The World Health Organization is flawed. It is underfunded, overly bureaucratic, siloed and often held hostage by political interests. Nevertheless, the decision by U.S. President Donald Trump to hold U.S. funding for the organization pending a review of its handling of the COVID-19 outbreak is petulant and short-sighted.
The move undercuts the organization as it attempts to respond to the worst pandemic in over a century; it is like de-funding the fire department in the middle of a three-alarm blaze. The decision also further marginalizes the United States within the WHO, undermining Washington’s ability to reform a vital institution.
Established in 1948, the WHO’s mission is “to promote health, keep the world safe, and serve the vulnerable.” In its 70-plus years, it has chalked up impressive successes. It is credited with eliminating smallpox, a deadly disease that claimed an estimated 300 million lives in the 20th century. It has nearly eradicated polio, the Hansen’s disease and river blindness, and has been instrumental in developing an Ebola vaccine. For many of the world’s poorest and most vulnerable citizens, the WHO is their medical lifeline — and the U.S. decision to cut funding threatens that support.
The organization’s record is not without its blemishes. It was slow to react to the H1N1 outbreak in 2009, and debate continues as to whether it overestimated the impact of the disease when the pandemic was declared over a year later.
The WHO was harshly criticized for mishandling the 2014 Ebola outbreak in west Africa. After examining the organization’s response to an outbreak that killed over 11,000 people in three countries, an independent panel of experts identified “systemic failures” in every phase of the response that “resulted in needless suffering and death, social and economic havoc, and a loss of confidence in national and global institutions.” The report concluded that the WHO was “unable to meet its responsibility for responding to such situations and alerting the global community.”
Trump has accused the WHO of “severely mismanaging and covering up” the COVID-19 outbreak, insisting that it did not obtain, vet and share information about the disease in a timely manner. He charged the organization is overly reliant on China and has failed to hold the Beijing government accountable for its handling of the outbreak. A White House National Security Council staff member explained that the WHO “took China’s assurances at face value, defended them and spread their misinformation.”
One source of irritation was the WHO’s delay in reporting information that the new coronavirus could be spread by human-to-human transmission. U.S. officials charged that the organization “repeatedly parroted” Chinese government claims that it was not spreading among humans, despite warnings that it was occurring. This was proof, said Trump in a tweet, that the WHO is “very China centric” and its funding should be held up and scrutinized.
Trump’s behavior suggests that there is more to his complaint than meets the eye. Earlier he was as trusting of the Chinese government as was the WHO. Trump had repeatedly praised China’s handling of the outbreak and downplayed any risk that it might pose to the U.S.
When asked in January, Trump said that he believed China was being transparent about the crisis, lauding his relationship with Chinese leader Xi Jinping. Trump has taken particular offense at WHO criticism of his January decision to suspend all air travel from China, calling it “disastrous.”
The evolution of Trump’s thinking — and his continuing insistence that collaboration with China depends on the trade agreement he struck with China in January — suggests that his real motivation is more a function of politics than health concerns.
Trump’s criticism of China aligns neatly with his claim that he takes “no responsibility” for any failure to anticipate or deal with the crisis and he is looking for a scapegoat to blame. In a tweet that drips with irony, Trump earlier this month condemned the WHO, charging that it has not “provided a serious explanation that acknowledges its own mistakes, of which there were many.”
A reckoning is required but the answers will not satisfy the WHO’s critics. The WHO is, like every other international agency, an empty vessel that depends for its successes on the support of its members. It cannot force states to accept its teams or to share their information. (Reports that U.S. experts were embedded in WHO offices since January and conveying information back to the U.S. in real time undercuts the assertion that the WHO was covering up Chinese behavior. It is more likely that the organization itself was in the dark.) The director general has no authority to compel governments to act. A determined leader can try to shame a government to be more cooperative, but that risks alienation as well, making cooperation even more unlikely.
A more longstanding criticism of the WHO is its refusal to give Taiwan membership. This, too, is a product of the power that members have over the organization. Beijing adamantly opposes letting Taipei become a member, believing that this would undercut its claim that the island is a province of China. This does great harm to the people of Taiwan by denying them access to information about diseases and denies the world contributions that Taiwanese scientists can make.
Suspending the U.S. contribution to the WHO will hurt. The organization’s budget in 2018-2019 was about $5.6 billion and the U.S. was the largest donor by far, contributing just under $900 million. Japan was the sixth-largest donor, providing $214 million, 3.8 percent of the total. China contributed a little under $86 million.
The U.S. decision was roundly condemned. Bill Gates, founder of the Gates Foundation, which provided over $530 million to the WHO, spoke for many when he tweeted that “Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds.” With the disease beginning to hit the most vulnerable countries with the least developed health infrastructure, there is no arguing with Gates’ conclusion that “The world needs WHO now more than ever.”
Japan is not following the U.S. lead. Prime Minister Shinzo Abe said last week that he would not cut funding to the WHO and while conceding that the organization faces challenges, reassessment should wait until after the COVID-19 outbreak has been contained.
That is the right decision. The U.S. decision reduces its ability to bring about reforms that are needed within the WHO. Funding provides leverage. A reduction of support theoretically gives Washington some say over future reforms, but that influence dissipates if another entity fills the financial gap. Beijing is likely to do so.
Once again, Japan must step up to fill the leadership vacuum created by U.S. withdrawal from a multilateral agency. It can do so in coordination with other Japanese funders, such as the Nippon Foundation, which has been instrumental in supporting WHO work around the world.
Funding is only part of the job, however. When the crisis has abated, Tokyo should focus on institutional reform of the WHO, hopefully working with Washington, but also engaging like-minded governments like those of Australia, New Zealand South Korea, Canada and the European Union as well.
Brad Glosserman is deputy director of and visiting professor at the Center for Rule Making Strategies at Tama University as well as senior adviser (nonresident) at Pacific Forum. He is the author of “Peak Japan: The End of Great Ambitions.”
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