Analysis: Trump halts funding to WHO. Experts say we need it now more than ever
In the middle of the worst pandemic in decades, President Donald Trump halted funding to the World Health Organization Tuesday while his administration investigates what he called the health body's "severe" mismanagement of its coronavirus response.
Trump accused the United Nations agency of "failing in its basic duty" by covering up the spread of the virus after it emerged in China and acting too slowly and in Beijing's favor. "We have deep concerns about whether America's generosity has been put to the best use possible," Trump said in a Rose Garden news conference.
Public health experts said that although the WHO is far from perfect and that some of the president's claims may merit investigation, Trump is threatening the WHO and pushing ahead with his war on multilateralism when support for the alliance is needed more than ever. The action comes as Trump has tried in daily news conferences to deflect criticism of his response to the outbreak that has killed more than 26,000 Americans.
"You can look at the 2014 Ebola outbreak in West Africa, where the WHO didn't perform well," said Michael Merson, who for many years directed its global program on AIDS prevention. "Most U.N. agencies have had problems. It's not a secret.
"But the WHO's role is critical right now," Merson said. "It's not time for a blame game."
In addition to accusing the WHO of not moving quickly enough to sound the alarm over coronavirus during the initial outbreak in Wuhan, China, Trump has criticized what he described as the agency's poor guidance on travel bans from China. He accused it of being too deferential to Beijing despite that government's track record for misinformation.
"So much death has been caused by their mistakes," he said Tuesday.
COVID-19 fallout:Trump announces 'halt' in US funding to World Health Organization
A USA TODAY fact check concluded that there is little evidence to substantiate Trump's accusations about the WHO criticizing his travel ban from China or being unfairly prejudiced in Beijing's favor.
The coronavirus pandemic is not the first time the WHO has been a target of condemnation, and even its supporters acknowledge the agency has a complex structure that can make it difficult to respond effectively to emergencies and to allocate resources. Trump's accusations don't account for how the WHO relies on member states to report public health information, a point that dulls his claim the WHO was complicit in helping China cover up the outbreak.
Trump has also effusively praised China's handling of the pandemic. He said in a tweet Jan. 24 that “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency."
The tweet came about a month after the virus was discovered in China's Hubei province and as the WHO met to decide whether to declare the outbreak a public health emergency of international concern. It did so Jan. 30.
WHO Director-General Tedros Adhanom Ghebreyesus said Wednesday the "U.S. has been a long-standing and generous friend to WHO, and we hope it will continue to be so. We regret" Trump's decision. U.N. Secretary-General António Guterres said the international community needs to unite "in solidarity to stop this virus."
Trump said his administration's review of U.S. funding to the Geneva-headquartered body will last 60-90 days. The United States paid $400 million to the WHO for 2018-2019, according to the organization's website. That money represents about 15% of the WHO's budget. Trump said he would "channel" the money into other areas to combat the coronavirus outbreak. He did not provide specifics.
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'Health risks that originate in one location pose a huge risk in others'
The list of international treaties, accords and pacts Trump's administration has abandoned, scorned or renegotiated is growing.
They include: the Iran nuclear deal (exited), the Paris climate agreement (exited), the NATO military alliance (questioned), the NAFTA trade deal (renegotiated as the United States-Canada-Mexico Agreement), the Trans-Pacific Partnership trade deal (exited), the U.N. Human Rights Council (exited), the Intermediate-Range Nuclear Forces Treaty (exited) and the UNESCO world heritage agency (exited).
Since taking office in 2017, Trump's White House has instituted a range of sanctions, embargoes and trade boycotts from Iran to China that divided traditional American allies in Europe. They have questioned their efficacy and whether these actions have their roots in Trump's "America First" ideology.
"Under its current administration, our closest ally, the United States of America, rejects the very concept of an international community," German President Frank-Walter Steinmeier said in a speech opening the Munich Security Conference in February.
Trump has surrounded himself with skeptics of globalism and China.
"The Chinese Communist Party has used a powerful colonial mix of bribery and debt diplomacy to directly capture the leadership of five of the U.N.'s 15 specialized agencies while controlling other U.N. agencies like the WHO through puppets like Tedros," Peter Navarro, one of Trump's economic advisers, said in an email.
