World Health Organization, the abandonment of the USA and the effects on low-income countries

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ROME – Donald Trump has definitively left the World Health Organization (WHO). With one of his coup de theater, gave the news during the press conference on Friday afternoon, the occasion for other bombastic announcements built artfully by the President of the United States to draw upon himself the attention of a country prostrated by the deaths due to the pandemic, kneeling for unemployment, injured by yet another public killing of an African American citizen: George Floyd, brutally suffocated by a policeman in Minneapolis. Once again in the throes of the racial crisis, America is on the verge of a dangerous escalation of social tension, which according to accredited analysts is a prelude to the start of a civil war. The parable of attacks on the WHO. Unprecedented is this parable of attacks against the WHO, in the midst of the most serious pandemic crisis of globalization. Unprecedented are the threats addressed to Beijing on the basis of accusations ranging from industrial espionage in the pharmaceutical field, to the illegitimate Chinese claim of some islands in the Pacific Ocean, to finally arrive at the recent approval of the Chinese authorities of the security law, in response to yet another wave of Hong Kong protests. At the press conference Donald Trump said he “terminated the relationship with the WHO”, due to the lack of reforms on the coronavirus due to the fact that China, the country that “with its wrongdoings has produced global suffering from many deaths and deep wounds to the economy of the globe “, in his opinion” has total control over the agency “.
A turning point. We are at a turning point in the geopolitical crisis triggered by the new coronavirus that has transformed the United Nations agency for health into the scapegoat of the new commercial, health and technological hegemony cold war between the United States and China. A twist that in recent weeks has resulted in the paralysis of the entire UN system – the US has blocked a Security Council resolution for the global ceasefire aimed at promoting the containment of contagion in conflict scenarios, due to a reference to the role of the WHO in interventions against the pandemic.Disengagement in the fight against diseases in the southern hemisphere. On April 14, the Trump administration had already decreed a first freeze on the disbursement of funds to the WHO, attracting many and harsh criticisms from the experts. Richard Orton, editorial director of the prestigious magazine The Lancet, had reacted to the suspension of the funds with a punctual reconstruction of the events in the very early stages of the epidemic in Wuhan, which sent back to the sender all the speculations relating to a treacherous silence of the WHO on the outbreak of the epidemic – an exercise that replicates the New York Times in these hours. Much tougher had been the reaction of a consistent representation of the international health community, which was always on The Lancet had branded Trump’s decision “a crime against humanity”, in consideration of the significant American commitment to the fight against important diseases in the countries of the world – polio, HIV, malaria and tuberculosis, but also maternal and child health and vaccination.

Nothing has affected the presidential strategy. Donald Trump was the only world leader to desert the first World Health Assembly online on 19 and 20 May, also historic for the level of representation of the international community. The presence of the United States made itself felt in Trump’s extremely harsh accusations against the WHO director general, Tedros Adhanom Ghebreyesus, in a letter of 18 May in which the WHO was granted 30 days to change its pace, requiring much “significant ”As unspecified improvements. By denying himself, after only ten days, Trump cuts bridges with Geneva.

A unilateral gesture of dubious constitutionality. “It cannot go away like this, for personal habit, without going through Congress” – says Professor Lawrence O. Gostin of Law Center of Georgetown University – and is of dubious realization, given one of the conditions for leaving the WHO is to have paid off the past debts with the organization, as sanctioned by the American Senate in the 1940s “.

A retreat that announces others. This withdrawal, however, stands in line with previous Washington’s unilateral withdrawals from international agreements – the latest, in order of time, the treaty on the surveillance of the skies (Open Skies Surveillance Treaty) – and could prepare other futures: we are talking about NATO and Wto. The funds disbursed to the WHO – 553 million dollars in 2019, almost 15% of the organization’s budget – will henceforth be destined for “other urgent global public health needs that deserve funding”. We also know that Trump is working with the Secretariat of State to create an international health agency, an alternative to the WHO.

A singular coincidence. Ironically, the US leaves the WHO on the day the Organization launched the Solidarity Call to Action, the mobilization of solidarity to declare the response to Covid19 a global common good, together with 37 member states. This initiative embraces the contextual establishment of a pool scientific knowledge on a voluntary basis – patents, clinical data, regulatory procedures, etc. – to be pooled to facilitate and speed up the discovery and production of new remedies against SARS-CoV-2.

Towards the production of common goods. This is a significant sign of exemption from intellectual property and an unquestionable improvement in the agency’s operational vision, with a view to public health. A vision of international cooperation in the sign of the production of common goods, which does not correspond in the self-sufficient management of the health crisis in the United States, the result of a surprising mix of denials, approximation, isolationism, unpreparedness, irresponsibility. The result so far is the count of 100,000 deaths and the daily infection of about 20,000 people.

Trump’s “sirens” and seductions in the press. In addition to the news, some reflections need to be made, also because I have found that Trump’s argumentative siren against China has also produced seductive effects in the Itaia on the press and on some intellectual circles not very familiar with the dynamics of health and the United Nations. The WHO director general, denying the notion of one of his slavish dependence on China syndrome, argues that if the WHO is to be accused of something, its fault is in the event that it was in the past American-centric (“US-centric“).

Yet the USA played an important role. In fact, the United States was instrumental in creating the WHO in 1948: the Rockefeller Foundation has played a decisive role in the organization’s conceptual and institutional approach. The United States has also always been the agency’s top financers, followed by the Bill and Melinda Gates Foundation, Germany, Gavi (the Bill Gates-funded vaccine initiative) and Great Britain. China accounts for 0.21% of the WHO budget, in a very remote and traditionally not very active position in the dynamics of multilateralism.

The blow to the health programs of poor countries. In addition to hitting the heart of decisive health programs in low and middle income countries, Trump’s withdrawal from the WHO risks having very negative implications also in America, as Senator Lamar Alexander, president of the Health Commission explains in a statement: “the withdrawal from the agency could interfere with clinical trials that are essential to the development of vaccines, needed by US citizens as well as everyone else. ” Furthermore, the abandonment of the WHO complicates collaborations with other countries to stop the infection and obtain vaccines.

How that emptiness will be filled. American philanthropy – in addition to Bill Gates, the Bloomberg Foundation is Rotary International, together with UN Foundation by Ted Turner – exercises significant influence over the Agency; it will be a question of how it will be able to mediate the vacuum that will come about, also in terms of US personnel present within the WHO. With Covid19, China has discovered multilateralism and the importance of health diplomacy to count in the world. A vision that leader Xi Jinping has framed in the centrality of the WHO and in the role that China intends to play with two billion dollars of investment, for the construction of a pandemic operating hub, with the supply of medical devices and solidarity trade routes with at least 30 African countries. Trump’s retreat leaves Beijing with no scope for action. If Trump’s Chinese prophecy comes true, the president will only have to thank himself.

* Nicoletta Dentico, journalist expert in global health, led the campaign to ban anti-personnel mines in Italy and promoted the campaign for the cancellation of the debt of poor countries. As director of Médecins Sans Frontières she launched action in Italy for access to essential medicines. He has collaborated with WHO and several international organizations. He is responsible for the global health program of the Society for International Development (SID).



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