Economics and Policy

Consequences of United States withdrawal from the World Health Organisation

In the midst of United States being brought down to its knees by the coronavirus, the President of U.S. Donald Trump, after halting the funds to WHO a couple of months ago, officially made a call to pull its membership from the WHO. This was followed with a notice of withdrawal dated July 6, 2020, to the UN Secretary-General António Guterres. The withdrawal will be effective one year after the notice i.e. in July 2021 conforming to the terms of the joint resolution of 1948, unless his counterpart Joe Biden takes the office after him and revokes the same. The U.S. will also have to satisfy the remaining assessed contributions which are around $110 million-plus 118 million CHF, to terminate a 72- year-long relationship.

WHO and US – a symbiotic relationship

Headquartered in Geneva, a successor of the Health Organization, the WHO was established on 7th April 1948 which is also commemorated as the World Health day. The specialized health agency is concerned with maintaining and promoting international health and has played a significant part in serving the impuissant parts of the world not possessing enough resources.

The U.S., hitherto, has been a stalwart member of the WHO since its inception, hosting around 82 of the 800 collaborated health centres along with helping to protect some of the world’s most disadvantage and vulnerable populations suffering from fatal diseases like Tuberculosis, Malaria and HIV. With the withdrawal of the U.S., the programs which focus on these diseases will be the immediate victims.

WHO is financed by voluntary and assessed contributions from the member states and independent donors. The exit of the U.S. from the organisation will devoid it of its biggest funding source, amounting to 14.67% of the health agency’s entire budget.

What went wrong?

According to Trump, the WHO has been kowtowing to the Chinese too much. The yearly contributions of $450 million were revoked after terming the WHO as ‘Chinese-centric’ on account of its initial failure to support the ban of incoming travel to the U.S. from China- the country of origin of the COVID-19 and refusal to act on his suggested reforms.

In these unprecedented times, where the international community should stand in solidarity to contain the virus, the withdrawal will stunt WHO’s response to the pandemic and other baneful diseases. This decision by the Trump administration has been seen as a political move rather than achieving something fruitful, shifting the blame for an appalling response to the pandemic, onto China and the WHO to bag votes for the upcoming election. Leaders of different countries have criticized this defunding but at the same time addressing their disappointment towards WHO for not taking any step against wet markets, commonly situated in parts of South Asia and China.

The U.S. has been at the forefront of developing the WHO and public health domain. Though Trump has announced that the U.S. will continue to fund global priorities and fund the money to other ‘deserving’ organisations, this step will still hinder the progress of achieving the goal of global health (global health is defined as ‘an area which places a priority on improving health and achieving health equity for all people worldwide’ find it here). As per Prof Heyman, an eminent epidemiologist, without the voluntary contributions of the US, the WHO will “struggle” to keep up with its polio surveillance activities.

Is it really just one of Trump’s propensities?

Well, this is not the first time Trump has backed out from International agreements and organisations. The U.S. under the presidency of Donald Trump has quit the UN Human Rights Council in mid-2018 along with Joint Comprehensive Plan of Action in 2018, followed with withdrawing from UNESCO in January 2019. Also, the U.S. has now withheld funding from the United Nations Population Fund (UNFPA) close to four consecutive years, after asserting serious allegations against the organisation’s work, which will consequently disrupt a crucial role to protect the health and lives of millions of women and girls around the globe, says UNPFA, and also let’s not forget about the UN agency which aids the Palestine refugees.

The WHO, through its Global Influenza Surveillance and Response System (GISRS), disseminate vital information about the influenza virus among the member states twice a year. In spite of the assistance by the GISRS, 34,200 Americans died during the 2018-19 influenza season, according to the U.S. centres for Disease Control and Prevention (CDC).

The exit of the US will clearly disconnect the country from sources of information, thus causing irreparable harm to the nation. Not just this, the flu vaccine that Americans receive is based on the works of the CDC and Food and Drug Administration (FDA) which is conducted through the WHO. The U.S. plays its part by providing key scientific information to the WHO via CDC and academic researches.

And what about the Pan American Health Organisation?

Among all other things, the Pan American Health Organisation (PAHO), which serves as the regional office of the WHO for inter-Americans countries, depends on the U.S. for its funding. It will also be there in the victim’s list affected by this decision which will jeopardise the health of all the American countries and not just the U.S. Besides this, the withdrawal will also impede the mass immunization campaigns carried out by the WHO for the protection of children from lethal diseases.

“It is always easy to fundraise for panic, but it is hard to fundraise for preparedness,” says Imre Hollo, Director, Planning Resource Coordination and Monitoring of WHO, signalling that the defunding will weaken the armour of the healthcare system and will affect future preparations against another novel virus or disease which may emerge anytime.

Other implicit ramifications:

Apart from all the health and economic ramifications of this exit, an estrangement between the WHO and the U.S. will also weaken their long-standing collaborations, including rotation of American scientists from the CDC and National Institutes of Health (NIH) via WHO’s headquarter in Geneva. Further, there is uncertainty regarding the fate of Americans employed in the organisation, not excluding that U.S. has a seat in WHO’s executive council till 2021 with Admiral Brett Giroir as its representative.

A reduced budget will also compromise the ‘Solidarity trial,’ an International clinical trial introduced by the WHO with the assistance of its members, to find an effective treatment of COVID-19. The revocation of membership will restrict the participation of the U.S. in this trial. However, that’s not all, if this exit is not overturned by the U.S. in the future, it will no longer be competent to suggest reforms for an effective functioning of the organisation as it will lose its voting rights and will be joining Liechtenstein, the Cook Islands and Niue (UN member states which are not a member of the WHO) consequently.

Conclusion:

This perilous move from the U.S. will open up differences in the UN-based health agency and thus, will prove to be costly for the entire health community in the upcoming time. The repercussions of this step will not have any finitude. For many years the reliable partnership between the U.S. and the health agency has contributed to make the world a healthier and safer place. Till now, it’s not clear whether the WHO is really submissive to China or not, but it cannot be ignored that the place of the U.S. as a global health leader after its retreat from the organisation, can be taken by the financially sound China.

This article is authored by Vaibhav Jairath, a student of JIMS School of Law.

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