Trump hits WHO where it hurts
Among the executive orders signed by Donald Trump soon after taking over as the US President is the one about America pulling out of the World Health Organisation (WHO). The order says that the decision follows the WHO’s “mishandling of the Covid-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states”.
The order adds that America has been supporting the WHO “far out of proportion” compared to countries like China — which has a population of 1.4 billion but pays a tiny sum. Trump’s decision has far-reaching implications not just for America but for global health security.
Trump’s disdain for the WHO was obvious during his first term when the world reeled under the impact of the Covid pandemic. He squarely blamed the health agency for its so-called mishandling of the situation. Trump suspended America’s contributions to the agency as it battled the worst global health emergency in a century. He also initiated the process for America’s eventual withdrawal from the agency, but before it could happen, he was voted out. His successor, Joe Biden, reversed the order and restored America’s financial support to the WHO.
The executive order issued now means America will cease its financial support to the agency in a year. At present, America contributes about 18 per cent of the WHO’s overall funding. The agency’s budget for two years (2024 and 2025) is $6.8 billion.
The WHO was formed as a specialised UN agency after World War II to address important matters of health and diseases. It was mandated to act as a technical agency with an international network of scientists, medical experts and health policymakers. One of its key functions was to launch coordinated action on new infections emerging through surveillance and sharing of information. The WHO provides technical assistance to poor countries and helps build their capacity to tackle health challenges. Over the decades, the agency’s work has led to the eradication and control of diseases such as smallpox, yaws, yellow fever, leprosy and polio. The global action on HIV/AIDS through a new agency, UNAIDS, too was noteworthy. Now, its focus is on ending tuberculosis.
The agency’s work has come into sharp focus since 2000 with the emergence of new infections and re-emergence of old ones — SARS, bird flu, MERS, Ebola, Mpox and Covid-19. In a globalised, hyper-connected and interdependent world, health security is intertwined with the economy.
The decision to withdraw from WHO is bad for the US as well as the global community. It will deny America access to critical data on disease outbreaks and health emergencies that the WHO shares with all member states. Several US pharmaceutical companies and laboratories depend on the ‘WHO Pandemic Influenza Preparedness Framework’ for information on new influenza virus samples for research and development. The decision also entails America’s withdrawal from ongoing negotiations for the global pandemic treaty and other mechanisms like the International Health Regulations. Dozens of American experts working with the WHO will also be recalled and reassigned. Two American institutions — the Centre for Disease Control and the National Institutes of Health — engage with the WHO on critical issues. The ending of such partnerships will be mutually harmful.
For the WHO, the loss of its biggest donor comes as a severe blow at a time when national contributions from governments are already dwindling. After America, the next largest national donor is Germany, contributing around
3 per cent of the agency’s funding. In recent years, contributions from some non-state donors to the WHO have gone up substantially. The Bill and Melinda Gates Foundation tops this list, followed by the European Commission and the World Bank. The Gates Foundation supports work in areas like polio eradication and vaccines. If national funding to the WHO does not go up after America stops its financial help, the WHO’s dependence on donors like Gates might rise. This is not such a good thing for the independent functioning of the UN agency. Critics have pointed out that private funding comes with strings attached, which, in turn, influences the global health agenda.
The call for reforming the functioning of the WHO to make it far more efficient, transparent and responsive is valid. In the wake of the pandemic, India also raised the issue at multilateral fora like the G20 and BRICS summits in 2020. It suggested that the WHO should devise objective criteria and parameters for declaring a public health emergency like Covid-19. Other countries have made similar demands. Being a UN body, the WHO is open to criticism and there are platforms to pursue the idea of reforms, but disbanding it or starving it of funds is not the solution. Responding to the demand for reform, the WHO has said that it has implemented the largest set of reforms in its history, covering “accountability, cost-effectiveness and impact in countries”.
Besides disrupting global health security, Trump’s reckless move — together with his decision to withdraw from the Paris climate change agreement and appoint a vaccine sceptic as the Health Secretary — severs public policies from evidence-based science and erodes the influence of science. Like the WHO, climate change treaties have been a favourite punching bag for Trump.
His support to the fossil fuel industry is bound to exacerbate climate change and result in an adverse impact on public health as well as livelihoods, among other things. His decisions on the WHO and climate change show that Trump is questioning the value of evidence and science while undermining multilateralism. These are not just internal policy matters of America but can have global implications, as already witnessed in the last round of climate talks where industrialised countries used Trump’s re-election to stall further climate action. Health security and climate change are interlinked, and if the world is going to scale down its response to both, it will be a disaster for the health of the planet and humankind.
