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Searching for a Scapegoat: Attack on World Health Organization jeopardizes more American lives By Adam Kamradt-Scott, Associate professor, University of Sydney President Donald Trump has announced the US is cutting its funding to the World Health Organization (WHO) – a decision that will have major implications for the global health response to the coronavirus pandemic. The United States contributes more than $400 million to the WHO per year, though it is already $200 million in arrears. It is the organization’s largest donor and gives about 10 times what China does per year. Trump has accused the organization of mishandling and covering up the initial spread of COVID-19 in China, and of generally failing to take a harsher stance toward China. What will Trump’s decision to cut funding mean for the organization? Who are members of the WHO? The WHO was established in 1948 to serve as the directing and coordinating authority in international health. It was created with a mandate to improve the health of the world’s population, and defined health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. While various civil society, industry and faith-based organizations can observe WHO meetings, only countries are allowed to become members. Every May, member states attend the World Health Assembly in Geneva to set the WHO’s policy direction, approve the budget and review the organization’s work. Currently, there are 194 WHO member states, which means the organization has one more member state than the United Nations. How is the WHO funded? The WHO receives the majority of its funding from two primary sources. The first is membership dues from countries, which are described as “assessed contributions.” Assessed contributions are calculated based on the gross domestic product and size of population, but they have not increased in real terms since the level of payments was frozen in the 1980s. The second source of funding is voluntary contributions. These contributions, provided by governments, philanthropic organizations and private donations, are usually earmarked for specific projects or initiatives, meaning the WHO has less ability to reallocate them in the event of an emergency such as the COVID-19 pandemic. Have countries pulled funding before? Over more than 70 years of operations, a number of countries have failed to pay their membership dues on time. At one point the former Soviet Union announced it was withdrawing from the WHO and refused to pay its membership fees for several years. When it then rejoined in 1955, it argued for a reduction in its back dues, which was approved. As a result of nonpayment of assessed contributions, we have seen several instances where the WHO has been on the verge of bankruptcy. Fortunately, governments have usually acted responsibly and eventually paid back their fees. Has there been political criticism of the WHO before? Yes. In 2009, the WHO was accused of acting too early in declaring swine flu a pandemic, in part over concerns it had been pressured by pharmaceutical companies. Five years later, the organization was accused of acting too late in declaring the West African Ebola outbreak a public health emergency. Trump has criticized the WHO for not acting quickly enough in sending its experts to assess China’s efforts to contain COVID-19 and call out China’s lack of transparency over its handling of the initial stage of the crisis. But these criticisms ignore China’s sovereignty. The WHO does not have the power to force member states to accept a team of WHO experts to conduct an assessment. The country must request WHO assistance. Nor does the organization have the power to force a country to share any information. It can only request. Of course, Trump’s comments also ignore the fact the WHO did eventually send a team of experts to conduct an assessment in mid-February after finally obtaining Chinese approval. The results from this investigation provided important information about the virus and China’s efforts to halt its spread. Does China have increasing influence over the WHO? Understandably China has grown in power and economic influence since 2003, when then-Director General Gro Harlem Brundtland publicly criticized it for trying to hide the spread of the SARS virus. China has also been criticized for blocking Taiwan’s bid to join the organization. Taiwan has had one of the most robust responses to the COVID-19 crisis. But China is ultimately just one of the WHO’s 194 member states. And one of the great ironies of Trump’s criticism is that the organization has been criticized by other member states for decades for being influenced too heavily by the United States. What happens if the United States cuts funding? If enacted, these funding cuts may cause the WHO to go bankrupt in the middle of a pandemic. That might mean the WHO has to fire staff, even as they are trying to help low- and middle-income countries save lives. It will also mean the WHO is less able to coordinate international efforts around issues like vaccine research, procurement of personal protective equipment for health workers and providing technical assistance and experts to help countries fight the pandemic. More broadly, if the United States extends these cuts for other global health initiatives coordinated by the WHO, it will likely cause people in low income countries to lose access to vital medicines and health services. Lives will be lost. There will also be a cost to the United States long-term strategic interests. For decades, the world has looked to the United States to provide leadership on global health issues. Due to Trump’s attempt to shift blame from his administration’s failures to prepare the United States for the arrival of COVID-19, he has now signaled the United States is no longer prepared to provide that leadership role. And one thing we do know is that if nature abhors a vacuum, politics abhors it even more. World Health Organization Originally published on The Conversation as Explainer: what Donald Trump’s funding cuts to WHO mean for the world Support evidence-based journalism with a tax-deductible donation today, make a contribution to The Conversation.
