Health politics: Why leaving the WHO will only hinder the US

Georgia Strong | United States Fellow

Since his successful presidential campaign in 2016, Donald Trump has shaken up the international system. He has implemented a nationalist foreign policy designed to distance the US from what he perceives to be unfair international institutions, such as the World Health Organization (WHO). This is a unique move given some of his predecessors actively worked to establish the WHO in 1948.

Earlier this year, President Trump accused China of downplaying the impact of the COVID-19 pandemic, as well as the WHO of being complicit by not investigating the origins of the virus. In reality, such criticisms are contrary to WHO protocols, which state the WHO must be invited by a host nation to investigate a health crisis. Although several other nations have highlighted the need for an independent review of the WHO’s pandemic response, none have critiqued the Organization as heavily as the US or withdrawn.

Why the US withdrawal is complicated

The formal withdrawal process of the US from the WHO is expected to take a year from its initial notification, which occurred on 7 July 2020. For the 2020 fiscal year, the US was assessed as owing the WHO USD 122.6 million. Despite contributing USD 57.9 million in January 2020, the US has decided to redistribute the remaining funds to other UN activities. However, a 1948 joint resolution of the US Congress stipulates that the US can only leave the WHO if it has fulfilled all financial obligations in full.

There also remains the issue of whether President Trump can unilaterally withdraw the US from the WHO. At present, the US Congress has the power to enact a joint resolution to extend the required withdrawal period beyond one year, or subject the withdrawal to congressional approval. This sets up a potential clash between the White House and Congress.

Alternatively, the President could reinstate the US’ membership to the WHO, something he has committed to do if the WHO adopts considerable reforms - such as distancing itself from Chinese influence. However, any reforms are unlikely to occur given the current global focus on the COVID-19 pandemic. By continuing with the withdrawal process, the US will find it increasingly difficult to influence any potential reforms. This creates something of a self-fulfilling prophecy, whereby US withdrawal from the WHO leaves a power vacuum in which others, namely China, can exercise increased power.

What impact will the US’ withdrawal have?

Ultimately, President Trump’s removal of USD 893 million or 15 percent of total WHO funding, will limit its ability to effectively operate. In the long term, the enormous funding hole left by the US cannot be filled easily. Amid a global recession, nations will be reluctant to increase voluntary contributions. Although the WHO’s COVID-19 response plan has been bolstered by a USD 2 billion pledge from Chinese President Xi Jinping, non-COVID-19 programs are suffering from a lack of funding.

The ramifications of President Trump’s actions will reverberate far beyond the US’ borders. Unable to maintain critical funding flows, the WHO will be forced to limit its provision of vital medicine to low-income countries and coordinate the flows of personal protective equipment and vaccine research. This could have drastic health consequences. For example, the redistribution of resources away from HIV/AIDS and tuberculosis treatments may see more than 500,000 additional people lose their lives in Sub-Saharan Africa from AIDs-related illnesses.

Further, non-cooperation with the WHO will see the US miss out on the critical flows of information and resources. This includes the WHO’s yearly aggregation of flu data to facilitate the development of life-saving vaccines every year. Given that 34,200 Americans died of influenza-related illness in 2018-19, a lack of access to this data could prove deadly for many Americans. In addition, by separating the US from crucial health research, President Trump is also eliminating the collaboration status of its chief public health institute, the Centre for Disease Control. This centre will not receive research compiled, or any final vaccine, produced under the COVID-19 Global Access (COVAX) initiative. This is an especially troubling revelation given the US exceeded 100,000 COVID-19 deaths in the same week Trump withdrew from the WHO, and now edges closer to 200,000 deaths.

As the 2020 federal election approaches, the US’ policy towards international institutions enters a crossroad. The re-election of President Trump could see a continuity of non-cooperation and force international institutions to either negotiate with the US or continue to develop new policies which circumvent the US. Should former Vice-President Joe Biden win, the international system could see a resurgence of support for international agreements given he intends to recommit the US to the WHO. However, regardless of the election outcome, President Trump has created a legacy of nationalist, non-cooperative foreign policy towards the WHO that it is unlikely to forget anytime soon.

Georgia Strong is the United States Fellow for Young Australians in International Affairs.