By the facts: US Funding cuts to WHO
Why is supporting the World Health Organization critical to responding to the COVID-19 pandemic?
The World Health Organization (WHO) is critical to the global response to the COVID-19 pandemic--providing access to personal protective equipment (PPE) for healthcare workers in, coordinating international clinical trials in the search for effective treatments for COVID-19, offering key technical guidance on addressing this emerging outbreak, and dispatching medical teams to countries in crisis.
WHO has worked to ramp up PPE access for healthcare workers, from delivering more than 4 million masks and nearly 3 million boxes of gloves to over 135 countries to having more than 195 million masks and over 26 million boxes of gloves in the pipeline. By contrast, the USAID actually prohibited countries from spending its aid on PPE.
In addition to PPE, WHO has strengthened laboratory capacities by supplying over 1.5 million diagnostic kits to more than 129 countries. An additional 30 million tests have been ordered by WHO since.
WHO has also coordinated international clinical trial programs to speed up research on potential COVID-19 treatments.
On top of the more than 90 technical guidance documents produced, WHO has provided social media fact-checking services and other guidance.
WHO has over 120 medical teams ready or getting ready for deployment, with twenty emergency medical teams already deployed to over sixteen countries.
Why does the U.S. need WHO?
The U.S.-led Global Health Security Agenda’s (GHSA’s) 2024 Framework cites WHO as playing “a key role in advising GHSA efforts.” And recent U.S. State Department memos have pinned WHO as “the most technically viable implementing partner on public health issues,” highlighting that “very limited alternatives exist.”
Between 1995 and 2015, the U.S. polio vaccination program is estimated to have prevented more than 160,000 deaths and over 1.1 million cases of paralysis. Internationally, public and private actors have worked together to immunize more than 2.5 billion children against polio in 122 countries, reducing polio cases by 99.9% worldwide. While the end for diseases such as polio are within sight, proposed WHO funding cuts would take US$163.2M from polio eradication efforts and HIV programs throughout Africa. At home and abroad, these cuts could jeopardize decades of investments, along with more than US$180 billion in potential cost savings from the polio vaccine alone, to the U.S. healthcare system.
Strategically, WHO funding cuts have far-reaching impacts domestically. These cuts impede the work of over 80 WHO Collaborating Centers throughout the United States--Centers that function as U.S. governmental organizations, such as the CDC’s WHO Collaborating Center for Surveillance, Epidemiology and Control of Influenza. Moreover, these Collaborating Centers give the U.S. the opportunity to directly influence WHO guidance and policies, benefiting both the U.S. as well as U.S. Collaborating Center leaders.
The United States relies on US$2.5 trillion in international exports and US$3.1 trillion in international imports each year. Without an effective global response to COVID-19, trade will remain disrupted by as much as 32% and the U.S. economy will suffer further, in both losses and volatility.
Worse yet, the United States may leave itself outside of a global pool of promising treatments for COVID-19. The WHO has organized the Access to COVID-19 Tools (ACT) Accelerator to coordinate and accelerate development of COVID-19 diagnostics, therapies and vaccines while also endorsing the creation of voluntary intellectual property pools for science and data. These voluntary pools would allow companies and governments around the world to scale up the availability of health technologies while lowering costs. Since the announcement of the ACT accelerator, over 40 countries led by the European Union, along with key philanthropic and industry stakeholders, have pledged more than US$8 billion.How do WHO funding cuts further strengthen China’s WHO influence?
Over the past decade, the United States has spent, on average, each year on the WHO, in the neighborhood of what are the average net patient revenues at a single U.S. hospital. Total US annual contributions to WHO have averaged no more than US$361 million for the past ten years. Comparatively, average net patient revenues at U.S. hospitals were found to be just short of this number, at US$334.5 million. However, the U.S. was already US$80M behind on assessed contributions and planned to cut the WHO’s funding by an additional US$64.7M before April.
In the meantime, China has been filling the vacuum. While both the U.S. State Department and Congressional Research Service previously warned that defunding WHO would “cede ground” to China, these warnings already ring true. In April, China pledged US$30M to WHO in an effort to fight COVID-19--a similar amount pledged by the U.S. But while the U.S. failed to build on their investment, China pledged an additional $2 billion.
The U.S. COVID-19 response raises significant questions:
President Trump and U.S. Secretary of State Pompeo have suggested that SARS-CoV-2, the disease causing COVID-19, might have emerged from the Wuhan Institute of Virology. However, scientific evidence indicates that COVID-19 is not man-made. Thus, at worst, SARS-CoV-2 would have been an accidental release. If this were the case—and there is no evidence yet made publicly available to establish this claim—then it is difficult to understand 1) why the United States, aware of weak biosecurity protocol at this lab two years prior, failed to act on this information and 2) why the United States, now alert to this possibility, withdrew funding to U.S. based research groups--groups collaborating with the Wuhan Institute of Virology--studying how bats might spread coronaviruses to people.
Emerging infectious diseases arise from animals and our environment, laboratories, and hospitals. NDM-1 from India spread across the globe in 18 months and carbapenem-resistant Enterobacteriaceae—a superbug with mortality rates as high as 26-44% and societal costs of more than US$37,000 per single infection—was first identified from a hospital in North Carolina here in the United States. Living in the real world means sharing the risks of being part of the same globe.
When faced with offers to scale up N95 mask production, the U.S. government refused, despite WHO March guidelines recommending the use of N95 masks for infection prevention and control. Similarly for testing, WHO outlined diagnostic testing guidelines by February, delivering 250,000 diagnostic tests to 70 laboratories around the world--tests offered to and rejected by the U.S. And while countries such as South Korea tested more than 1,000 people each day by mid-February, the U.S. continued to utilize flawed CDC tests, testing a total of less than 4,000 people by March.
Moreover, while the U.S.-Chinese travel ban has been touted as early action, other countries give an example of what should have been done instead. Singapore was quick to implement COVID-19 screening and was also one of the first countries to cancel all inbound flights from Wuhan--48 days before the U.S. attempted to do so--after identifying its first imported case. To make their travel restrictions more effective, Singapore took supportive measures like placing travelers under mandatory quarantine and compensating individuals and employers for any workdays lost. While Singapore sees a much larger influx of Chinese visitors (3.42 mainland Chinese tourists in 2018 compared to 2.9 million in the U.S.), the effects are clear: Singapore currently has under 29,000 cases and 22 deaths while the United States has over 1.5 million cases and 92,000 deaths.
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