Whatever the UN body’s faults, now not the time for such an action, they say
Medical experts and civil society organisations globally have decried United States President Donald Trump’s move to cut funding to the World Health Organization (WHO) at the height of the novel coronavirus disease (COVID-19) pandemic.
The US had threatened a week back that it would withdraw funds from the WHO as it was China-centric and had delayed making some key announcements under pressure from Beijing, particularly human-to-human transmission.
In response, WHO Director-General Tedros Adhanom Ghebreyesus had rebutted all these allegations and said resources would not be an issue if global solidarity was maintained. He had asked China and the US to come together and stop politicisation of the virus.
“By the way, I will like to thank the US for generous support so far. Funding has always been a bipartisan issue in the US and I believe it would remain so. Hope the US would continue contributing,” Ghebreyesus had said, referring to fact that any decision on US funding will have to be cleared by its Senate.
On April 14, 2020, President Trump acted on his threat. “I am directing my administration to halt funding while a review is conducted to assess the World Health Organization’s role in severely mismanaging and covering up the spread of the coronavirus,” Trump said while addressing the media.
The US is the biggest funder of the United Nations health body and contributed $400 million to it last year.
“This is unethical and highly condemnable,” Indranil Mukhopadhyay, associate professor at OP Jindal Global University, told Down To Earth (DTE).
“It may be good in Trump’s political interest if he wants to deflect his own shortcomings in handing the outbreak to the WHO but it would do no good to the US or any other country. World leaders should unite against Trump,” he added.
“The impact would be much beyond this pandemic,” Sakthivel Selvaraj, director of Health Economics, Financing and Policy division at the Public Health Foundation of India told DTE.
“Since the US was the largest funder, many programmes of WHO, especially the ones which are undertaken in developing countries would be worst hit,” he added.
The WHO’s annual budget is close to $ 2.5 billion.
Who is at fault?
Experts will find it difficult to decide about whether the WHO or the US was completely right or wrong.
The WHO did delay declaration of human-to-human transmission in the early days of COVID-19 till China itself said so. Till WHO had its own evidence from the field, it was difficult for it to say on its own that this was happening overruling China, a health expert said.
It was as late as January 23 that WHO finally changed its stance and said there was such a transmission. However, a WHO delegation did not land in China till Ghebreyesus flew to Beijing on January 29 and met Premier Xi Jinping.
WHO kept discouraging travel and trade restrictions to China, saying it will not help reigning in the spread of the virus when most countries, including the US had imposed and enforced them.
But the US certainly has its own faults which it can’t dismiss. In February, Trump dismissed the threat posed by COVID-19 as a ‘hoax’ despite introducing travel bans.
He was widely criticised for virtually stopping testing for two weeks or more in February that made the number of cases grow by at least eight times as compared to an otherwise scenario.
However, it is now the US, that is facing flak from across the globe for its move.
“I am trying best to stick to science and not politics. But as a public health professional and an American, it makes me ill to see the US President cutting funding to WHO at any time but especially during a pandemic,” Marc Lipsitch, a professor of epidemiology at Harvard T Chan School of Public Health, said.
Even the American Medical Association, the largest association of doctors in America, has strongly criticised the move.
“During the worst public health crisis in a century, halting funding to the WHO is a dangerous step in the wrong direction that will not make defeating COVID-19 easier,” it said in a statement.
“Fighting a global pandemic requires international cooperation and reliance on science and data. Cutting funding to the WHO — rather than focusing on solutions — is a dangerous move at a precarious moment for the world,” it added.
A host of other civil society organisations too have issued a strong joint statement to this effect.
Why is WHO’s funding an issue?
The WHO has been consistently underfunded since the 1980s, according to a paper authored by Srinath Reddy and others on the organisation’s financial sustainability.
“The assessed contribution from member states decreased significantly to 21 per cent in 2016–2017 from 46 per cent in 1990. In 2015, only 25 per cent of the WHO’s programme budget came from assessed contributions,” the paper published in the journal Global Health in 2018, said.
Apart from statutory assessed contributions that various member states give to WHO, they do project-based funding too, for example to vaccination development programmes.
“Now, while the statutory funding has gone down, the programme-based funding has gone up. This hampers WHO’s autonomy because it can’t divide funds among various activities as it deems fit,” Mukopadhyay said.
Another issue with WHO funding has been a lack of transparency.
“Many analysts identify the lack of transparency and accountability as a key weakness of the WHO in regard to its performance and financial spending,” the Global Health paper said.
“This problem is intertwined with concomitant challenges of obtaining assessed contributions and the practice of earmarking funds for specific projects from donors who are suspicious of mismanagement,” it added.
This was not the first warning for WHO.
The third edition of Global Health Watch clearly said the WHO was in danger of compromising its own mission and principles because of conflict-of-interest issues that arise as a result of contradictions between its constitutional mandate and the interests of individual donors.
“The WHO must speak the truth to power, as its director-general promises it will. But that means standing up to powerful industries and being more prepared to speak out against its most powerful member state,” it said, quoting the second edition of GHW.
All flaws of WHO notwithstanding, civil society organisations and experts are unanimous that this was not the time for the US to take this step.
“The WHO is not perfect, and its scientific, normative and policy-orientation functions need to be strengthened,” the statement by the People’s Health Movement and other organisations said.
It added the problem lay with the fact that cooperation by member states was voluntary and not enforceable.
“Once the pandemic is over, the International Health Regulations (according to which member states operate with WHO) may need revision based on the experience and evaluation of how WHO and its member states handled the COVID-19 public health emergency,” it advised.
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