Public/Global Health

Trump escalates WHO fight by redirecting funds to other groups

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The U.S. is starting to shift its World Health Organization (WHO) contributions to other health-focused groups, marking an escalation in President Trump’s fight with the WHO.

The move is part of the Trump administration’s efforts to punish the WHO after suspending payments to the global health body pending a “review” of its response to the coronavirus pandemic.

“For every contract or dollar flowing today, we’re just taking WHO off the table,” Jim Richardson, director of foreign assistance at the State Department, said in a press briefing Wednesday. “We’re going to provide that assistance to these other organizations in order to get the job done. Our system simply can’t wait.”

“At the end of the day, this should be about saving lives, not about saving a bureaucracy,” he added.

John Barsa, who became acting head of the U.S. Agency for International Development (USAID) last month, said the pause in WHO funding has allowed his agency to pursue contributions to other on-the-ground initiatives.

“During this pause, what USAID and other entities are doing — we’re looking for alternate partners to carry out the important work,” Barsa said at the same briefing. “We’re going with existing programs outside of the World Health Organization.”

Barsa said a funding mechanism already exists as part of a USAID pilot program that he expects will be formalized within a week.

But global health policy experts are warning against handicapping the sole international body capable of directing a global response as the world braces for coronavirus outbreaks among some of the most vulnerable populations.

“There needs to be a moment where we look back and understand who knew what, and when,” said Amanda Glassman, executive vice president of the Center for Global Development. “But certainly I don’t think now is the time for reform and re-creation, I think we have to get through this crisis.”

Secretary of State Mike Pompeo has started laying the groundwork for a U.S. exit from the WHO, accusing the agency’s leadership of failing to exercise authority over China for its handling of the outbreak, which originated in Wuhan.

“This isn’t the first time we’ve had to deal with the shortcomings of this organization that sits inside the United Nations,” Pompeo said in a Fox News interview Wednesday. “We need a fix. We need a structural fix for the WHO.”

The U.S. owes an estimated $203 million to the WHO for its biennial operating budget, which includes funds owed for 2019, according to the WHO. That amount is calculated by each member state’s wealth and population.

But voluntary contributions — funds provided on top of required dues — make up a bulk of the budget. The U.S. provided up to $656 million for 2018-19.

State Department officials suggest moving contributions away from the WHO could be permanent.

Glassman, of the Center for Global Development, called this a “dumb idea.”

“No existing program can replace the work of the WHO,” she said in an email, noting that individual organizations can’t coordinate large-scale projects like vaccine development.

“A U.S. non-governmental organization is not able to obtain and share genetic sequences from around the world that enable a fit-for-purpose COVID-19 or influenza vaccine to protect U.S. citizens,” she said. “A U.S. NGO cannot coordinate the more than 70 COVID-19 vaccine trials and their data.”

The absence of U.S. contributions to the WHO could have a ripple effect on the agency’s COVID-19 response, but it will also take away from health initiatives like HIV/AIDS prevention and vaccine programs, such as the eradication of polio.

“No agency, country, or organization could step in and do the work of WHO, particularly in the middle of a global health emergency,” said Loyce Pace, president and executive director of the Global Health Council, a consortium of nonprofit organizations, corporations and universities that work on responding to global health issues.

“To suggest that feels dangerous and irresponsible,” Pace added. “They play an essential role coordinating efforts across sectors and providing guidance across regions that would be very difficult to replace and nearly impossible to do in real time.”

Pompeo and State Department officials have increased their attacks on the WHO and its leadership, saying the director-general has failed to enforce the agency’s own policies against member nations’ violations, namely China.

Pompeo has zeroed in on the WHO’s International Health Regulations (IHR), guidelines established in the wake of the 2003 SARS outbreak that instruct countries when and how they should alert the world to a possible health threat.

“We strongly believe that the Chinese Communist Party did not report the outbreak of the new coronavirus in a timely fashion to the World Health Organization,” Pompeo said Wednesday, citing the IHR guidelines.

He went on to say that the WHO also failed to call out China’s noncompliance.

The IHR guidelines “gave the director-general of the WHO encouragement and the ability to go public when a member-country wasn’t following those rules,” Pompeo said, “and that didn’t happen in this case either.”

The Trump administration says issues like those will be part of its evaluation of U.S. participation with the WHO over the 60 to 90 day suspension period, though officials said a review of the agency’s leadership is among the most pressing issues.

“There’s numerous questions in terms of the management of the World Health Organization, how they have been operating, holding member states accountable in their actions,” Barsa said. “The review is going to be all encompassing, in all manners of management and operation questions.”

The WHO has pushed back on the administration’s accusations, sharing on Twitter this week that it declared COVID-19 a “Public Health Emergency of International Concern” on Jan. 30, with less than 100 cases and no deaths outside of China.

As industrialized nations work to bring the virus under control, poorer countries are beginning to see a spike in cases.

The Africa Centers for Disease Control and Prevention on Thursday announced a 43 percent increase in cases over the past week, The Associated Press reported, and warned that the virus could kill upward of 300,000 people and push 30 million into poverty.

Ben Weingrod, director of government relations for CARE, a global nonprofit working to eliminate poverty and hunger, said the coronavirus threat to African nations is almost beyond comprehension.

“It’s hard to almost say where the need is greatest because it is almost a different reality to what we’re seeing in the developed world,” he said, adding that the WHO should be empowered despite the political clashes.

“It is concerning to see politicization of bodies like WHO and others right now, and my hope is that people will continue to realize that there truly does need to be a coordinated global response,” he said.

Updated at 4:02 p.m.

Tags AIDS CARE China Coronavirus COVID-19 Donald Trump HIV Mike Pompeo Pandemic State Department USAID WHO

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