President-elect Joe Biden has pledged to move quickly once he is in office to reverse Donald Trump’s ill-founded pledge to cut ties to the World Health Organization during a deadly worldwide plague.
But it will not be easy for Biden to erase the damage, which will weigh on Washington’s standing in the international health arena and could well have a lingering impact on the management of the current pandemic as well as future ones.
Because of the way Trump withdrew from the WHO, it will take just the stroke of a pen for Biden to counter the action. But that will not stem the loss of influence, trust and collaborative opportunities that were lost on the global stage this year.
Nor will it quickly restore international respect for the United States Food and Drug Administration and the Centers for Disease Control and Prevention, American public health agencies once praised around the world but now deeply compromised by Trump’s politicization of the system.
Then there’s the question of money.
A global health care juggernaut, with 194 nations as members (including the US), the WHO has a current two-year budget plan of $4.84 billion, underwritten by members’ dues plus voluntary contributions from both governments and private organizations, according to the Congressional Research Service. Its two-year, 2018-19 budget was funded through $956.9 million in dues payments and $4.5 billion in voluntary contributions. Washington, long a leader on global health issues, was the WHO’s top donor in 2018-19, providing $853 million in dues and voluntary contributions.
China ranked 15th, with total payments of $89 million. Individual contributions are typically paid out over time rather than in a single lump sum.
But Trump, saying he was angry over its handling of the emergency, suspended all US contributions in April to the WHO and announced about a month later that Washington would withdraw from the agency.
With Republicans quite possibly retaining control of the Senate in the new Congress, can lawmakers round up the votes that are needed to settle the past-due bills? Or might Washington, as it has in the past, simply rely on IOUs for a while, building up arrears at the WHO as well as at numerous other United Nations agencies dismissed by Trump since 2017?
Trump has also inflicted deep wounds on the WHO bureaucracy, piling on insults to dramatize his dispute. During the early months of the pandemic, he and his sycophantic underlings, including Secretary of State Mike Pompeo, repeatedly attacked WHO leaders as corrupt, untrustworthy and unable to keep Americans safe.
Bizarrely, Trump’s real target was not so much the UN agency as Chinese President Xi Jinping, an international rival he sought to belittle as part of a global power play with Beijing.
But Trump also wanted a scapegoat for his own failed handling of the pandemic as tens of thousands of Americans died from the virus ahead of the November elections. The WHO became a favorite villain as he ceaselessly accused it of shielding China’s leaders from blame over Covid-19’s initial spread.
He pushed the WHO Director-General Dr. Tedros Adhanom Ghebreyesus, without success, to aggressively investigate theories that the virus got its start in a Wuhan live animal market or had escaped from a high-security Chinese virology lab. He branded the UN agency as “China-centric” and “a puppet of China.” He and other administration officials regularly demonized both China and the WHO by referring to the virus as the “kung flu” or the “China flu” and calling it a “product of the Chinese Communist Party.”
Sadly, many outside health experts now agree that the WHO was indeed too trusting of Beijing and continues to be so. A recent investigation by The New York Times found that the agency was only too willing to bend to China’s interests, never insisting, for example, that Beijing take aggressive action to get to the bottom of the virus’s origins and early spread and to make its findings public.
In February, when the WHO was scrambling to learn how to contain the pandemic, it dispatched a team of scientists to China with instructions to go to the Wuhan market and search for viral samples. But the scientists discovered on arrival that they lacked clearance to question the relevant Chinese officials or visit the market.
“Nine months and more than 1.1 million deaths later, there is still no transparent, independent investigation into the source of the virus. Notoriously allergic to outside scrutiny, China has impeded the effort, while leaders of the World Health Organization, if privately frustrated, have largely ceded control, even as the Trump administration has fumed,” The Times said.
“The WHO’s staunchest defenders note that, by the nature of its constitution, it is beholden to the countries that finance it. And it is hardly the only international body bending to China’s might. But even many of its supporters have been frustrated by the organization’s secrecy, its public praise for China and its quiet concessions. Those decisions have indirectly helped Beijing to whitewash its early failures in handling the outbreak,” it said. “China has extracted concessions from the health organization that have helped the country delay important research and spared its government a potentially embarrassing review of its early response to the outbreak.”
When he takes office, Biden will be closely watched to see whether he maintains Trump’s hard line on China or takes a softer approach. The findings of The Times investigation could make it even harder for him to persuade the US Congress to reverse course and green-light the full resumption of US participation in WHO operations.
Then, too, with the memory of Trump’s scheming still fresh, it will be natural for the WHO’s 193 other members to take their time weighing whether Washington can again be a reliable partner in seeking to ensure global health.
They will perhaps wait to see whether a Biden administration will sign onto Covax, an international initiative, spurned by Trump, that aims to ensure vaccine supplies to poor as well as wealthy nations. While Washington has spent billions of dollars seeking to provide enough vaccine doses for every American, the developing world will surely be looking for a more equitable global approach.
In the same vein, WHO members may also wish to go slow on enabling Biden to take a major role in international efforts now underway to reform the WHO and possibly bring in new leadership.
Whatever the path ahead turns out to be, the mechanics of a US comeback are straightforward. While Trump cut most ties to the WHO in July, his formal letter pulling Washington out of the organization sets the full withdrawal for July 6, 2021. Biden promised during his presidential campaign to act on his first day in office to simply rescind Trump’s letter. If he keeps that promise, Washington will technically never leave but simply remain a WHO member. And that will be that.
How much better the whole affair would have been managed if Trump, rather than withdrawing, had used Washington’s enormous contributions as leverage in an all-out internal push for reforms. That would have been the best deal.
All of which underlines another sad truth about the UN: money talks. It is well known at the UN that big donors typically dominate in how things are run and by whom. This can be a good thing — money can also mean momentum — but it can be followed to backdoor channels that end in political interference as well.
Clearly, Trump’s determined campaign to damage the WHO, already deeply painful, could keep on hurting for some time.
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