In the midst of the ravages of the COVID19 pandemic, President Trump’s announcement that the US will defund and depart from the World Health Organization (WHO) poses a clear and present danger to all Americans and the international community. Infectious diseases do not recognize national boundaries nor a person’s politics, and our responses to them cannot respect those differences either. Furthermore, the bulk of the cost of the US defunding the WHO will be borne by low-income countries that rely on the organization to help them roll out essential services including vaccinations for children, maternal care, cancer screening, access to essential medications and more. These programs will now be threatened which would result in the preventable deaths of hundreds of thousands of the world’s most disadvantaged people moreover threatening global security. How does this serve America’s interests?
We feel this was a deeply irresponsible and reckless decision. However, outrage is not a strategy. We need to lay open to the American public and policymakers at all levels of government the work, value and importance of the WHO and global health to the United States’ interests.
Founded in 1948, the WHO is the leading global health agency of the United Nations (UN) charged with organizing international efforts to improve health outcomes worldwide. The WHO has navigated complex political environments with shifting axes, geopolitical instability and the rise of non-state actors. Its work is embedded in achieving the UN’s Sustainable Development Goals and has three, immediate, bold objectives: provide health coverage to an additional one billion people; protect one billion more from health emergencies such as epidemics; and ensure another one billion people enjoy better health and well-being, including protection from non-infectious diseases such as cancer, diabetes, cardiovascular disease, injury, lung diseases and mental health disorders. The WHO also collaborates with other UN agencies across a range of programs intended to address global health challenges including: emergency response; environmental threats; maternal and child health; adequate nutrition; safe water; sanitation; immunizations; neglected tropical diseases; the provision of essential drugs; and building capacity particularly in the world’s poorest nations. The WHO has well documented successes; eradicating smallpox, nearly eliminating polio, reducing tobacco use, improving access to medications, tackling HIV, tuberculosis and malaria to name a few. It has saved millions of lives, strengthened health systems and in so doing has improved global security. Support for WHO will protect Americans wherever they live work or travel. This is clearly in America’s interests.
The WHO is controlled by delegates from its 194 member states who vote on the organization’s policies and elect its director general (DG). The DG must manage this global organization with multiple stakeholders and limited resources, with diplomacy, stewardship and encouragement. States have sovereignty so a DG cannot dictate what they do. In other words, the WHO is just us.
Multinational organization’s structures are not as nimble and proactive as desired. This makes the WHO an easy scapegoat. But rather than tossing out criticism and derision, the US should use its immense strength in public health diplomacy in the Centers for Disease Control and Prevention, National Institutes for Health, USAID, and the State Department to reform and strengthen the WHO and not weaken it. To accomplish this, we will have to shift from a stance of nationalism, populism and individualism, to global collaboration and a spirit of collectivism. Those of us who work in global health recognize that the WHO is the structure that offers us hope for the global coordination and collaboration needed to address the complex threats we are facing such as the COVID19 pandemic.
The exit of the US from the WHO will be a bleak signal to the world. This is not just about money, it is about the values that this country represents- freedom, equality, and justice and global leadership. The international community has looked to the US to stand up for these principles, particularly within the WHO. The US must not compromise the health of its citizens and that of the international community by leaving leadership to those who may in fact threaten our values and security.
Dr. Keith Martin (Executive Director, Consortium of Universities for Global Health)
Dr. Patricia Davidson (Dean, School of Nursing, Johns Hopkins University, Co-Secretary General World Health Organization Collaborating Centers for Nursing and Midwifery)
Dr. Michele Barry (Chair of the Board of the Consortium of Universities for Global Health, Director Center for Innovation I Global Health, Stanford University