A Reformed WHO: Making Its Case to America

A Platform for Cooperation and Progress

After announcing its intention to withdraw from the World Health Organization (WHO), President Donald Trump has indicated that he might be willing to reconsider. At issue is one of Trump’s favorite themes: reciprocity and fair burden-sharing. He believes that China contributes too little and exerts too much influence over WHO.

Fair Burden-Sharing: A Matter of Principles

Trump is right to point out the importance of equitable burden-sharing. In fact, WHO has already adopted measures suggested by its member states to address this imbalance.

Assessed Contributions: A Fair Share of the Burden

At present, only 26% of WHO’s approved budget comes from assessed contributions, a membership fee of sorts based largely on a country’s share of global gross domestic product (GDP) and population (United Nations Peacekeeping, the International Monetary Fund, and the World Bank also use this approach). But member states are now on a path to financing at least 50% of WHO’s main budget in proportion to their economic and population size by 2031.

A More Level Playing Field

Under the current formula, America’s portion of the assessed contributions is capped at 22% even though it accounts for 26% of global GDP. China now pays 15% and that percentage will continue to rise as the country’s share of global GDP grows. The more that WHO is financed through assessed contributions, the more that China, India, the Gulf petrostates, and several Central European countries will be obliged to contribute, ensuring that all countries pay their fair share.

A Stronger WHO: A Platform for Global Health Cooperation

Addressing Concerns and Fears

Trump is equally concerned about China’s influence on WHO and the country’s handling of the Covid-19 pandemic. WHO Director-General Tedros Adhanom Ghebreyesus shares some of these concerns. He has repeatedly called on China to investigate and disclose what happened in Wuhan five years ago and has drawn China’s condemnation by rightly insisting that, until that occurs, all hypotheses about the virus’s origin remain on the table.

A New Era of International Health Coordination

Ironically, given the torrent of falsehoods about it, the pandemic accord under negotiation at WHO would improve international health coordination and prevent similar failures from happening again. If this proposed instrument, as well as the updated international health regulations, were to require earlier reporting, full information-sharing, and a more rapid response to health threats, we could avoid repeating past mistakes.

A Case for Rejoining WHO

A Stronger Voice for the United States

But the US will lose all influence over these negotiations if it leaves WHO, while the Trump administration could instead use its clout within the organization to reach an agreement that the US can accept. In fact, all WHO member states have requested reforms to enhance the organization’s performance, accountability, and transparency, as a quid pro quo for agreeing to increase the percentage of assessed contributions.

A Decentralized and Transparent WHO

Trump also wants evidence of reform at WHO. This means decentralization, with country and regional offices gaining greater authority vis-à-vis what he sees as an overly bureaucratic Geneva headquarters. It also implies avoiding the mission creep that often arises from member-state requests and earmarked funding designed to give priority to their own projects. WHO must demonstrate progress on both issues in a transparent manner.

A Compelling Vision for the Future

The last half-century has shown what such collaboration can achieve: smallpox was eradicated, polio and many tropical diseases are close to being eradicated, and HIV-related deaths have fallen by nearly 70%. But progress will falter if countries decide to go it alone. That is why, to reassure the Trump administration and other governments like Argentina that are threatening to leave, there is a case for bringing together a group of highly respected leaders, representing every continent, and a top-level American official.

Conclusion

In this age of mass travel, increasing urbanization, industrial livestock farming, and human encroachment on wildlife habitats, the need for WHO is stronger now than it was in the 1850s, when the first formal international health conference was held in response to a cholera outbreak. Even more vigilance – and greater cross-border cooperation – is required if we are to prevent the spread of infectious diseases. We must never forget the medical lessons we have learned, from cholera to Covid-19: no one is safe until everyone is safe.

FAQs

* What is the current state of WHO’s financing?
WHO’s approved budget is financed through assessed contributions, a membership fee of sorts based largely on a country’s share of global GDP and population.
* How is the US currently contributing to WHO’s budget?
The US is currently making contributions beyond normal member-state dues, making it the largest donor to WHO.
* What are the concerns about China’s influence on WHO?
Trump and WHO Director-General Tedros Adhanom Ghebreyesus share concerns about China’s influence on WHO and its handling of the Covid-19 pandemic.
* What is the proposed pandemic accord under negotiation at WHO?
The proposed accord would improve international health coordination and prevent similar failures from happening again by requiring earlier reporting, full information-sharing, and a more rapid response to health threats.