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वासिङ्टन — अमेरिकी राष्ट्रपति डोनाल्ड ट्रम्पले विश्व स्वास्थ्य संगठन(डब्लूएचओ) सँग अमेरिकाको सम्बन्ध तोड्ने घोषणा गरेका छन् । राष्ट्रपति ट्रम्पले डब्लूएचओले सुरुमै कोरोना संक्रमण रोक्न पूर्ण रुपमा असफल रहेको आरोप लगाउँदै डब्लूएचओसँगको सम्बन्ध तोड्ने घोषणा गरेका हुन् । अमेरिकाले यसअघि नै डब्लूएचओलाई दिँदै आएको सहयोग रोकिसकेको छ । अमेरिकी राष्ट्रपति डोनाल्ड ट्रम्पले डब्लएचओ चीनको ‘कठपुतली’ बनेको आरोप लगाएका छन् । शुक्रबार ह्वाइट हाउसमा आयोजित पत्रकार सम्मेलनमा राष्ट्रपति ट्रम्पले भने, ‘हामीले डब्लूएचओलाई व्यापक सुधारका लागि अनुरोध गरेका थियौँ । तर उसले सुधार गर्न सकेन । आज हामी डब्लूएचओसँगको सम्बन्ध तोड्ने घोषणा गरेका छौं । अमेरिकाले डब्लूएचओलाई दिँदै आएको सहयोग वैश्विक जनस्वास्थ्यको क्षेत्रमा दिइनेछ ।’ ट्रम्पले अगाडि भने, ‘डब्लूएचओ पूर्ण रुपमा चीनको नियन्त्रणमा रहेको छ । जबकि उसले अमेरिकाको तुलनामा अत्यन्तै थोरै सहयोग गर्दै आएको छ ।’ ट्रम्पले फेरि डब्लूएचओलाई वार्षिक रुपमा करिब ४ सय ५० मिलियन अमेरिकी डलर सहयोग गर्दै आएको र चीनले ‘मामुली ४० मिलियन’ सहयोग गर्ने गरेको कुरा दोहोऱ्याए । अमेरिकी राष्ट्रपति ट्रम्पले गत महिना डब्लुएचओलाई सुधारकालागि भन्दै ३० दिने अल्टिमेटम दिएका थिए । ट्रम्पले महानिर्देशक डाक्टर ट्रेडोस एडहानोम गेहब्रेयससलाई पत्र लेख्दै एक महिनाभित्र डब्लूएचओले आफ्नो कार्यशैलीमा ठोस सुधार नगरे सधैंका लागि सहयोग रोक्ने चेतावनी दिएका थिए । डब्लूएचको गल्तीका कारण पूरा विश्वले मूल्य चुकाउनु परेको पनि उनले आरोप लगाएका थिए । उनले डब्लूएचओले आफूलाई चीनको नियन्त्रणबाट मुक्त गरेमात्रै अमेरिकासँगको सम्बन्ध सुधार हुने बताएका थिए । अमेरिकी राष्ट्रपति ट्रम्पले कोरोना भाइरसको संक्रमणका बारेमा चीनले सूचना लुकाएको आरोप लगाउँदै आएका छन् । चीनले भने उक्त आरोपको खण्डन गर्दै आएको छ । अमेरिका–चीनबीचको सम्बन्धमा आएको तिक्तताले विश्व स्वास्थ्य संगठनलाई थप कमजोर बनाउनुका साथै त्यसको असर वैश्विक स्वास्थ्यमा नै पर्ने देखिएको विश्लेषकहरु बताउँछन् । डब्लूएचओसँगको सम्बन्ध तोड्दा त्यसको असर अमेरिकालाई नै पर्ने चिकित्सकहरु बताउँछन् । अमेरिकाको सेन्टर फर डिजिज कन्ट्रोल एन्ड प्रिभेन्सनका पूर्वप्रमुख डाक्टर टम फ्राइडेन भन्छन्, ‘डब्लूएचओ अमेरिकाकै पहलमा स्थापना भएको हो । आज हामी त्यही संस्थाप्रति पिठ्युँ फर्काइरहेका छौं । हामी पूरा विश्वप्रति पिठ्युँ फर्काएका छौं । त्यसले हामीलाई पनि र पूरा विश्वलाई नै कम सुरक्षित बनाउनेछ ।’ अमेरिकी राष्ट्रपति ट्रम्पले एकल रुपमा गरेको डब्लूएचओसँग अलग हुने घोषणा कार्यान्वयन गर्न चुनौती रहेको बताइएको छ । जर्जटाउन विश्वविद्यालयकाको ‘ओ’निल इन्स्टिच्युट फर नेसनल एन्ड ग्लोबल हेल्थ ल’ का निर्देशक प्राध्यापक ल्यारी गोस्टिन राष्ट्रपति ट्रम्पले संवैधानिक अधिकारको दुरुपयोग गरिरहेको आरोप लगाए । अमेरिकी राष्ट्रपति ट्रम्पले संसद्को स्वीकृतिबिना राष्ट्रसंघीय एजेन्सीसँगको सम्बन्ध तोड्न नसक्ने उनी बताउँछन् ।