The Downside of Defunding the World Health Organization

On April 14, President Donald Trump announced that he is freezing U.S. funding for the World Health Organization (WHO), denouncing it for “severely mismanaging and covering up the spread of the coronavirus.” But while the WHO deserves criticism, especially for helping China spread disinformation, it’s not clear how this particular action will help the United States or the world.

Our actions should be driven by national interest and strategy: What are America’s goals for WHO and global health, and how will defunding achieve them? There’s no indication the Trump administration can answer that, or has even thought about it.

The United States contributed $553.1 million in 2018–19, about 10 percent of the organization’s two-year budget of $5.62 billion. For the federal government, it’s not a lot of money. To put it in perspective, $553.1 million is just 15 percent of the tax cut Wells Fargo got in December 2017, or about .025 percent of the recently -passed coronavirus rescue package. The U.S. barely saves any money, and China could easily fill the gap if it wants.

International institutions are an arena of great power competition, and if the goal is weakening China, ceding control of an institution America helped create won’t do that. It will, however, upset a lot of people who are looking to the World Health Organization for help managing the global pandemic, and who think highly of its efforts to eradicate smallpox and other diseases. 

It’s not that Trump is wrong to confront the WHO. It’s that doing it this way is self-defeating. A wise strategy would have lined up allies in advance to pressure WHO together, perhaps demanding a change in leadership. If the organization is unsalvageable — I don’t think it is, but if you do—then form an alternative global health initiative that sidelines China.

But the Trump administration can’t do that, because it has spent three-plus years alienating U.S. allies, squandering trust, and undermining the global architecture that brought America so much influence.

In one of his first acts in office, Trump left the Trans-Pacific Partnership, a trade deal that tied 11 Pacific Rim economies to the United States and excluded China. Later he launched a trade war with China, but picked trade fights with U.S. allies in the process, rather than uniting them to confront China as a bloc. A trade agreement that included Vietnam and Malaysia, as the TPP did, would be really useful in shifting supply chains away from China.

No American interest is served by defunding WHO in this manner. At best, it’s an act of petulance detached from any logical strategy. At worst, it’s forfeiting American power and weakening global health capacity at the worst possible time in the hope of distracting from Trump’s own coronavirus failures.

WHO’s errors.

It’s undeniable that by failing to prevent or contain the coronavirus pandemic, the WHO failed in its mission to protect global health. And it’s true that the organization and its director-general, Tedros Adhanom Ghebreyesus, have acted like a mouthpiece for the Chinese government.

On January 14, the WHO issued a statement that there was “no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCoV) identified in Wuhan China,” uncritically citing “Chinese authorities.” This came more than two weeks after Chinese doctor Li Wenliang issued warnings about COVID-19 (and after Taiwan reportedly warned the WHO about such transmission). Chinese government documents acquired by the Associated Press in April show that China’s top medical authorities warned in a confidential memo that the outbreak in Wuhan was “likely to develop into a major public health event.” They shared their concerns in a private teleconference with provincial health officials on January 14, but withheld this information from the world, likely due to instructions from Chinese president Xi Jinping.

On January 23, the WHO’s emergency committee regarding the outbreak of novel coronavirus issued a statement acknowledging human-to-human transmission. The committee warned that “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO,” providing technical advice on how to do so. 

But on January 28, Director-General Tedros met with Xi in Beijing and publicly praised the “seriousness with which China is taking this outbreak, especially the commitment from top leadership, and the transparency they have demonstrated.” At the February 15 Munich Security Conference, Tedros expressed concern over “the continued increase in the number of cases in China,” but also argued that “the steps China has taken to contain the outbreak at its source appear to have bought the world time, even though those steps have come at greater cost to China itself.”

China backed Tedros in the WHO’s director-general election in 2017, he has shown more willingness to criticize other countries’ responses to coronavirus, and his positive statements about China’s response have gotten a lot of play on Chinese state media. It’s not unreasonable to act diplomatically to maintain some access to China and Chinese data — incomplete information is better than none, especially when the stakes are this high — but Tedros has crossed the line into complicity with China’s efforts to deflect blame for its own lies and mismanagement.

