Hours after taking office Jan. 20, President Donald Trump signed 26 executive orders, including a formal withdrawal from the World Health Organization.
In the executive order, Trump cited the global organization’s “mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.” He also noted that “the WHO continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments.”
During his first term in office, Trump tried unsuccessfully to pull out of the WHO in 2020, amidst the Covid-19 pandemic.
‘Viruses Don’t Need a Passport’
The World Health Organization is a collaboration of 197 countries. The US pays roughly 1/5th of the WHO’s total annual budget: last year, the US contribution to WHO was almost $1.3 billion.
“We Americans participate in the World Health Organization for two reasons,” said Dr. William Schaffner, professor of medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine, in Nashville, Tennessee. “One is our humanitarian instincts. We wish to reach out and help the less served,” he said in a Jan. 22 interview with Ethnic Media Services.
“But the other is in our own self interest. What’s over there can quickly be over here. The more we are engaged with the world’s community, we have a better and earlier sense of what’s over there, and we can prepare ourselves.”
“By not being associated with the World Health Organization, we will get the word last,” said Schaffner. “And the viruses out there don’t need a passport.”
Excerpts from the interview:
EMS: Dr. Schaffner, could you broadly state the importance of the World Health Organization and what it contributes to the global health community?
Dr. Schaffner: The World Health Organization is an extraordinary institution. It was founded back in 1948, in association with the United Nations, and it is now 77 years of age. What it does is bring the world’s countries together, in order to improve the health of the people of the world.
Certainly with infectious diseases, this is very evident. It has been so very important in eliminating smallpox from the world. We’re on the verge of eliminating polio. We’ve profoundly reduced the occurrence of polio. We’ve helped the countries of the world deal with HIV, Ebola, Zika, and most recently, of course, Covid. And now the threat of bird flu.
“People work together, share information about what’s happening regarding infectious diseases around the world, share specimens, share training, share expertise. This is a way that our global village works together.
So what were you feeling when you heard the news about the US pullout from WHO?
Well, there’s certainly a great sense of disappointment, and a puzzlement of why we would wish to do this because of all the benefits that accrue from working with the World health Organization.
I fear we will be less tuned in to what is happening around the world. We won’t be able to participate as effectively in guiding responses to, for example, bird flu, which is on the agenda of all of us in public health at the present time.
It’s so much better to be internal, working with everyone rather than outside.
This puts us in an isolationist position in terms of global public health?
Yes, we are in a more isolated position. You can put up walls, but the viruses don’t care.
How do we continue to engage with the global health community following this pullout?
All of us have colleagues abroad. We will be using our informal networks, our organizations, our professional and public health organizations will be working with public health organizations, nonetheless. But it won’t be within that formal structure of the World Health Organization.
And you know, there’s something very important out there that’s called white coat diplomacy, a way to make friends with people around the world, enhance the health of their own populations that goes to their hearts as well as their minds.
That is the way the US has always helped other countries. Reach out with a helping hand rather than with a fist, and you’ll have allies that are clearly aligned with you. So that’s in our self-interest.
Do you expect to see outbreaks of the illnesses you mentioned earlier because of a lack of funding?
Well, you know, we are responsible for, roughly speaking, about a 5th of the funding of the World Health Organization, and unless they can now make that up by contributions from other organizations, their activities will have to diminish. They will have to reduce programs, and let people go, because that would be a large diminution in their budget.
And so I would anticipate that the world’s health circumstances will not be bettered by our leaving the WHO.
Are we sufficiently prepared to tackle the next pandemic, which looks to be avian flu?
Should the bird flu virus acquire the genetic capacity to spread readily from person to person, then we would see essentially the entire world’s population newly susceptible to this new version of influenza. And that would be a pandemic.
A pandemic is an epidemic that involves the entire world’s population. It would take a couple of years for this virus to circulate around the world, and it would cause an enormous amount of illness, hospitalizations, and deaths, I’m afraid. So that would provide the next challenge.
Yes, we’re better prepared. But I wonder whether we’ve learned all the lessons we should have from the Covid-19 pandemic? One of the things that would concern me is withdrawing from the World Health Organization.
The world’s medical and public health communities continue to be devoted to bettering the health of the people of the world. And I think we ought to continue to join in that effort. We have a history of triumph and advances that extend back over the 77 years of the World Health Organization’s existence. And we can carry that tradition on into the future to make sure that our children and grandchildren and their children have a healthier, and as a consequence, happier and more productive life.
