Why would you ever reduce the flow of water in a fire hose while you are trying to gain control of the fire?
Only a year ago, I was debating the merits of the World Health Organization (WHO) in my Global Health Governance course at Columbia University Mailman School of Public Health. Now living through the COVID-19 pandemic, my conclusion remains the same – the world’s leading public health agency is imperfect – yet essential.
President Trump’s decision to cut the United States’ funding to WHO is simply unbelievable. As the single largest contributor to the WHO’s annual budget, such a reduction hamstrings the organization when a pandemic is raging. Why would you ever reduce the flow of water in a fire hose while you are trying to gain control of the fire? AMA President Patrice A. Harris’ agrees. “During the worst public health crisis in a century, halting funding to the World Health Organization (WHO) is a dangerous step in the wrong direction that will not make defeating COVID-19 easier.”
To provide context, the WHO was established in 1948 by international treaty with a broad mandate to promote and improve global public health. The WHO serves as a central coordinating body during public health emergencies such as infectious disease outbreaks. In this role, the WHO efforts are focused on identifying and mitigating risk by guiding containment efforts, encouraging rapid and transparent information sharing, gathering scientists worldwide, and supporting the advancement of testing and vaccines.
On December 31, 2019, Chinese Health officials informed the WHO about a cluster of patients suffering from a mysterious pneumonia in Wuhan, a city with a larger population than New York City. Exactly one month later, the WHO’s declaration of SARS-CoV-2 (the pathogen responsible for COVID-19) as a global public health emergency was followed by Health and Human Secretary Alex Azar’s declaration of a public health emergency for the entire United States.
Eleven weeks after these declarations, the COVID-19 virus has spread all over the world with the United States holding the dubious distinction of having the most deaths of any country – nearly 27,000 and growing. Multiple models indicate that we are nowhere near the apex for the pandemic’s initial wave of infections and deaths. And we can anticipate that this pandemic will have multiple waves until a sufficient number of people become immune with an effective vaccine or by surviving the infection.
The actions and missteps of both the WHO and the Trump administration will undoubtedly be debated for years to come. The WHO has been fairly criticized over the years for being too bureaucratic, indecisive, and influenced by powerful players such as the United States, China, and private donors. Grossly underfunded, plagued by administrative redundancies, and lacking meaningful enforcement authority, the WHO needs to be reimagined or replaced with a new, more robust and nimble global health organization to meet the needs of a changing world.
President Trump’s attempt to blame the global health agency’s record of “severely mismanaging and covering up of the spread of the coronavirus” and punishing it through defunding, is steeped in hypocrisy. In January, Trump tweeted, “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well … I want to thank President Xi!” Praise came for the WHO in a February tweet. “The Coronavirus is very much under control in the USA … CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!”
What has changed? Facing stinging criticism for weeks of inaction, littered with misinformation of COVID-19’s severity, Trump employs his favorite political tactic – scapegoating. At the White House press briefing announcing the funding cut, Trump said that the WHO failed and “must be held accountable.” But can you name a single moment when Trump admitted a misstep or accepted responsibility for anything? Trump disavowed any accountability for his bungling of the US response to COVID-19, leading to exponential growth of transmission and lives lost as the economy spirals downward. Trump too must be held accountable for this overtly political decision to reduce WHO funding, a decision that places the United States at greater risk.
Strategic, long-term decisions around the WHO’s leadership, organization, and funding should be made, but not during a global pandemic when collaboration between organizations and countries is needed most, and time is of the essence. The interconnectedness of our world – and the indiscriminate nature of COVID-19 which knows no political boundaries – means that solidarity is our surest route to protect our citizens and rebuild our economy. WHO Director-General Tedros Adhanom Ghebreyesus had a simple message in response to Trump’s announcement of the funding cut. “… please quarantine politicizing COVID — the unity of your country will be very important to defeat this dangerous virus.”