By Julianna Iwasinski
In recent weeks, the United States’ formal notice of withdrawal from the World Health Organization (WHO) has some worried and some optimistic. Due to the withdrawal, many pros and cons will unfold while being front and center on the world stage. Many people do not know what the World Health Organization is and its role before the current pandemic. Nevertheless, the organization has played a central role in regards to global health communication with the nations of the world amid the pandemic.
The World Health Organization’s role is to coordinate with the world’s nations, specifically the United Nations, and provide international help. The WHO’s primary focus is on communicable diseases like the coronavirus (COVID-19) and non-communicable diseases like cardiovascular disease. However, the World Health Organization also plays a crucial role in preparedness for particular outbreaks, and most importantly, surveillance and response. Nations who are members of the WHO are in charge of reporting outbreaks and coming up with a proper response to these outbreaks. The World Health Organization is responsible for taking the information reported to them, and distinguishing that it is enough to declare a Public Health Emergency of International Concern.
One significant issue that the Trump Administration had with the World Health Organization and its handling of the coronavirus is that it cannot mandate. Although doctors in China were privately stating that about 50% of cases were asymptomatic, the World Health Organization stated that there was only 1%. Furthermore, the World Health Organization cannot go to any country and find out specific information that they need to know, which frustrated many. The focus of surveillance and communication is one of the many reasons the Trump Administration wanted to cut ties with the organization.
There are substantive issues that the United States feels are infringing on the relationship with the WHO, including structural issues and lack of response during a crisis. Never before has a nation tried to separate from the World Health Organization. Although there are no provisions in the organization’s constitution that were put into place in 1948, the United States is standing firmly against our nation’s involvement with the organization. The separation was made possible by the United States Congress in 1948 when the country joined the World Health Organization. They passed a joint resolution that laid out the conditions in which it would be acceptable for our nation to withdraw. Although the formal withdrawal will not take effect until 2021, the public is concerned about the effects this will have on our health programs and our current relationships with the rest of the world. Although, no nation has separated from the World Health Organization before it should be noted that in the 1980s, President Reagan froze the World Health Organization’s budget because of an issue with the organization’s budget process. President Reagan threatened to leave the World Health Organization if there was no cap on the number of contributions a country supplies the organization. This was simply due to the fact that the budget would not keep growing.
Although US withdrawal from the WHO has been met with significant criticism, there are still some glaring issues with US involvement in its current form. First,there was a tremendous lack of communication by the World Health Organization in regards to the current pandemic, especially in regards to China. Representative Jim Banks stated that, “China violated international health regulations,” and mentioned that the World Health Organization tried to cover up the misinformation from China rather than hold them accountable. Senator Portman pointed out that the United States has contributed 2.3 billion dollars of congressionally appropriated funds to help other countries combat the coronavirus. He believes the United States is not given enough credit and/or attention to that matter. Portman said that there should be more attention given to what the nation is doing that is helpful, but instead, there is the underlying issue of China and Russia spreading disinformation. The United States joined the World Health Organization with the understanding that there were standards to uphold. If China is not upholding these standards and is not held accountable due to vital information to the pandemic, it is possible that another nation may believe the rules do not apply to them either.
One aspect that can come from this withdrawal is the nation developing a domestic attitude towards its overall health. With that being said, another outcome that can correspond with the exit is the understanding that this may open doors to more transparent communication and may reduce the likelihood of having to report to the United Nations, regularly. The United States is the World Health Organization’s largest funder, which lends significant concern as to why there is a wide-ranging number of conflicts between the organization and the nation. The misallocation of these funds for other health programs in our nation could result. This is especially important at the time of the COVID-19 pandemic because the United States lacked specific resources needed for a proper response. Although one nation can never adequately prepare for a pandemic and its magnitude, they can invest in research and better surveillance that could lead to more robust and quicker responses.
Another strong point to be made in support of the nation’s withdrawal is that it may benefit its relationships with others by directly communicating with other nations concerning global health issues. The United States will have to understand that some countries may not feel as though they must oblige or work together because they are no longer part of the World Health Organization. On the other hand, the United States could create a legitimate yet trustworthy organization that other countries would be willing to work with and share research and vaccines. Thus creating a potential avenue in which the United States maintains its presence in the global health realm. However, with the current health of the nation so uncertain, and without a solid back up plan, there could be a substantial amount of ramifications that can and will unfold.
As the coronavirus becomes a more dangerous pandemic with a second wave on the way, the race to find a vaccine becomes more urgent. In a recent House briefing, Fauci explained that the United States is on track to find a vaccine. He stated that, “We hope that as time goes on and we get into the late fall and early winter, we will have a vaccine we can say would be safe and effective.” The vaccine is already undergoing trials and is currently in phase three, where the trial is taking place on thirty thousand individuals. Dr. Fauci feels cautiously optimistic and believes that this vaccine will be successful. During phase one of the study, the vaccinated individuals ended up mounting a neutralizing antibody response. In particular, Dr. Fauci mentioned that this response was at least comparable and sometimes even better than what has been seen from individuals who have recovered from COVID-19. Brett Giroir also added that there is not just one vaccine; there are more. He said that there are about a dozen currently being worked on. Moreover, there are five or six that the federal government is actively involved with, and those are going into phase three trials over the next few months. Lastly, Representative Steve Scalise mentioned in the house hearing that the United States is already mass-producing vials right now. This is so that if one of the current vaccines the United States is currently working on gets FDA approved, they will be ready to distribute.
