On the day that the number of confirmed cases of Covid-19 in the US reached 600,000 and deaths topped 26,000, President Donald Trump announced that he would suspend funding to the World Health Organisation, alleging that it had severely mismanaged the coronavirus pandemic and accusing it of a “cover-up”. Trump said the WHO, which is leading the global response to the pandemic, “failed in its basic duty and must be held accountable”.

The announcement drew instant criticism from across the world and is widely seen as an attempt to shift attention from Trump’s own initial reluctance to take action against the pandemic — when other countries were already imposing strict restrictions and public health measures. It is also seen as a politically motivated retaliation for what Trump claims was WHO’s “pushing China’s misinformation about the virus”.

As reported in the New York Times, Trump claimed the WHO “willingly took China’s assurances at face value” and “pushed China’s misinformation”.

Asked by reporters at the White House Rose Garden briefing where he made the announcement why he was taking this decision at this particular time, Trump said the WHO was “China-centric” but did not explain what he meant by that, nor its relationship to the spread of Covid-19.

Though Trump accused the WHO of accepting China’s assurances that there was no human-to-human transmission delays in declaring a public health emergency and of delays in declaring a public health emergency, which he said “cost valuable time”, the facts do not confirm his assertions. A WHO tweet on 14 January – which formed the basis for Trump’s comments – reported that “preliminary investigations by the Chinese authorities have found no clear evidence of human-to-human transmission”.

As Britain’s The Guardian newspaper reported, the WHO warned the US and other countries from as early as 10 January about the risk of human-to-human transmission of the coronavirus, in technical guidance notes and in briefings by top WHO officials. These “made clear that there was a threat of catching the disease through water droplets and contaminated surfaces, based on the experience of earlier coronavirus outbreaks, such as SARS and MERS,” The Guardian said.

The WHO’s technical lead on Covid-19 told reporters on the same day as the tweet about China’s inconclusive preliminary results that the risk of human-to-human transmission should not be seen as “surprising”, given the two earlier coronavirus outbreaks.

The WHO guidance note from 11 January asked health officials and clinicians to be alert to the emergence of clusters of cases, The Guardian said, as well as “evidence of amplified or sustained human-to-human transmission”. By 23 January, WHO had officially warned of human-to-human transmission and that high transmissibility of Covid-19. Its guidance note was sent to WHO’s regional emergency directors and country heads, for circulation to national senior health officials.

“The documents add to a body of emerging evidence of the widespread early warnings about the coronavirus, many communicated by – and to – senior US officials, which were ignored by Trump,” The Guardian said.

In the meantime, WHO director-general Tedros Adhanom Ghebreyesus had begun to repeatedly and publicly warn countries that a small window of opportunity to stop the corononavirus was closing. After a week of issuing these warnings and urging precaution, on 30 January the WHO declared the spread of the SARS-CoV-2 virus a Public Health Emergency of International Concern.

By the end of February, news media reported that Trump was still minimising the coronavirus threat. Strict public health measures to try and contain the disease in the US were not in place and a failure by the Centers for Disease Control and Prevention to rapidly develop accurate diagnostic tests for Covid-19 delayed the rollout of widespread testing.

It was only in March that various forms of lockdown in states across the country began to be imposed, as the numbers of confirmed Covid-19 cases began to rise at a staggering rate.

The US contribution to the WHO represents around 10% of its annual $6-billion budget (based on 2019 figures), with the remainder made up by the 192 other member states. While the US administration can stop or suspend current payments to the WHO, long-term funding decisions by the US must be approved by the House and the Senate’s appropriations committees.

Trump had previously proposed massive cuts to the US’s global health funding, including that destined for the WHO, in its fiscal year 2021 budget proposal.

On 9 April, the US’s Committee on Oversight and Reform (the House of Representatives’ principal oversight committee) sent a letter to Tedros regarding its “ongoing investigation into the Chinese government’s role in exacerbating the Covid-19 pandemic, including its large-scale propaganda campaign”.

The letter said that “despite the WHO’s purported mission to operate as an apolitical international institution within the UN, recent media reports suggest that the WHO helped Beijing disseminate propaganda, downplayed the extent of the disease, and possibly delayed ordering a public health emergency. Given the actions and statements of WHO officials during the past few months, we are concerned that the WHO is no longer serving the needs of the world and is taking its cues from China.” (The letter went on to detail the alleged failings on the part of the WHO and request a staff-level briefing by the WHO no later than 16 April.)

Reaction

Though the WHO has been criticised before about its responses to previous pandemics, and has been criticised more generally as an organisation in need of reform, global leaders and influencers have pointed out that its role in leading the global response to Covid-19 is irreplaceable and that cutting its funding in the middle of a global pandemic is hugely damaging.

Billionaire philanthropist Bill Gates tweeted in response to the White House announcement: “Halting funding for the WHO during a world health crisis is as dangerous as it sounds. Their work is slowing the spread of Covid-19 and if that work is stopped no other organisation can replace them. The world needs @WHO now more than ever.” 

Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds. Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever.

— Bill Gates (@BillGates) April 15, 2020

UN secretary general Antonio Guterres said that once the world turned the page on this pandemic, lessons would be learned that “will be essential to effectively address similar challenges, as they may arise in the future”. But, he said, “now is not that time. It is also not the time to reduce the resources for the operations of the WHO or any other humanitarian organisation in the fight against the virus.”

In a tweet, Guterres emphasised that ongoing support of the WHO is “absolutely critical to the world’s efforts to win the war against Covid-19”.

The WHOS Tedros has previously urged countries not to politicise the fight against Covid-19.

In an online live briefing on 8 April, Tedros said: “The focus of all political parties should be to save their people … If you don’t want many more body bags, then you refrain from politicising it. My short message is: Please quarantine politicising Covid … It’s like playing with fire.” He has also urged the US and China to “come together and fight this dangerous enemy”.

Richard Horton, editor of leading medical journal The Lancet, on Twitter called Trump’s decision (or threat) to defund the WHO “a crime against humanity”.

Horton wrote: “Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity.” DM/MC

 Adèle Sulcas writes about global health and food systems. She has worked at the Global Fund to Fight AIDS, TB and Malaria and the World Health Organisation in Geneva. This article is reprinted from the Global Fund Observer.