created a leadership vacuum that others will happily fill — to the detriment of the U.S. and the world.
Ashish K. Jha is a physician, director of the Harvard Global Health Institute, and professor of global health at the Harvard T.H. Chan School of Public Health.