Some nations may be able to help the United States maintain its relationships with other countries after the exit from the World Health Organization. According to Secretary Pompeo, the United States is actively working with the Quadrilateral Security Dialogue (the Quad) after eight years on a hiatus. The Quad consists of four nations Australia, Japan, India, and the United States. Pompeo also mentioned that these four nations have been communicating on some frequency about economic efforts together, on COVID response, while finding frequent touchpoints where the Quad can develop real strength and unity. With that being said, the United State’s intense involvement with the Quadrilateral Security Dialogue could potentially ensure the nation’s path to global health involvement, especially in the Indo-Pacific region.
Many surmise that the United States should fix the WHO’s structural issues without pursuing separation from them. This is an idea that a plethora of people agree with including Democrats and Republicans. Nevertheless, one issue raised by Secretary Pompeo in his recent Senate hearing included, “The decision the President made, and I concur with this decision. We went through multiple rounds of reforms with the World Health Organization. Our team and Geneva fought for years and previous administrations too. Furthermore, each time we got reforms, there was no capacity to make that a science-based organization and not a political one.” Some individuals disagree with this statement. In particular, Senator Murphy disputed Pompeo’s characterization of the World Health Organization and remarked that it is an international body and that there is no way that there will not be some level of politics affecting decisions, and it is a science-based organization. He mentioned that the World Health organization is indispensable to the continuation of the world’s efforts to prevent the next disease.
Looking at pros come a handful of cons regarding our separation with the World Health Organization. The disadvantages that come from the United States withdrawal can be looked at in a manner of short term and long term ramifications that will impede on the nation. Health professionals, especially, are condemning the United States’ withdrawal. One of the World Health Organization’s critics, Dr. Ashish Jha, director of the Harvard Global Health Institute, believes that the United States must stay a part of the World Health Organization, especially amid the pandemic where things are only going to get more complicated. He believes it is vital to globally give the United States a voice at the table in managing the coronavirus.
Some ramifications from the United States withdrawal include, but are not limited to, a lack of correspondence with countries involved with the World Health Organization. There is the unfortunate possibility that countries will no longer feel a need or obligation to converse with the nation, especially after a large amount of funding is no longer available for the organization. The lack of communication can result in the United States learning about certain communicable diseases far later than other countries, making the United States respond slowly and find the nation vulnerable. With the World Health Organization no longer receiving millions of dollars from the United States, there could be severe consequences the organization may undergo. They may have to cut funding for specific initiatives and research paramount to the world’s health.
One crucial aspect of the separation to look at is amid the current pandemic without a vaccine. It could lead to a race for one. With that said, there is a possibility that the United States may not have a vaccine before other countries.
The uncertain future of the Covid-19 pandemic worries many, but the eradication of polio comes to mind when thinking about the United States’ withdrawal. The World Health Organization and the world have done their part in successfully eradicating two out of the three wild poliovirus strains. The concern is that the United States, who had one of the highest pledges of $215.92 million to eradicate type 1 wild poliovirus, may no longer be given to the World Health Organization. It has been along road to eradicating polio. With that being said, without the United States and its funding, there is a substantial possibility that the commitment to eradicate polio may be in hindsight. This can mean that all the money and work the United States, and taxpayers have contributed to the World Health Organization for the push in eradicating polio, could be viewed by some as a waste even though two out of the three strains are eradicated.
There may no longer be an obligation that the World Health Organization has to maintain with the United States, especially considering that their largest funder will be absent. When keeping that in mind, structurally, the World Health Organization will have to find a way to recover from this loss. If there is a vaccine created within the United Nations and given to the World Health Organization and the United States is separated by then, this may create conflict with the nation not being a recipient of the necessary information. It is important to note that due to a lack of coordination with the World Health Organization, the hopes of finding a vaccine could be more challenging to obtain. With the future so uncertain, we may not know the answers until the United States officially withdraws from the World Health Organization.
There are significant concerns for the United States citizens working within essential roles within the World Health Organization. Individuals like Maria Van Kerkhove, the World Health Organization’s leading expert on coronaviruses, plays a vital role in the current pandemic. Stewart Simonson is another individual part of the organization and is one of the agency’s assistant director generals. There are also many United States-based agencies with individuals from the Center for Disease Control and others who work within the World Health Organization for a specified period. When the United States officially withdraws from the World Health Organization, there is a substantial risk that those individuals will be losing their jobs. Without these critical individuals, their roles can open up to countries like China, whom the United States, among other nations, does not want to have any more power in the global health realm than they do already.
There is a majority that believes that the World Health Organization is not perfect. One of these individuals includes Dr. Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases. Dr. Fauci has stated in a CBS interview that, “The WHO is an imperfect organization. It certainly has made some missteps, but it has also done much good.” No one is arguing about the actions of the World Health Organization, but everyone is concerned about the United States’ exit. Many individuals, especially very experienced health professionals like Dr. Fauci, believe the World Health Organization is not perfect and that it needs reform.
What lies ahead cannot be determined quite yet, but can be speculated. Many believe the current issues the organization and the nation are undergoing should be solved internally. Nevertheless, it must be duly noted that the United States may not be the only country that will endure hardships due to the withdrawal from the World Health Organization. The United Nations must continue to work together for the greater good and health of the world as a whole. No matter what one may believe the United States should do in regards to our association with the World Health Organization Secretary, Pompeo stated, “I am convinced that the world will benefit; when the United States leads and we will lead, good things can happen in the international health realm.” Although the country may no longer be an active member, it is essential to have optimism for the road ahead.