Exercising checkbook diplomacy at the WHO
© Getty Images

Leave it to the World Health Organization (WHO) to insist that the only way to prevent the next pandemic is for its member states to relinquish control over the organization’s budget and programming. That is, despite mounting evidence that WHO’s governance and prioritization deficiencies exacerbated the COVID-19 crisis. And yet, this was the key takeaway during the WHO’s recently concluded annual agenda setting meeting, one which coincided with a precipitous decline in U.S. influence over the global health body.

This year’s World Health Assembly took place against the backdrop of increasing condemnation of the WHO’s pandemic response, including demands that the “lab-leak” theory be re-examined. It also coincided with reports of sexual abuse within WHO’s ranks, along with allegations that WHO director general Tedros Adhanom Ghebreyesus may have played a role in covering up the scandals.

With storm clouds brewing over its Geneva headquarters, the organization recently released a mea culpa, acknowledging the pandemic “could have been prevented.” In its report, the WHO also conceded that it waited “too long to declare a global health emergency” after learning about a Chinese COVID-19 cluster in 2019. While the report’s summary contains nary a reference to China’s refusal to cooperate with WHO investigators, it reaffirms that the organization lacks the power to investigate and act swiftly when confronted with potential outbreaks.


To remedy this weakness, the WHO report proposes a bold, expanded organizational mission, and the ratification of a new international pandemic treaty. The catch — it comes with a 16 percent budget increase and new rules preventing states from earmarking donations for specific programs, in essence conferring all operational decision-making to WHO’s leaders.

This new WHO vision contradicts the findings of previous experts empaneled following the WHO’s calamitous responses to SARS and Ebola, which called for streamlining, not enlarging, the WHO’s bureaucracy and core functions. In soliciting additional funding, the report also minimizes the organization’s sordid financial history, including how it spent more on executive travel in 2019 than its HIV/AIDS, malaria, and tuberculosis programming combined.

With the report in mind, WHO’s leaders used this week’s gathering to advocate for the establishment of a “Global Health Threats Council” consisting of foreign heads-of-state, which presumably includes Xi Jinping and other autocrats, to hold countries accountable for their pandemic missteps. They also demanded pandemic vaccines be classified as “public goods,” undercutting the intellectual property protections of Western companies footing the billion-dollar bill to develop revolutionary therapeutics.

WHO’s leaders also insisted that wealthy G7 nations immediately commit $2 billion to the WHO’s COVAX program to provide vaccine support to low income countries. This includes dictatorships, like Myanmar, North Korea, and Syria, the last of which recently won a seat on the organization’s Executive Board, its highest-level decision-making body, even though the WHO documented more than 494 attacks by the Assad regime on Syrian hospitals and medical facilities since 2016.

Following Chinese lobbying, the U.S. fell short in achieving either of its goals for the Geneva gathering — securing Taiwan’s WHO observer status or meaningfully advancing the second phase of the WHO’s COVID-19 origins investigation. Adding insult to injury, the United States’ three-year Executive Board appointment concluded this month, leaving stewardship of the organization to countries like Belarus and Russia, the latter of which is collaborating with China to undermine an EU-led proposal to counter pandemic disinformation. The Board will also soon help select the WHO’s next director general. Despite a rocky tenure and questions about his objectivity, Tedros appears on track to win a second five-year term. That is unless the U.S. and its allies nominate a more qualified candidate by mid-September.

While Washington may have relinquished its Board seat, it does retain control over one thing — its checkbook, which funds 20 percent of the WHO’s budget. Of the $400 million dollars the U.S. contributes each year to the WHO’s coffers, nearly $300 million is entirely voluntary. In other words, the U.S. need not disburse any or all these funds until the WHO agrees to certain concessions, like updating its sexual assault reporting procedures and dropping its demands for no-strings attached donations. Policymakers can also withhold funding pending the reinstatement of Taiwan’s observer status, a decision which rests solely with Tedros.  

The U.S. has other tools at its disposal to achieve its objectives. These include recommending G7 sanctions on China until it cooperates on COVID-19’s origins and weaponizing congressional hearings to pressure the UN’s Office of Internal Oversight Services to open a truly independent inquiry into China and WHO’s pandemic actions.

At its core, the Biden administration’s multilateral strategy depends upon securing a meaningful return on investment for U.S. taxpayers. After 500,000 needless deaths, exercising checkbook diplomacy at the WHO is as good a test case as any.

Craig Singleton, a national security expert and former U.S. diplomat, is an adjunct China fellow at the Foundation for the Defense of Democracies, a non-partisan think tank focused on national security and foreign policy issues.