11/17 Roundtable: WHO [Info Sheet]

World Health Organization Talking Points and Relevant Information

Compiled by: Luke Henkel, Markus Kempin, Margaret Edsey, Eri Hayakawa, TJ Rausch, Pooja Reddy, and Tyler Van Patten

Conservative Talking Points about the WHO

Official Briefing from President Trump regarding the WHO (White House official fact sheet):

1. The WHO has shown it was not prepared to prevent, detect, and respond to a severe infectious disease crisis like this.
2. The WHO lacks the structure to ensure accurate information and transparent data sharing from members, which makes it vulnerable to misinformation and political influence.
3. The United States seeks to refocus the WHO on fulfilling its core missions of preparedness, response, and stakeholder coordination.
4. The United States is also calling for reforms to promote transparency and data sharing, hold member states accountable for abiding by the International Health Regulations, increase access to medicines, and counter China’s outsized influence on the organization.

September 2020: Citing the WHO’s failures to implement requested reforms, the Trump administration announced it is

1. redirecting American funding for the WHO to other parts of the UN;
2. recalling American health experts from the WHO headquarters, regional offices, and country offices, reassigning them elsewhere;
3. limiting US participation in WHO technical meetings and events; and
4. fully withdrawing from the WHO on July 6, 2021.

In an official letter from Trump to Dr. Tedros, the Director-General of the WHO, Trump explains his reasoning (full letter here, more information in timeline below):

• The WHO mishandled the pandemic in a manner that cost very many lives:
  • The WHO ignored credible reports of the virus spreading in Wuhan in early December 2019 and failing to independently investigate the reports due to reliance on the Chinese government’s accounts
  • A lack of communication with the world after receiving information on Dec 30th that there was a “major public health” concern in Wuhan. 
  • Did not condemn or intervene when China destroyed samples of the virus, which deprived the world of life saving information. 
• The WHO’s relationship with China is unacceptable:
  • Dr. Zhang Yongzehn of the Shanghai Public Health Clinic Center told Chinese authorities he has sequenced the genome of the virus on Jan 5th, yet the virus was not available to the world until 6 days later when he himself posted it online. The WHO praised this as a great act of transparency, yet the Chinese government, one day after he posted the information, closed his clinic down for “rectification.” The WHO remained silent and did not intervene when the CCP closed down Dr. Zhang’s Clinic. 
  • Jan 28th: after meeting with President Xi Jinping, WHO praised China for its transparency and said it should be the “new standard for outbreak control” 
  • The WHO was unable to press China to allow entry of medical experts of the WHO until Feb 16, 2020. It also did not oppose China denying the entry of 2 American members of the team to access Wuhan. 
  • The WHO said that travel bans “caused more harm than good.” This delayed countries from imposing travel bans that could have helped limit the spread of the virus.
• The United States should not be funding an organization that is not effective at combating a global pandemic and that is lenient with Chinese misdeeds. 

Liberal Talking Points about the WHO

Senator Cory Booker on behalf of Senate Dems, 3 reasons why we should not exit the WHO:

1. The US should be cooperating with other countries and leading the fight, not running away from it; this is an international issue and withdrawing from the WHO both isolates the US and turns our back on the world.
2.  Withdrawal puts American lives at risk; isolating the US from other countries working to solve the problem may mean the US does not receive treatments or information as fast as we could.  
3. Withdrawal undermines the US’s status as a leader both on coronavirus and in the global arena; this empowers China and gives other countries a reason to look to China over the US. 

Joe Biden: “[I will] immediately restore our relationship with the World Health Organization on Day 1, which — while not perfect — is essential to coordinating a global response during a pandemic”

Opinion Piece from the NYT Editorial Board (Quick read, very direct and packed with arguments against withdrawal and proposals for other solutions) Main Points:

Key arguments against withdrawal:

• WHO does not improperly defer to China; it acts as it was designed to as a technical resource, not a regulator (and it was designed largely by the United States)
• “While the group has certainly made mistakes in its response to the coronavirus pandemic, those mistakes are a far cry from the dark and deliberate obfuscations that the administration has accused it of.”
• “Further siloing public health efforts will only add confusion and complexity to a crisis response that’s already desperate for better coordination.”
• “There are also some things that the United States cannot do on its own. It was only through the WHO, for example, that American scientists were able to visit China to see the country’s coronavirus response firsthand.”
• Defunding the WHO could be disastrous for efforts like eradicating polio, in which the US has already invested hundreds of millions of dollars.
• “Pulling out of the WHO also will severely limit the administration’s ability to influence international drug pricing regimes and vaccine distribution efforts, including for the coronavirus.”

Key proposals for improving the WHO:

• Giving the WHO “sticks to wield” to enforce its policy. For example, in exchange for openness about emerging disease threats, a country is guaranteed that other nations won’t cut off travel and trade. But, individual countries routinely violate the edicts that don’t suit them, and the WHO has almost no recourse when that happens.
• “The nations critical of the WHO might also consider investing more money, instead of less. The organization’s two-year budget of $4.85 billion is inadequate for the tasks it will face in that time. The United States currently covers roughly 15 percent of that budget. If the president is truly worried about China’s influence on the organization he should not leave such an easy spot for that country to step into.”
• Conclusion: “the United States and other member nations should try seeing the WHO for what it is: a reflection of the countries that created it and that wrote its bylaws. If they don’t like what they see, they should work to improve that reflection.”