Navarro is a longtime China hawk and trade protectionist.
"China's broader strategy is to seize the reigns of international power while continuing to violate international norms across a wide swath of issues, from communications and intellectual property protection to trade and health," Navarro said.
The United Nations has 17 specialized agencies with separate members, budgets and rules. Their remits range from tourism to labor rights. It wasn't clear which five agencies Navarro said have been "captured" by China.
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Thomas J. Bollyky, director of the global health program at the Council on Foreign Relations think tank, said there's no question the WHO is "essential" for overcoming coronavirus and stripping it of funds or penalizing it is counterproductive.
"If this outbreak has demonstrated anything, it's that this world is really interconnected and health risks that originate in one location pose a huge risk in others," he said, noting the WHO provides daily technical coronavirus guidance to its 194 member states that helps them to marshal resources and plan ahead for new infections.
"The WHO has been urging control efforts for the better part of three months. The fact that some nations didn't act on it isn't something WHO can be blamed for," he said.
'A scapegoat for our own incompetence at health diplomacy'
The WHO was founded in 1948 with a $5 million budget and a mandate to help prevent and control malaria, syphilis and other diseases. It was established shortly after the creation of so-called Bretton Woods institutions such as the World Bank and International Monetary Fund – postwar initiatives intended to stabilize and usher in a new monetary world order still largely intact. The North Atlantic Treaty Organization (NATO) military alliance, another Trump target whose members he has accused – with some justification – of not paying their fair share was set up a year later, in 1949.
The United States' 15% contribution makes it the WHO's largest overall contributor.
The second-biggest donor, at 10%, is the Bill and Melinda Gates Foundation, the private philanthropic organization established by Microsoft's co-founder and his wife.
"Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds," Bill Gates tweeted. "Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them."
China's overall contribution to the WHO's annual budget is about 1.5%. Yanzhong Huang, a global health expert specializing in China at Seton Hall University, said that low figure may partly inform Trump's animosity toward the health body.
The WHO has a complicated oversight model that obscures accountability.
Tedros presides over six regional WHO directors. He has no say over their appointments.
Huang said that the organization suffers from an internal management system that is too bureaucratic, that its staff has too many doctors and not enough foreign policy experts who could help shape its emergency playbook and that it lacks a clearly articulated mission that can be turned into work on the ground.
"What should the WHO's core function be?" Huang asked. "Coordinating responses for acute outbreaks at the national level or just a gatekeeper that shares global data? Should it be a norm-setter for international health? And if it's expected to do any of these things, how can it do it effectively if its budget is smaller than a typical Massachusetts hospital?" He referred to that part of the WHO's $5 billion annual budget that is known as an "assessed contribution" – mandatory membership dues that countries pay. These dues are calculated relative to a nation's wealth and population.
For 2020-2021, the United States' WHO membership fee is $116 million.
The "assessed contribution" typically accounts for less than a quarter of the WHO's financing. The rest is mobilized through "voluntary contributions" that allow the donor country to specify which global public issues it wants the money to be spent on.
The United States does not have a representative on the WHO's executive board. The White House said it intends to nominate Assistant Secretary for Health Brett Giroir. He serves on Trump's Coronavirus Task Force. It is not immediately clear whether the White House's funding halt will affect this nomination process.
Although the WHO, like other Bretton Woods-era agencies of the United Nations and beyond that have relied on American money, expertise and rule-making, may suffer from structural weaknesses, there is a dearth of concrete evidence to corroborate claims from Trump and others that the WHO dropped the ball on coronavirus as a direct result of bias toward China.
"With China, we are finding a scapegoat for our own incompetence at conducting health diplomacy," Huang said. He said that although China's voice with the WHO has grown and Tedros' predecessor was a Chinese-Canadian national, the Trump administration adopted an attitude toward the WHO of demanding fealty because of its large budgetary contributions while largely refusing to engage with it.
"I view Trump's remarks about the WHO as part of his attempt to deflect blame for his own handling of the worst pandemic our world has seen in a hundred years," said Merson, the ex-WHO director of its AIDS program, who is a professor of medicine at Duke and New York University. Merson has advised the Bill and Melinda Gates Foundation.
