U.S. President Donald Trump announced a pause in funding to the World Health Organization (WHO) on April 14. As part of his daily press briefing, Trump emphasized the country’s “duty to insist on full accountability” and publicly asked for a review into the agency’s “mismanaging” of the pandemic. The United States is the largest single contributor to the WHO, and the withdrawal of Trump’s support will be a significant hit to its budget. It is not yet clear whether the White House can actually withhold funding, especially the portion approved by Congress, and if so, how much can be held back. Nevertheless, even talk of doing so in the middle of a global health and economic crisis may have dire consequences.
The WHO was founded in 1948 as the branch of the United Nations concerned with international health. The agency provides necessary guidance and support for a multitude of causes, like improving childhood nutrition, distributing vaccines and pledging a leadership role during health emergencies. Specifically in relation to epidemics and pandemics, the WHO is responsible for setting guidelines and best practices, though countries are under no legal obligation to follow them.
In terms of the coronavirus (COVID-19) outbreak, the WHO declared a public health emergency of international concern, provided guidance for health workers on how to care for patients in medical settings and issued information for the general public on how to stay safe and protected.
However, President Trump argued that these early measures in January were not enough to stop the spread of COVID-19, even claiming that the WHO was “China-centric” or acted in delay in order to spare China’s reputation. Such statements are not only biased and wrong but could also hurt the agency’s efforts to curtail the pandemic by tainting the public impression of their intentions.
A global health crisis is always a big test for the WHO. In previous emergencies the organization has been criticized for acting too slowly, or in the case of the 2009 H1N1 influenza crisis, for exaggerating the risks. But many leading public health researchers and practitioners agree that the agency has acted rightly so far regarding COVID-19. The WHO was first notified by China of a cluster of SARS-like pneumonia cases on Dec. 31 and began an emergency response process the following day. The WHO then updated guidance on how to diagnose COVID-19 globally and procured and distributed tests.The organization’s science division also consulted with world experts and country representatives to assess potential treatments.
These early discussions yielded an adaptable clinical trial protocol called “Solidarity,” which over 100 countries have adopted to help find an effective treatment for COVID-19. This unified and proactive effort is a vital step in procuring a treatment for the virus and containing its spread.
In addition to these critical early steps, on Jan. 30, the WHO established a comprehensive program for testing and quarantining people suspected of contracting the virus and tracing their contacts. Some countries acted quickly, including Germany, Singapore and South Korea. The United States was not one of the countries that followed these recommendations. Even today, the U.S. neither has the national infrastructure required to widely test for the virus nor that for tracing the contacts of those infected.
In early March, WHO Director-General Tedros Adhanom Ghebreyesus said, “You can’t fight a virus if you don’t know where it is. That means robust surveillance to find, isolate, test and treat every case, to break the chains of transmission.” Again, the Trump administration did not follow the WHO’s advice. Instead, influential officials and lawmakers called for an investigation into the WHO’s actions and pedaled a narrative that the agency was “deferential” to the Chinese government.
The Trump administration has increasingly focused on China and the WHO while seeking to deflect blame for its inadequate response to the pandemic which, at the date of publication, has recorded over 55,000 deaths.
Indeed, there are questions to be asked of China. Why did Chinese public officials put out misleading information and data and continue to do so? Why did it take many weeks after the outbreak to place Wuhan under lockdown? While such questions must be asked of China, they are not for the WHO to answer. The WHO is an agency part of the United Nations, not a pawn for regional political gain.
In a time when global unity and solidarity are required to fight an invisible enemy, defunding the WHO is particularly dangerous for low-income developing countries in which the agency's work is crucial to controlling spread and providing critical equipment. Recently, the WHO set up a supply chain management system to ensure that low-income countries can still attain tests, medical equipment and protective gear for health workers, especially given the competition for these limited global resources.
In addition to its efforts in the COVID-19 pandemic, the WHO is also overseeing more than 35 emergency operations, including a measles outbreak in the Democratic Republic of Congo and a cholera outbreak in Yemen. The U.S. contributed approximately $450 million to the WHO budget in 2019, and Trump’s decision to withdraw funding will significantly harm countries that depend on WHO support to survive this pandemic.
Of course, it is essential that we learn from our mistakes. We should review how stages of the pandemic were handled and how they could’ve been handled better. Once this is all over, there will be many investigations, including some led by the WHO, to uncover as many details about the source and spread of COVID-19 as possible. While many questions will be targeted toward the Chinese government’s mishandling of the outbreak, there will be some questions for the WHO as well. Primarily, why did it take the agency so long to declare COVID-19 a pandemic, especially after concurrent outbreaks in Italy and Iran?
While there needs to be discussion regarding such topics, in the midst of mass infection and death is not the time to do so. It is difficult to operate a global health agency during a pandemic, especially when there is little cooperation between governments. Questions asked and concerns raised are an opportunity to grow and learn from our circumstances. They are not a reason to undermine the WHO.
Srinidhi Polkampally is a sophomore studying Writing Seminars and Molecular and Cellular Biology from Westchester, NY. She is a global health advocate through Partners in Health: Engage.