“President Trump is trying to downsize the WHO, and the question is whether other high-income nations like those in Europe, Australia, Japan, and elsewhere, pick up some of the slack,” says Vermund. “Will the Gates Foundation, which has been a very generous donor, pick up some? It’s conceivable that others will tide things over until we have a new administration that might be more friendly to the WHO, but I’m dubious that they can pick up the entire chunk of the WHO budget which is paid for by the US.”
And it isn’t just money that the US provides to the WHO, but staff and expertise too. “The Centers for Disease Control and Prevention has seconded a number of staff to the WHO, and I would predict that the Trump administration, with a new CDC director, will call those folks home,” says Vermund. “That would create quite a gap, because WHO funds do not pay for those individuals. So I think you’d have an almost immediate reduction of workforce and removal of critical professionals within the WHO organization.”
According to Gostin, a lot of the money the US provides to the WHO is core mandatory funding, which all members are required to give, but some funds are particularly earmarked for causes in which the US has a vested interest, such as polio eradication, HIV/AIDS, and the process of identifying and controlling disease outbreaks before they spread and reach American shores. Without US funding, Gostin says that these programs wouldn’t completely disappear, but they would be significantly weakened.
“Polio could come surging back,” says Gostin. “Remember we had polio in the wastewater in New York just a couple of years ago, and our kids are not being immunized. And we’ve had other real health scares in the United States, not just Covid-19, which killed more than a million people. We’ve had Zika, and the next health emergency might be just a mutation or two away. Maybe it’s already here in the form of avian influenza, and we’re going to need WHO to help us with that.”
Both Gostin and Vermund fear that withdrawing from the WHO will place the US at the back of the line when it comes to receiving critical information such as pathogen samples and genomic sequencing data, which pharmaceutical companies require to generate effective vaccines. Gostin cites how the US relies on WHO data every year to effectively update the seasonal influenza vaccine, while Vermund explains that financially speaking, it is far more efficient for the US to fund the WHO to help “snuff out” diseases at their source, rather than trying to tackle them when they arrive in the country.
“We spent over $2 billion preparing for Ebola to hit US shores in 2014 and 2015, and since we only had five or six cases, that was very cost-ineffective,” says Vermund. “So that’s a typical example of how when the US goes it alone, it will be very inefficient compared with contributing to a multinational response to control a disease in the country of origin.”
