If ever there was any doubt about the ill-fated trajectory of current United States politics, the ploy by President Donald Trump to defund the World Health Organization (WHO) in the middle of the worst global pandemic of our lifetimes offers yet another dose of evidence.
The WHO, and the United Nations system to which the health body belongs, are far from perfect. Those of us working in health and humanitarian sectors across the developing world know full well the many colossal failures over its 75-year existence.
Many of the challenges faced by the UN system are institutional and systemic. And calls for UN reform are almost a permanent agenda item at the UN General Assembly.
But it is curious and important to note the move by the Trump administration, as well as the tone and approach it is taking in dealing with this world body. In defunding the WHO and calling for the resignation of its chief, Dr Tedros Adhanom Ghebreyesus, the US is displaying its privilege and illustrating yet another example of Western exceptionalism – where a problem is only paid attention to when it inconveniences or threatens certain lives.
Across the Global South, disease outbreaks, natural disasters, ongoing conflict and high poverty levels have meant that, for the most part, the UN system has been essential. In as much as individual countries through their governments are responsible for the health of their citizens, the WHO plays a critical part in coordinating the efforts of different actors.
A global pandemic warrants a global response and, as it stands, can only be coordinated by the WHO and other multilateral institutions.
In the case of the coronavirus pandemic – whilst the WHO continues to face criticism – it has in fact done well to provide global leadership and warn countries to prepare for what, only a few months ago, was an unknown disease.
Within four weeks of the first alert, the WHO had declared COVID-19 a public health emergency of international concern, and in less than three months it was declared a pandemic.
Compared to the previous inertia displayed by the WHO in other disease outbreaks, particularly in the developing world, the speed with which it moved for COVID-19 was commendable.
Deep flaws in the system
But the multilateral institutions governing global responses have always had deep flaws, and deserve criticism.
In Rwanda in 1994, the UN’s peacekeepers stood by as over 800,000 Tutsi were massacred in a genocide. The UN mission was mandated to keep the peace and even though it was clear that a genocide was happening in April 1994, the peacekeepers stood by as hundreds of thousands of people were killed, maimed, raped and tortured.
The UN later apologised for failing to protect the Rwandan people, but for those who lost loved ones, the apology by the Secretary-General was an empty one. No one was held accountable for this gross failure. And no one called for the defunding of the UN, either – even though almost a million people died.
From 2012, the UN in Myanmar downplayed human rights violations against the Rohingya community and ignored warning signs of a run-up to a genocide that commenced in August 2017. A UN-commissioned report by Gert Rosenthal concluded that the failure to act by the UN to stop the genocide was due to “systemic failures”.
This of course became a leeway through which individuals escaped accountability. As another independent analyst remarked about the UN response: “Dealing with UN officials during this period was like dealing with members of a dysfunctional rich family who despise each other.”
Indeed, they fiddled while Rome burned. Yet, again, no call was made to stop funding for any organisation, even though today almost one million Rohingya people have been forcibly displaced and are living in horrid conditions in refugee camps in Bangladesh.
In March 2014, the humanitarian organisation Doctors Without Borders (Medecins Sans Frontieres, or MSF) warned about an “unprecedented” Ebola outbreak in Guinea as a total of 80 cases were reported with some of them in the capital, Conakry. The WHO downplayed the outbreak, claiming that there was no need to panic.
In later evaluation reports, it was found that the slow-paced reaction of the WHO contributed to the failure to contain the outbreak, which infected over 28,000 people and killed more than 11,000 of them. Still, no one called for the defunding of the WHO.
In the case of coronavirus, if we accept – as we must – that every life matters, then the question about the WHO’s alleged failure deserves attention. But it is particularly concerning that at such a crucial time for global health, Trump chooses a route that is inward-looking and self-consumed at the expense of the greater good.
A call for reform
On the face of it, it appears that when the lives of people who are viewed as lacking agency are impacted by the failures of these multilateral institutions, it is regarded as an “occupational hazard”. But when the lives of those who “matter” are impacted, at least according to President Trump, real action must be taken.
But the question of what action is an important one. And as many of us who have worked within and around the system will agree, the answer is reform, not defunding.
The UN, like many other multilateral institutions including the International Monetary Fund and World Bank, continues to escape responsibility because of weak accountability mechanisms.
Calls for UN reform go back over two decades. But these calls for change have come from countries not represented in the Security Council, whereas the rich and powerful countries have repeatedly blocked any challenge to the power that they currently enjoy.
A reform process underpinned by global solidarity and recognition of the added value of other countries is long overdue.
The UN and other multilateral institutions cannot continue to be a replication of global economic and colonial power structures and expect to get away with it. If the UN fails to undergo this process, it will continue to be in a state of paralysis when confronted by crises.
If anything, COVID-19 has shown that more funding must be made available for global health and for building health systems – not less.
For us to return to life as we knew it, and be able to live as a global community, the reopening of travel and trade routes depends on all countries managing to contain this pandemic together. The WHO should continue to coordinate multiple actors and governments towards the control and containment of COVID-19.
The decision to stop funding the WHO at this critical time is therefore not only irrational, but also a threat to the very people the decision claims to protect.
COVID-19 has exposed the danger of ensuring access to health for only a certain part of society. It has shown that if only some people do not have access to adequate healthcare, then the collective is at risk.
With more than 800,000 coronavirus cases and climbing, the US should know that best of all.