Timeline of Actions from the WHO and the Trump Administration

December 31, 2019: WHO’s China office picked up a media statement by the Wuhan Municipal Health Commission on cases of “viral pneumonia” in Wuhan. That same day, Taiwanese officials sent emails to WHO asking for more information about “atypical pneumonia cases and patients who have been isolated”. These messages have been referred to as “early warnings about human-to-human transmission”, and although they did not provide any evidence that the disease was transmissible, they did question the validity of information from Beijing. WHO did not respond directly to the email.

January 5, 2020: WHO shared detailed information on the cases of pneumonia without a known cause, advising member states to take precautions to reduce the risk of acute respiratory infections.

January 9: WHO reported that Chinese authorities determined the outbreak was caused by a novel coronavirus.

January 11: The Chinese state media reported the first known death from the virus.

January 13: The first case outside of China was confirmed in Thailand.

January 14: WHO tweeted that there has been no clear evidence found of human-to-human transmission by the Chinese authorities.

January 20: The first American case was reported in Washington state.

January 21: President Xi Jinping allegedly pressured the WHO to not declare the coronavirus outbreak an emergency. The next day the WHO stated the coronavirus did not pose a Public Health Emergency of International Concern (PHEIC). 

January 23: The Chinese government locked down Wuhan after 17 people were dead and more than 570 were infected.

January 30: The Director-General reversed the decision of a week prior and declared the coronavirus outbreak a public health emergency of international concern (PHEIC), which is WHO’s highest level of alarm. He also stated that China should be “the new standard for outbreak control”. Read his brief statement here. (it’s interesting to read knowing what we know now)

January 31: The Trump administration suspended entry into the US for those who had traveled to China in the past 14 days who weren’t a US citizen, family of a US citizen, or a permanent resident.

February 3: The WHO faces pressure from China to reopen travel. Dr. Tedros says the spread of the virus outside China was “minimal and slow” and that “the chances of getting this going anywhere outside China (were) very low.”

February 5: The Diamond Princess cruise ship quarantined off the coast of Yokohama. After passengers were tested, officials reported on Feb. 13 that there were 218 cases on  board.

February 11-12: WHO convened Global Research and Innovation Forum on the novel coronavirus, which was attended in person by more than 300 experts and funders from 48 countries and 150 joining online.

February 14: The first COVID-19 death in Europe in Paris. Around 75,000 cases worldwide.

February 23: The number of confirmed COVID-19 cases in Italy explodes.

February 28: The first COVID-19 death in the US was confirmed in Seattle.

March 5: There is coordination between WHO, China and the US.  Trump proclaims, “It’s all going to work out. Everybody has to be calm. It’s all going to work out.”

March 7: WHO issued a consolidated package that categorized existing guidance into four different transmission scenarios: no cases, sporadic cases, clusters of cases, and community transmission. Death toll rose to around 3,500 and infected cases to 102,000 in more than 90 countries.

March 11: WHO characterized COVID-19 as a pandemic. The virus had killed more than 4,000 people and infected more than 100,000 people in 114 countries.

March 13: The director-general of WHO announced that Europe had become the pandemic’s epicenter. Trump declared a national emergency. 

March 15: Western European countries shut down nonessential businesses.

March 19: China reported no new local infections. Italy overtook China as the country with the most deaths.

March 20: Confirmed deaths exceeded 10,000 globally.

March 21: WHO published recommendations for laboratory testing strategy as countries face shortfalls in testing capacity.

March 26: Global cases surpassed 500,000.

March 27: US became the country with the most confirmed cases, with 82,000 cases.

March 30: WHO had shipped approximately 2 million items of PPE to 74 countries and was working with partners to increase access to life-saving products.

April 2: WHO reported that transmission from a presymptomatic case can occur citing evidence of transmission from symptomatic, presymptomatic and asymptomatic people infected. Cases surpassed the 1 million mark.

April 7: Trump disapproves of the WHO’s handling of the pandemic. He publicly critiques the WHO’s “China-centric approach”, especially its recommendation to maintain open borders with China. Trump states, “The WHO really blew it. For some reason, funded largely by the United States, yet very China-centric. We will be giving that a good look. Fortunately, I rejected their advice on keeping our borders open to China early on. Why did they give us such a faulty recommendation?”

April 8: In a briefing, Tedros comments against the politicization of the virus. 

April 13: Cases surpassed 2 million. The US had more than 600,000 total confirmed cases with over 25,000 dead.

April 14: Trump announces, “[His] administration to halt funding of the World Health Organization while a review is conducted to assess the World Health Organization’s role in severely mismanaging and covering up the spread of the coronavirus.”

