Trump and the World Health Organization— Facts Beyond the Outrage

Yesterday President Trump ordered a temporary halt to US funding of the World Health Organization (WHO) while his administration conducts a review of the organization’s response to the outbreak and spread of the pandemic. The President questioned the relationship between the WHO and China. This story will be the popular outrage on the various media outlets today so here is a fact-based perspective of what occurred and what the background on the issue is.

What Did Trump Do?

“America and the world have chosen to rely on the WHO for accurate, timely and independent information to make important public health recommendations and decision. If we cannot trust that this is what we will receive from the WHO, our country will be forced to find other ways to work with other nations to achieve public health goals.” Donald Trump April 14, 2020

It is a temporary action that can be reversed at any time. Two months ago, this action may have had devastating consequences for the countries currently facing the highest confirmed case counts and death tolls from the coronavirus. Today however the efforts to fight the pandemic have been largely nationalized. Each nation is conducting its unique fight and strategy against the pandemic. The greatest impact of Trump’s move will not be felt in the US or Europe but in the developing world.

Less than 3% of the US contributions to the WHO go toward emergency operations. An additional 2.3% goes toward outbreak control. The bulk of US funds given to the WHO are marked for programs to like cancer and heart disease prevention, mental health care, and AIDS.

According to a report from Forbes, over the last decade, the US gave the WHO $3.5 billion. A small fraction of that was required dues, the rest included various donations above US dues to the organization. Additionally, more of that total came from the first three years of President Trump’s administration than the final three years of President Obama’s tenure. The US is the largest contributor to the WHO making up 14.67% of the organization’s budget. The United Kingdom is the second-largest contributor to the WHO at less than half of that amount. Bill and Melinda Gates ranks third on the list of WHO sponsors.

Chinese Influence

China’s funding of the WHO is a fraction of what the US contributes but still grew by 52% since 2014. The tale of the donation receipts suggests the growing influence of the Chinese at the WHO. President Trump accused the WHO of being too “China-centric.” In effect, the US pays the bills and China reaps the rewards of special status and treatment from the WHO.

The WHO is typically hamstrung by the delicate political balances it must dance to maintain its mission and objectives. On the norm the WHO tries to not weigh in on politics. Offending the governments where the WHO needs to work can easily hinder that mission from being accomplished.

In the 2003 SARS outbreak, the WHO stepped beyond its normal political self-restraint to broadcast coverup efforts that were occurring in China at the time. Public criticism of China by the WHO in 2003 helped destroy the coverup which the Chinese government was seeking to employ. Although this embarrassed the Chinese government at the time it also set the stage for China to become more aggressive toward future outbreaks. In 2009, for example, China was far more aggressive and transparent in the H1N1 outbreak. Many see the WHO’s tough responses to China in 2003 to be a contributor to the new behavior demonstrated by the country over the following decade.

The WHO behaved unnaturally friendly to China in recent years. As China expanded its influence in the developing world over the last decade steps taken by the WHO helped legitimize Chinese traditional medicines and practices.

The current Director-General of the WHO is Tedros Adhanom Ghebreyesus is the organization’s first leader who did not previously serve as a physician. He rose to political prominence in Ethiopia as the nation’s health minister and then head of the country’s foreign affairs. His political party in Ethiopia was uniquely allied to China as China sought out investment and influence opportunities in Africa. Many believe Chinese lobbying helped secure Ghebreyesus’s seat as Director General at the WHO in May 2017. It is also worth noting that Ethiopia was among the last African nation to continue flights to and from China.

Did the WHO Allow the Pandemic to Grow?

The WHO was almost certainly played by China in the early weeks of the COVID-19 outbreak. Throughout December and January, the WHO parroted official Chinese statements regarding the outbreak. Included among these was a belief that the virus could not spread person to person so there was little reason to believe the virus would move beyond China’s borders.

At the time the WHO appeared to be soft-pedaling issues with China to stay in the country’s good graces and thereby employ WHO resources to fight the outbreak on the ground. It should also be noted that few people understood the significance of what was occurring in China throughout the first half of January. That ignorance was partly due to Chinese coverups but more to the simple fact that the COVID-19 was something completely new.

President Trump himself lauded the Chinese efforts against the virus at that time as well. On January 24thhe tweeted “China has been working very hard to contain the Coronavirus. The United States greatly appreciated their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”

By the end of January, there were less than 10,000 confirmed cases in China and less than 300 deaths. It was at that time that the WHO declared the outbreak a global health emergency. As late as February 10, China was still ignoring the WHO’s offers of assistance. Meanwhile, the WHO fawned over China’s response to the outbreak and explained how different this round of Chinese actions was compared to the threat of the SARS outbreak in 2003. That analysis turned out to be horribly inaccurate.

The Chinese government was actively engaged in various combinations of ignorance regarding the new coronavirus, a coverup of its spread, and failed cooperation efforts with international organizations.

The WHO did not declare a pandemic until March 11. Many at the time believed this declaration was too long delayed. It is largely forgotten but many governments and organizations were already behaving as though the world was dealing with an outbreak by that time.

Many believed the WHO was slow to declare a pandemic out of fear of offending the Chinese government. Thus the organization believed it was worth helping China save face so that WHO could be employed on the ground to fight the virus. Others believed the slowness of the WHO was evidence of its loyalty to China. In either scenario, the WHO made a terrible miscalculation.

The organization’s posture toward China since that time did not improve matters. While Ghebreyesus and the WHO criticized many European nations and the US for their slow response to the pandemic the praise for China continued to be poured on. This continued even after the realities on the ground in China were beginning to be questioned. While there is little doubt that most nations of the world mishandled the pandemic in its initial stages (being caught by surprise is the nature of a crisis after all) this reality did not explain the continued support of the WHO for China.

Is Trump Scapegoating?

To some extent yes. While there are plenty of concerns regarding the actions taken by the WHO in China as the coronavirus became known and spread, the bulk of US funds to the WHO are not aimed at outbreak control. So, a hold on US funds to the organization does not impact the concern. It is also not reasonable to believe the US government relies more on the WHO than it does its intelligence services to determine steps and responses on national security issues such as a pandemic. The WHO is not the guide for US policy against a pandemic. Therefore, the emphasized role of the WHO in President’s Trump’s pronouncements do not make sense.

President Trump has come under a barrage of criticism in the last ten days for his administration’s own slow and chaotic response to the pandemic. The move against the WHO yesterday is in line with the President’s previous strategies to “change the story” when faced with criticism. As he has done with various scandals and political missteps throughout his time in office, terminations are an easy pathway to change the story that the media is talking about. He could not terminate WHO Director-General Ghebreyesus so he did the next best thing. He suspended funding to the organization.

Does It Matter?

This move will not play a major role in interrupting current global efforts to fight the pandemic. Those who will pay the highest price are the impoverished populations in the developing world who receive the greatest benefits from the work of the WHO. That is the next front in the fight against the coronavirus and many will suffer there. US funds to the WHO may resume in time for that fight and the presence of the WHO in the developing world does make a difference.

In the end, Trump’s actions yesterday were a political move to deal with a political issue. It was poor timing and probably a deliberate distraction by the President. It is not the first, nor will it be the last, of missteps by national leaders in the course of this crisis, that history will judge harshly.