The same can be said of other WHO officials. In March, a Hong Kong reporter interviewed Bruce Aylward, co-lead of the WHO-China Joint Mission on Coronavirus Disease 2019, in an exchange that is now famous. The reporter asks about Taiwan potentially joining WHO. Aylward sits in silence and then says he didn’t hear the question. The reporter starts repeating it but he cuts her off and asks to move on. She then asks about Taiwan’s handling of coronavirus — one of the best in the world — and Aylward responds with “we already talked about China.”

It’s a stunning exchange that highlights how closely the WHO has toed the Chinese government line. Ducking the question about Taiwan’s membership is one thing. It’s not directly relevant to the current crisis, and adhering to the “one China” policy, which the U.S. officially honors as well, is a diplomatic way to maintain Chinese participation. But a global public health official refusing to inform the public about how a country of 24 million people has fewer than 400 confirmed COVID-19 cases and only six deaths is a dereliction of duty.

According to WHO’s official stats, there have been 83,482 cases and 3,349 deaths in China (population 1.4 billion), and barely any cases since February. New York City (population: 8.4 million) has had 118,302 confirmed cases and 8,455 deaths. Madrid (population: 6.7 million) 50,694 cases and 6,877 deaths. Wuhan alone has a population over 11 million. It strains credulity that the center of China’s outbreak suffered less than half the death of still ongoing outbreaks in smaller cities, let alone all of China. 

The Chinese government is not a reliable source. It is likely hiding — or deliberately not counting — coronavirus deaths and obstructing investigations into the pandemic’s origins. Chinese foreign ministry spokespeople spread unfounded conspiracy theories that COVID-19 started in America last September, insinuating that the U.S. military brought it to China, while an army of real and fake accounts try to deflect blame for coronavirus across social media. If kowtowing to China in exchange for information was ever a worthwhile trade, it isn’t paying off anymore.

And yet, in April, the WHO defended reopening China’s wet markets — a possible source of COVID-19 — “because they are a source of livelihood and food security to many people.” Even if this particular zoonotic virus did not cross over from animals to humans in Wuhan’s wet markets, the unsanitary conditions pose an ongoing public health risk. There’s no reason one can’t respect the wet markets’ economic and cultural value while also supporting improved regulations.

Trump’s errors.

WHO deserves serious criticism for boosting Chinese propaganda and failing to issue early warnings. But you know who else downplayed coronavirus and praised China? U.S. President Donald Trump.

On January 24, Trump thanked Xi and complimented China’s “efforts and transparency.” Throughout February, the president praised China’s response. He said the Chinese government handled coronavirus “professionally” on February 10, 13, and 18. On February 23, according to a White House transcript Trump said, “ I think [Xi]’s doing a very good job.”

On February 24, Trump showered similar praise on the WHO, tweeting that the organization had been “working hard and very smart,” while also claiming that the “Coronavirus is very much under control in the USA.” And he continued downplaying the danger in March as cases began rising rapidly. Maybe Trump was gullible, like the WHO, which trusted China, or perhaps he wanted to protect trade negotiations rather than gain access to health data. Or maybe he saw coronavirus as a political liability, and, worried about his reelection, decided to try BS’ing his way through it. Arguing that China and the WHO had it under control was part of a PR strategy to convince the American people — especially stock market investors — that it wasn’t a serious threat.

All of these possibilities make Trump look awful, which helps explain his recent attempts to shift blame onto China and WHO. That both deserve a lot of blame doesn’t absolve Trump of blame as well. Part of the president’s job is considering the possibility that international institutions and foreign governments may be mistaken or lying.

Fixing global health.

The coronavirus pandemic highlights the need for more global health capacity, not less. Defunding the WHO without making specific demands or securing support from allies in advance indicates it’s more a show for the president’s domestic audience than a strategy to advance American national interests. Even worse, because Congress allocated those funds and the president signed them into law, it might not be legal for Trump to freeze them without congressional permission. 

This isn’t like withdrawing from an international agreement — such as the Iran nuclear deal, Paris climate accords, or Intermediate-Range Nuclear Forces Treaty — which at least allows America to take additional action. Suspending WHO funding without any larger strategy just cedes more control to China and upsets countries around the world, weakening the United States.

Nicholas Grossman is a political science professor at the University of Illinois and senior editor of Arc Digital. Follow him on Twitter @ngrossman81.

Photograph of WHO director Tedros Adhanom Ghebreyesusby Fabrice Coffrini/AFP/Getty Images.