Don’t Cut Off the Fire Brigade

by Karl Hofmann, President & CEO, PSI

The Trump Administration announced April 14 that it intended to halt the U.S. contribution to the World Health Organization. Other Republican voices in Congress have clamored for an investigation of the WHO’s handling of COVID-19 and called for the resignation of Director-General Dr. Tedros Ghebreyesus, or even replacement of the entire institution.

These actions seem like transparent efforts to shift blame for the uneven response in the U.S. to the virus, and raw scapegoating of a convenient external target. As we know, President Trump was praising the WHO response only two months ago, just as he has alternately praised and criticized the Chinese government’s response to COVID.

Look, people are tense, and afraid of this invisible enemy. So emotional reactions, including looking for convenient scapegoats, should not surprise us. However, we expect more of leaders at times of stress and tension.

The WHO works as it was designed: as a member state organization that relies primarily on member state contributions for its operating budget. The U.S. has a strong voice and a large vote, supplying the largest contribution annually. The U.S. knows the strengths and shortcomings of the WHO, and the Trump Administration was right to support the election of Dr. Tedros in 2017 as an agent of change and reform.

The WHO’s response under Dr. Tedros to global health emergencies has been notably stronger and more energetic. Compared to the 2014 West African Ebola outbreak, when WHO officials were slower to react, the WHO in 2018 and 19 ran toward the Ebola outbreak in the Democratic Republic of Congo, leading the global response at a time when the U.S. was reluctant to deploy our own capabilities there due to security concerns. WHO responders have perished in this fight, which is still ongoing.

“If we didn’t have the WHO right now, we’d be frantically trying to build it.  We need it stronger, not weaker.  Defunding it is a mistake.” 

The WHO are firefighters running into our neighbors’ burning homes – this is not the time to cut off our support to this fire brigade, just when the flames are building everywhere in our neighborhood.

Dr. Tedros and his staff of professionals are the reference point for so many ministries of health in the Global South, where capacities and resources are often scarce and weak. The WHO sets standards, prequalifies drugs and devices, and often is the first and last place developing world governments turn for advice on investments and policies within their health care systems. Is this really the institution that we think needs undermining? Does this really advance U.S. interests in advancing healthy and self-sufficient developing world health systems, built on principles of quality and transparency?

Critics of Dr. Tedros and the WHO assert that there was too much deference to Beijing as it wrestled with the initial outbreak in Wuhan. I have sympathy for WHO experts here: they were gathering information, trying to understand the virus and its characteristics, trying to influence host government authorities who were politically sensitive and perhaps downplaying the severity (strike any familiar chords?), and attempting to help a national government respond to a crisis with international ramifications. That’s what we want and need international and UN institutions to do: help weaker governments respond to national challenges that threaten the rest of us. The WHO is doing what we and others designed it to do.

We need a strong and effective WHO. The U.S. is best placed to support that by being a strong internal stakeholder. Dr. Tedros is an agent of positive change and deserves the support the U.S. gave him when he was elected in 2017.

Defunding the WHO now risks American and foreign lives, opens a vacuum for other stakeholder voices to steer the WHO away from reforms, undermines a vital and evidence-based pillar of global health security, and ultimately weakens U.S. public and private investments in high-performing health systems around the world.

Banner image courtesy of Flickr/United States Mission Geneva

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