
Trump's WHO withdrawal could cost the US dearly
More ominously, at least 70 human cases of bird flu have been identified in the US, with one death reported in Louisiana. In a recent report about enhancing the response to H5N1 in America and globally, the Global Virus Network, a consortium of the world's top virologists, warned of 'the terrible consequences of underreacting to current threats'.
But while bird flu poses the most immediate risk to Americans, it is by no means the only one. Virulent infectious-disease outbreaks in other countries, such as mpox in the Democratic Republic of the Congo, Ebola in Uganda, Marburg in Tanzania, and multi-country outbreaks of cholera, do not respect borders, and thus are a threat to people everywhere – including in the US.
Without the efforts of the World Health Organization (WHO) to contain these outbreaks, the risk of wider transmission would be much greater. This underscores the need for a global agency like WHO to supervise cross-border cooperation – and the shortsightedness of President Donald Trump's decision to withdraw the US from the organisation.
Despite being the world's richest and most powerful country, America is not immune to another Covid-style calamity, and abandoning multilateralism and neglecting pandemic preparedness (such as the stockpiling of treatments and vaccines) will make it all the more vulnerable.
One might think that the deadly spread of Covid-19, prolonged by the emergence of new virus strains, would convince policymakers to strengthen the world's public-health architecture – especially as experts warn that future pandemics could be even worse.
But with other leaders indicating that they may follow Trump's example and leave WHO, the resources for pandemic prevention and control could dwindle to the point that global outbreaks become more frequent and difficult to overcome.
If Trump follows through with the move, his administration will become increasingly isolated and impotent. American officials, including at US military installations abroad, will lose access to WHO-led and -facilitated global networks that collect and share information about infectious-disease threats and respond to outbreaks.
Moreover, the US government will have no say in developing new solutions (which will almost invariably be less effective) for controlling the spread of diseases across borders – including its own.
Trump has suggested that he may change his mind, presumably if the grievances set out in his executive order to withdraw the US from the organisation are addressed. This implies that WHO should apply pressure on China to identify the pandemic's origins.
WHO director-general Tedros Adhanom Ghebreyesus, for his part, has refused to accept the Chinese government's prevarications. If Trump can propose a way to determine the cause of Covid-19, I am sure that WHO's leadership would gladly hear it.
Trump's second condition is that WHO undertakes reforms and uses its resources more effectively at the local level, with a greater focus on stopping the spread of infectious diseases. This is a demand that can and should be met.
To that end, Tedros has already promised more targeted use of funds and implemented other measures to transform the organisation. In addition, under Tedros, WHO has transformed the way it raises funds. Its member states have sharply increased their annual contributions, and it has diversified its donor base to share the funding load more widely.
This is all part of WHO's drive to be more sustainably financed, a plan launched as part of Tedros's effort to transform the organisation's operations after he took office in 2017.
Back then, he and member states assessed that the departure of a major donor could leave WHO's programmes and independence vulnerable to funding shocks. Who knew it would be the US. But, had those changes not been made, we can only imagine how much more challenging WHO's current financial situation would be.
The Trump administration should welcome these changes, not least because it benefits from having a seat at the table. If the US ultimately abandons WHO, developing evidence-based guidance and regulations for chronic-disease prevention and management will be significantly harder, undermining the administration's goal of addressing America's chronic-disease epidemic.
The US will also no longer be a part of WHO's medicine prequalification process, a programme that opens a host of new markets for drug producers in a cost-effective manner.
Instead, US pharmaceutical companies will be forced to sell their prequalified products to each country individually, putting them at risk of losing access to highly profitable multibillion-dollar markets.
Twenty-first-century trends – including more mobility and international travel, greater urbanisation, and increasing human encroachment on nature – fuel the global spread of infectious diseases, to the detriment of everyone.
US officials would be better positioned to protect their citizens if they joined – and perhaps even led – a discussion on how WHO and other global health organisations, such as Gavi, the Vaccine Alliance, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, can meet the world's needs.
One such initiative, in which the US had been a strong partner until Trump took office, was to negotiate a WHO Pandemic Agreement, which was adopted by consensus by WHO member states at the World Health Assembly on May 20.
This historic compact, based on the principles of equity, collaboration, and the reaffirmation of national sovereignty in public-health decision-making, will make the world safer from future pandemics.
The US, bolstered by its world-class medical professionals and substantial public investment in medical research, has long exerted considerable influence on global health priorities. But withdrawing from WHO places America on the outside, unable to shape the agency's policy agenda and reforms.
When the next pandemic strikes, the US will be left watching from the sidelines, as WHO and its remaining member countries manage the global response and pick up the pieces as they see fit.
Gordon Brown, a former prime minister of the UK, is UN special envoy for global education and chair of Education Cannot Wait.
The views expressed are those of the writer and do not necessarily reflect those of FMT.
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