Trump was slow to offer federal guidance on a coronavirus lockdown despite evidence from Asia and Europe that it could slow transmission of the disease. He has pushed governors to relax state restrictions so the economy can reopen.
"The WHO is a flawed agency," tweeted Richard Haass, a veteran U.S. diplomat and adviser to former Secretary of State Colin Powell. "Its failings do not explain our own poor performance on testing, PPE (personal protective equipment for medical workers) or slowness to require social distancing."
An influential voice of American business partly concurred.
"The Chamber supports a reformed but functional World Health Organization, and U.S. leadership and involvement are essential to ensuring its transparency and accountability going forward," Myron Brilliant, executive vice president of the U.S. Chamber of Commerce, said in a statement. "However, cutting the WHO’s funding during the COVID-19 pandemic is not in U.S. interests given the organization’s critical role assisting other countries – particularly in the developing world – in their response."
Monday, as Trump showed a promotional video praising his handling of the coronavirus outbreak, he said, "Everything we did was right."
The reality is that he spent months downplaying the crisis.
"We have it totally under control. It’s one person coming in from China, and we have it under control," he said during a TV interview Jan. 22, a day after the Centers for Disease Control and Prevention reported the first travel-related coronavirus case in the USA and almost a month after the WHO put itself on an emergency footing over the outbreak.
'Chinese Health Organization'
The Trump administration's voice is not the lone one in terms of raising concerns about how the WHO responded to what it was told by China in the earliest stages of the outbreak that has infected more than 2 million people and killed more than 134,000.
In early April, Taro Aso, Japan's deputy prime minister, said in an address to his nation's Parliament that some people were beginning to refer to the WHO as the "Chinese Health Organization" because of what he described as its close ties to Beijing.
"Early on, if the WHO had not insisted to the world that China had no pneumonia epidemic, then everybody would have taken precautions," he said.
Wang Ting-yu, a Taiwanese lawmaker, told USA TODAY the WHO ignored his country's early warnings about coronavirus because China has blocked Taiwan, a self-governing island Beijing claims as its territory, from becoming a WHO member.
"The WHO solely serves China's interests," he said.
"The WHO didn't take into account a huge amount of unofficial evidence that was coming out of China about the virus that was being relayed quite publicly on social media," said François Godement, a senior expert on Asia political affairs at the Institut Montaigne, a Paris-based public policy think tank.
Godement referred to a period last December when China tried to conceal growing evidence of the mysterious viral respiratory illness by arresting whistleblowing doctors and medical workers. China may have hidden early evidence of human-to-human transmission of the virus, he said.
"Tedros has repeatedly gone out of his way to praise China at every turn," Godement added. He suspects the WHO director's motivation was to get "more cooperation" from an authoritarian government long practiced at hiding state secrets.
He acknowledged there is no evidence to support this idea.
Senior WHO officials did not immediately respond to comment on this suggestion.
Godement said Trump's funding move is a "hit to political morale" but not as operationally dangerous as it appears because private contributions dwarf public ones.
He said there is scant evidence that China wants to play a more active and assertive role in the international organization because most of the aid it provides to other countries, it does so directly and it is not involved with the WHO's regional committees.
"Unfortunately, whenever the U.S. pulls back from (the global stage) in some form, China mechanically moves forward, even if it doesn't fill the gap," he said.
He agreed that the WHO is an essential component of fighting the virus.
Bollyky, of the Council on Foreign Relations think tank, said the "WHO at the end of the day defers to its member states and operates on the principle of solidarity," meaning that it is empowered to act only on the official information it is provided.
There is evidence that China delayed reporting what it knew to the WHO.
As Haass, the U.S. diplomat, put it in his tweet, the WHO is "only what the major powers, including the U.S., allow it to be. It navigates a world of sovereign states."
"There's definitely a legitimate debate to be had on whether that should be the case during an emergency outbreak," Bollyky said, referring to the WHO's reliance on information it is provided about outbreaks by member nations. "But there doesn't appear to be a case to be made that the WHO was in any way in China's back pocket."
Bollyky said that from a U.S. perspective, there seems to be little point in complaining that the WHO should have acted sooner or faster or differently when it's not clear whether the Trump administration would have heeded the organization's advice.