Is defunding the WHO really just a backdoor attack on sexual and reproductive health?
In April, President Trump suspended all funding to the World Health Organization (WHO), which he accused of “mismanaging and covering up the spread of the coronavirus.” On May 18, he escalated his attacks on the WHO by sending a four-page letter to its director general, in which he threatened to make all cuts permanent.
It goes without saying that now is a spectacularly bad time to defund the WHO. We are in the midst of a pandemic and the WHO remains the only international body capable of effectively spearheading the global response. Not only is the WHO responsible for both tracking the spread of COVID-19 and coordinating relief efforts, but the organization also serves as an irreplaceable support to low- and middle-income countries with poor health infrastructures.
As the United States is the group’s single largest contributor — with U.S. funding accounting for approximately 20 percent of the WHO’s 2018-2019 budget — losing U.S. funding would cripple our worldwide response to this threat. We would all be less safe as a result.
So, what is this really about? President Trump seems to be trying to deflect attention away from his own catastrophic missteps in handling the coronavirus crisis. But there is more to it than that. The Trump administration is also trying to make a backdoor attack on sexual and reproductive health.
Abortion is currently the main issue that unites the fissured right, with President Trump’s vehement anti-abortion stance attracting conservative voters who are repelled by his other positions. We have already seen Republican lawmakers exploit the COVID-19 crisis to restrict abortion on a domestic level. In the early stages of the pandemic, conservative governors rushed to halt abortion procedures on the grounds that they were “non-essential” (despite medical evidence to the contrary) — and Republican lawmakers on Capitol Hill also refused to pass coronavirus relief bills that did not include the anti-abortion Hyde Amendment. Defunding the WHO is just the same move, replicated on the international stage.
President Trump has made similar global moves in the past. Long before Republican lawmakers began using the COVID-19 crisis as an excuse to restrict abortions within the United States, the Trump administration was diverting international aid money away from sexual and reproductive health by defunding the UN Population Fund and expanding the Global Gag Rule (which now applies to all U.S. global health financing).
Anti-abortion political appointees at the State Department, the Department of Health and Human Services and USAID have also repeatedly expressed dissatisfaction with the way that UN bodies handle sexual and reproductive health, preferring that the phrase “sexual and reproductive health” be erased from all UN documents. In fact, on the same day that President Trump sent his condemnatory letter to the WHO, the U.S. acting administrator sent another letter to the UN Secretary-General, requesting the removal of all references to “sexual and reproductive health” from the UN Global Humanitarian Response Plan, as well as the elimination of abortion as an “essential component of the UN’s priorities to respond to the COVID-19 pandemic.”
It should come as no surprise, then, that administration appointees have also frequently called for the creation of an alternative to the WHO, which actively collects global data on abortion incidence and provided key support for the inclusion of safe abortion care in the 2018 revision of the Minimum Initial Services Package (MISP) for sexual and reproductive health.
The Trump administration has been advocating for steep cuts in global health funding since early February, long before COVID-19 was declared an emergency in the U.S. Its 2021 budget proposal, if approved, would have reduced this funding by more than $3 billion, while halving the U.S. contribution to the WHO and allocating paltry “new” resources to organizations like USAID and the State Department. Now that COVID-19 has become the next best pretext for defunding the WHO, administration officials have spoken repeatedly about “redirecting” WHO funding to other groups. These groups again include organizations like USAID and the State Department — which are tightly leashed, in terms of how they can direct their money and expertise, and are therefore much more easily controlled than international bodies like the WHO.
These moves are part of a calculated shift in global health financing. The Trump administration wants to exercise political control over how public health money is spent. But defunding the WHO would be disastrous, especially now that a strong WHO is crucial to weathering the COVID-19 pandemic. This is a moment when the right to health — for everyone, everywhere — should supersede partisan maneuvering.
Terry McGovern, JD, is chair of the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, and a human rights lawyer. Emily Battistini, MD, MPH, MA, is an independent researcher on women’s health, and an alum of both the Mailman School and Columbia’s College of Physicians & Surgeons. Serra Sippel, MA, is the president of the Center for Health and Gender Equity (CHANGE).
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