A child is immunized in Utter Pradesh, India. February 2007. Credit: Global Polio Eradication InitiativeThe Trump Administration’s Decision to Cut Ties With the World Health Organization Will Make the Coronavirus Pandemic Much Worse Mark Leon Goldberg May 29, 2020 By: Mark Leon Goldberg on May 29, 2020 UPDATE: On May 29, Donald Trump formally announced that the United States was cutting with the World Health Organization. This followed a letter he sent to Dr. Tedros one week prior, threatening such a move. That letter was rife with mistakes and falsehoods, including a claim that the WHO ignored a report from The Lancet about the coronavirus in December. No such report exists and the Lancet was forced to issue a statement calling out this lie. Freezing Funding For The World Health Organization The Trump administration is freezing United States funding to the World Health Organization. This will hurt the World Health Organization. But more importantly, it will harm the millions of people around the world who are served by the WHO’s day-today work, including children in poorer countries who rely on the WHO for vaccines, people in conflict and humanitarian crisis, and ordinary people who live in countries where the government works with the WHO improve its health system. This move will also undermine global efforts to contain covid-19 and mitigate its impact. Ultimately, this decision could cost the United States far more than the $400 million it spends through the WHO. The United States is the single largest funder of the World Health Organization, providing about $400 million of its budget each year. That money is not evenly disbursed across all of the WHO activities and operations. In fact, only about one third of the total US contributions to the WHO go to its regular budget as an assessed dues payment. The rest is contributed in the form of what is known as “voluntary contributions” which can be earmarked for specific causes. In the last two-year budget of the World Health Organization, the United States contributed about $893 million, over $650 million of which came as earmarked voluntary contributions. In other words, when the United States funds the WHO, it mostly funds the activities and causes the United States deems a priority. Of these, the single biggest priority has been polio eradication, for which the United States has spent over $158 million in the last two years. The next top priority has been increasing access to essential health and nutrition services in parts of the Middle East deep in humanitarian crisis, like Syria and Iraq, for which the United States contributed over $100 million over the last two years. And after that, the third top funding priority is for vaccine preventable illnesses, for which the US has spent over $40 million. Each of these spending priorities are important in their own right. The global fight towards polio eradication has been a world-historic achievement. Today, polio is endemic in only two countries, Pakistan and Afghanistan, with just a handful of cases reported this year. In the eastern Mediterranean region, the WHO supports the health of millions of refugees and others caught in crisis. And vaccines development and distribution is saving of children from dying before the age of five years old, including from illnesses like measles. But as important as these funding priorities are in their own right, they are also useful in the global fight against COVID-19. For example, when Ebola ravaged west African in 2013 and 2014, the largest country in the region, Nigeria, was largely spared — despite its sprawling cities and huge population. That is because Nigeria (which is the most recent country to rid itself of Polio) re-purposed its polio surveillance operations for Ebola. Thanks to the WHO-supported polio work, Nigeria has robust polio surveillance and management protocols, which it was able to tap to stop ebola. It is not a stretch to think that those same systems are now being harnessed to track covid-19 in much of the developing world. Similarly, supporting essential health services in Syria and Iraq are one way to ensure that vulnerable populations there are as protected as possible from covid-19, and that cases are dealt with. And finally, it is only through vaccines that covid-19 will be eradicated globally — and the WHO is the keeper of a global network of vaccine logistics and distribution. When a vaccine is developed, it will be through the WHO that this vaccine makes its way to every corner of the earth. Unless or until covid-19 is contained globally, it will remain a threat in the United States. The decision by the Trump administration to cut off funding for the WHO will have a devastating impact on the millions of people around the world who are served through the day-to-day work of the WHO, from childhood vaccinations to nutrition programs to the global eradication of polio and much more. It will also undermine the global effort to contain covid-19. Since the start of the crisis, the WHO has sought to prioritize pandemic preparedness in countries with little or limited capacity — countries where a small cluster of cases could quickly overwhelm the entire health system. This includes countries with very few ventilators, a small number of ICU beds, and not enough trained staff. In fact, the very same day that President Trump announced a hold of all funding to the World Health Organization, the WHO and and other UN agencies mounted a major airlift of covid-19 supplies like personal protective equipment to several countries in sub-Saharan Africa. This is part of a strategic response plan developed by the WHO to fight covid-19 in places that lack the capacity to do so on their own and require international support — places where billions of people live. At some point, the economy will need to open up — and that includes international trade and travel. The borders cannot remain shut forever. Even if the United States is able to do contact tracing and testing at a scale that will enable the country to slowly get back to normal, so long as the the global burden of covid-19 remains high, the United States will keep needing to play covid-19 whack-a-mole within its own borders. The cost of this will be enormous–likely much more expensive than the $400 million the US pays to the World Health Organization. This is what makes the decision by the Trump administration not just morally disasterous, but also incredibly myopic. Supporting the health of people in sub-saharan Africa or in refugee camps in the Middle East is central to stopping covid-19 everywhere. By cutting off funding to the WHO, the Trump administration has not only pulled a lifeline from some of the most vulnerable people on earth, but it has also jeopardized recovery here in the United States.