Trump’s funding cut won’t fix WHO’s problems

By DAVID FICKLING 

GLOBAL health emergencies will be a fact of life in the 21st century. So, too, will be the World Health Organisation’s (WHO) chronic inability to rise to the occasion.

US President Donald Trump is hoping that the body’s failures in dealing with the Covid-19 pandemic can be corrected with punishment.

The US will halt payments to the WHO to hold it “accountable” for its failure to warn earlier of a public health emergency and recommend travel restrictions from China, he said on Tuesday in the US.

There’s a certain pot-kettle quality about a president who spent weeks declaring the pandemic was under control and likely to disappear naturally blaming others for a failure of leadership.

On top of that, there’s strong empirical backing for the view that travel bans are rarely enough to halt a pandemic — especially not ones that exempt most citizens from quarantine (citizens who had been in Hubei Province in the previous 14 days were obliged to enter quarantine under the US’ Jan 31 rules) — as in the US.

Analysis of virus genomes indicates that most of the key early cases in the New York area originated in Europe, not Asia.

Still, as my colleagues Therese Raphael and Adam Minter have written, criticisms of the WHO’s handling of the outbreak are justified. The trouble is, holding back funds in the middle of a global pandemic will only harm public health, without forcing any change to the organisation’s behaviour.

If it was money that talked in the WHO’s Geneva headquarters, no one would be complaining about Chinese influence. The country is notoriously stingy in its contributions to an organisation that gets three-quarters of its funding from voluntary donations.

The US$10.2 million (RM44.27 million) that China provides through this route is less than from Kuwait, Pakistan or the Democratic Republic of Congo. Even private donors such as Rotary International, the Wellcome Trust and the Bill & Melinda Gates Foundation give more. Almost all the money China contributes comes through its membership fees, which are assessed for each state based on its population and income, and make up just 17% of WHO revenue.

How, then, does Beijing manage to exert such influence in Geneva?

Part of it comes down to the way the WHO operates through regional and country offices. As defenders of the organisation have pointed out, it’s only able to work as a guest in countries where disease breaks out, and has few mechanisms to force compliance.

Governments far short of China’s international stature have nonetheless managed to cow the WHO: During the 2014 Ebola outbreak in West Africa, Guinea, Liberia and Sierra Leone caused the organisation to delay warnings about the epidemic until it was too late.

More important, though, are the subtle arts of diplomacy — stacking influential United Nations (UN) committees and organisations with allied countries and representatives, so that they’re simpatico with your views of the world, even if they’re not dependent on you for cash.

Beijing’s tight-fistedness at the WHO in some ways helps in this regard: Most of its spending to support public health overseas is provided directly to foreign countries instead, giving more opportunities

for demanding quid pro quos than if the funds were being consolidated through a multilateral body.

Western countries retained an outsize influence at the top of UN agencies, decades after the fall of colonialism. It’s welcome that trend has passed, but democracies’ slow-footedness in cultivating friends in the emerging world had until recently left the field wide open for China to establish its hegemony. There are signs this is finally changing.

Last month, the US threw its weight behind Singaporean Daren Tang to head the World Intellectual Property Organisation and won, beating off China’s favoured candidate. The same approach now needs to be taken across the board.

Withholding funds isn’t the way to achieve that end. We tend to look to the WHO for leadership precisely when it’s least equipped to deliver: During emergencies. At those moments, an organisation with the budget of an average city hospital (much of it locked down for long-term programmes like polio eradication) is expected to suddenly mobilise more effectively than entire governments.

A better approach for the US would be to work with other countries to raise the level of member contributions going to the WHO’s core budget, giving it the funds and operational flexibility it needs to respond in a crisis.

Much of the voluntary donations that currently go through Geneva for specified programmes could then be brought back into the bilateral arena, making the US not just a distant funder, but a partner to nations in the emerging world. That would be particularly beneficial in sub-Saharan Africa, where the triple plague of tuberculosis, HIV and malaria still accounts for a paltry 5% or so of WHO spending and where improved health would generate ample goodwill.

Trump isn’t wrong in diagnosing the WHO as sick. His mistake is in spurning a more holistic treatment. Doctors have long since given up bloodletting as a cure for disease. Diplomats need to take the same approach to funding. — Bloomberg

  • This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.