President Trump’s Break-Up With the WHO
On May 29, 2020 President Trump announced at a news briefing that the United States was ending its relationship with the World Health Organizations, citing concerns about their relationship with China. He further said that the US would be “redirecting those funds to other worldwide and deserving urgent global public health needs”.1 The President’s main complaint was the China has too much influence over WHO, which in turn allowed the Chinese government to coverup the extent of the COVID-19 outbreak. It is clear from previous speeches that President Trump blames China for the ongoing epidemic, so it comes as no surprise to most that this would be the reason for pulling out of a multinational health organization. But this decision from the President raises so many more questions: can he do it; what does it mean for our country; and what does it mean for healthcare around the world?
What does the US give to WHO?
On their budget portal2 , the World Health Organization outlines all of their contributors, how much they donated, and what that money was used for. Looking at the information for the United States, we can see that their total donation amount was $893 million, which is about 20% of the entire WHO budget3. About 1/3 of that is for mandatory dues and 2/3 is voluntary donation. That money is then distributed to multiple different causes, including:
Polio prevention 27%
Increase access to essential health and nutrition services 17%
Vaccine-preventable diseases ~8%
Tuberculosis ~6%
Many, many others, all of which are listed on the WHO website
What would happen if the US stopped giving money to WHO?
In a nutshell, a lot could happen because the US is such a big contributor to WHO’s overall budget. Public health experts worry about resurgences of polio, si
nce nearly a third of the US’s contributions go directly there, and even malaria. There may be difficulties getting vaccines and preventative care to patients. There may be fewer treatments and resources available for tuberculosis patients. There may even be discrepancies between the US’s initiatives to fight COVID-19 globally and the work being done in the rest of the world because those connections and a fully-funded WHO would be lost. Basically, it would make a coordinated response against a global pandemic far more difficult, on top of reducing much needed support for other health services and initiatives.
Can the President leave WHO?
This is still pretty unclear. If anything, countries are trying to get in to the organization, not out of it. That being said, President Trump can withhold funds from WHO without congressional approval. However, even that is unclear because some of the funds may have already been promised and earmarked for WHO, whose budget is set two years in advance. So no one is sure of the immediate effects of this decision, but it will be felt next year when the budget resets.
What is the US going to do instead?
Amy Maxmen in her Nature article reports that there are a few initiatives and ideas currently circulating. One is creating the President’s Response to Outbreaks, an organization that would help oversee national and international responses to pandemics. Additionally, a new bill came to light on May 21 called the Global Health Security and Diplomacy Act of 2020, which would earmark $3 billion for international initiatives to contain epidemics at home and abroad; the work would be overseen by a presidential appointee. As of June 26, the bill has not yet gone to committee.
Those both sound great in theory, but there is a still the problem of a lack of international coordination. Having international collaboration for global health initiatives means that there are more resources available, more professionals able to help with efforts, and more ability to track and monitor progress. It also can take years to develop strong enough relationships with countries before they allow healthcare providers and other forms of aid to even enter the border, let alone provide services. And WHO has already built those strong relationships, especially in countries that do not get as much attention from Western nations.
What does this all have to do with the US?
A lot! Jobs of Americans working at WHO may be thrown into question if relations become too strained. There is also the question of what to do with the WHO collaboration centers already in the US and the people who work there.
Researchers rely on information and connections gotten through WHO, especially in countries we have almost no other relationship with. That information is also critical for monitoring global health crises that could affect the US, like COVID-19. The US severing ties with WHO would cause a block in the flow of vital information to medical professional, public health officials, epidemiologists, and many others during a time when that could endanger the lives of Americans.
Finally, it could mean that the US no longer has a voice in global health initiatives because we would no longer have the necessary information or connections. We also would lose the platform that WHO gives us to voice our concerns and to push for certain goals.
So all in all, President Trump is at the very least going to stop US contribution to WHO and take away 20% of their funding. It’s still unclear if that means the United States will leave the organization entirely and what the role of the US will be in global health in the future. But it does have some important consequences, not just for Americans but for all the patients who benefit from our donations. We, and the world, will have to wait and see and hope that these crucial life-saving initiatives are not dismantled by the President’s decision.
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