April 15: WHO expresses regret over the halting of funding. 

May 18-19: The World Health Assembly is held virtually. Delegates adopted a resolution that asked Tedros to initiate an impartial, independent, and comprehensive evaluation of COVID-19 response. This resolution was co-sponsored by more than 130 nations, making it the largest number on record.

May 18: Trump sends an official letter to the WHO outlining its mismanagement of COVID-19, as well as its lack of autonomy from China. 

May 29: Trump makes public his intentions to “[terminate]” the U.S.’s relationship with the WHO and will be diverting funding from WHO projects. 

June 5: Tedros advised workers in clinical areas of a health facility to wear medical masks, and the general public to wear non-medical masks where physical distancing cannot be maintained and in areas of widespread transmission. 

July 6: The U.S. State Department formalizes its intent to withdraw from the WHO, which would go into effect in July 2021. 

July 15: Pompeo claims that the WHO facilitated China’s covering up of the pandemic. “When you have an incident in your country that could potentially lead to a pandemic, you have an obligation to report that and to allow others to come in and help you be transparent about it. The Chinese Communist Party chose differently. They co-opted the World Health Organization to achieve that cover-up,” states Mike Pompeo in an event with the Hill. 

July 23: Tedros rejects Pompeo’s comments from July 15th. The US passes 4 million total cases and 145,000 deaths.

August 6: The WHO asks the United States to reconsider its withdrawal from the WHO.

September 3: The State Department publicly announces on its website that the U.S. withdrawal from the WHO will go into effect on July 6, 2021 and its intentions to redirect funding to other UN assessments. 

September 19: US deaths surpassed 200,000.

October 2: President Trump announced that he and Melania tested positive for COVID-19.

November 10: 140,000 new cases and 1448 deaths in one day in the US. Total of 10.3 million cases and 240,000 deaths nationwide.

A Brief History of the World Health Organization

The World Health Organization (WHO) is the United Nations Agency responsible for matters of international public health. Its founding mission is “the attainment by all peoples of the highest possible level of health.”  It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide, and over 7000 staff from 194 member countries. 

Significant accomplishments include the eradication of smallpox, the near-eradication of polio, and the development of an Ebola vaccine. 

(chart from Axios)

Financing: The chart shows WHO funding by country. The whole WHO has a bi-annual budget of $4.5B. Assessed dues can be used however the organization wants; voluntary payments are normally earmarked for specific activities. Bill Gates’s charity provides about 9% of the organization’s funding. 

“Except for polio eradication activities, and for certain health emergencies, such as in areas affected by conflict in Yemen and South Sudan, WHO budgets are rarely spent directly on delivering health services or programmes. Instead, the money is mostly used to provide scientific and technical advice to governments.” 

– Great (bipartisan) article on where the WHO receives and spends its money here. Does a great job explaining their day-to-day activities.

The agency’s governing body is the World Health Assembly (WHA), which is composed of one representative from each member country. It also has a handful of observing members (from the Vatican, the Red Cross, etc), of which Taiwan was one from 2008-2016. It was not reinvited after Chinese pressure, and there is an ongoing attempt to re-include them. The WHA meets annually in May to determine the policies of the Organization, appoint the Director-General (5 year term), supervise financial policies, review and approve the proposed programme budget, and elect an Executive Board of 34 health specialists. 

“The WHO’s broad mandate includes advocating for universal healthcare, monitoring public health risks, coordinating responses to health emergencies, and promoting human health and well being. It provides technical assistance to countries, sets international health standards and guidelines, and collects data on global health issues through the World Health Survey. Its flagship publication, the World Health Report, provides expert assessments of global health topics and health statistics on all nations. The WHO also serves as a forum for summits and discussions on health issues.” –Wikipedia article on the WHO

Point is, the WHO’s activities are mostly centered around promoting international cooperation and providing a forum for discussing and sharing information. Aside from public statements, the WHO has no actual mechanisms to compel states to do anything specific; they can only provide recommendations.  Their power lies solely in giving advice, standard-setting, and research.

Regarding China: Here are two articles I found interesting that discuss China’s relationship with the WHO. New York Times article that is critical of the WHO and of China and Wired article that is defensive of the WHO but still calls for heavy scrutiny of Chinese influence.

The WHO’s investigation into the source of the virus has been subject to terms negotiated with the Chinese government. “Beijing approved a list of outside investigators. The WHO has agreed that key parts of the inquiry — about the first patients in China and the market’s role in the outbreak — will be led by Chinese scientists, according to documents obtained by The NYT. The documents, which have never been made public, show that W.H.O. experts will review and “augment, rather than duplicate,” studies undertaken by China.” It has not publicly disclosed the details of those negotiations. – Above NYT

“Mara Pillinger of Georgetown University’s O’Neill Institute for National and Global Health Law told the Washington Post, it is ‘politically tricky for WHO to publicly contradict or go around the Chinese government, because WHO needs to do everything it can to encourage stronger cooperation from China.’”   – Wired piece (from a liberal who accuses the WHO of being too biased towards China)