TRANSCRIPT
TRUMP: "What is this one?"
AIDE: "Withdrawing from the World Health Organisation, sir."
TRUMP: "Oooh, that's a big one.”
That's newly sworn-in US President Donald Trump, signing an executive order that will take the United States out of the WHO.
The agency's spokesperson Tarik Jasarevic says the group does important work.
“WHO plays a crucial role in protecting the health and security of the world's people, including Americans, by addressing the root causes of disease, building stronger health systems, and detecting, preventing and responding to health emergencies, including disease outbreaks and often in dangerous places where others cannot go.”
But Mr Trump maintains the Organisation fails to act independently from the political influence of member states, and has required payments from the U-S disproportionate to the sums provided by other large countries, such as China.
“And when Biden came back, they came back for 500 million. He knew that you had to come back for 39 million. They wanted us back so badly. So we'll see what happens. Pretty sad though, think of it. China pays 39 million and we pay 500 million, and China's a bigger country.”
The WHO hopes he changes his mind, as do others in the international community, like European Union Commission spokesperson Eva Hrncirova..
“We see with concerns the announcement to withdraw from the WHO (World Health) Organization by the United States, and we trust that the U.S. administration will consider all this ahead of the formal withdrawal.”
But Mr Trump's mind appears to be firmly made up, based on his history.
The President first announced he was taking the US out of the WHO near the end of his first term in 2020, just months after the US declared the COVID pandemic to be a national crisis.
NEWS REPORT: "Breaking news tonight: President Donald Trump declaring COVID a national emergency.”
At the time of the 2020 withdrawal, President Trump claimed the agency hadn't done enough to trace the origins of the virus in China, something the agency vigorously denied.
That initial withdrawal was also widely panned by critics - including University of California professor Paula Braveman in a DW News interview - who felt it was designed to redirect attention away from his own failures to address the crisis.
“Really what many of us think that he is trying to do with this is he's looking for a scapegoat, to hide his own incompetence, his dereliction of duty.”
President Joe Biden reversed the order before it could take effect after winning the November 2020 election - but now Donald Trump is back, some say history is repeating itself.
Lawrence Gostin is a public health law professor at Georgetown University and the director of the WHO's Collaborating Centre on Global Health Law.
“I think part of it of course is just populism. And he's just against institutions writ large, and what he sees to be elitist institutions in Geneva.”
But if Mr Trump is playing to his local political base and fulfilling long cherished conservative ideas, Professor Gostin and other experts say there are global implications - namely for the world's ability to fight disease.
Scientists are worried it could mean a roll back on decades of gains on diseases like malaria, tuberculosis, and AIDS - and unnecessarily complicate plans to prepare for the next big pandemic.
Negotiations on a draft accord to handle pandemic prevention, preparedness and response have been underway for some time in Geneva - and if the withdrawal is formalised, Lawrence Gostin says the United States will no longer be a part of those talks.
“I think that's a grave strategic error. That treaty is about preparedness, early warning, response, equitable allocation of vaccines and therapeutics, and also about one health, a so-called interchange between animal health, climate change, and human health. The United States needs to be at the table while global rules are formed. By walking away and taking away all of our marbles we're on the outside looking in, and the treaty won't reflect our interests and our values. We're much better off being there, getting the kind of access to scientific information that we need for our pharmaceutical companies, our public health agencies, and for global solidarity.”
All of this is made possible through the WHO budget - which the US's withdrawal will create a major hole in.
The agency receives money from its 194 member states, plus non governmental organisations and other donors - but the US is by far its biggest backer, contributing around 18 percent of its overall funding.**
Terry Slevin is the CEO of Australia's Public Health Association.
He says without a new plan, the pain of US induced budget cuts could show up in lower income countries the most.
“It'll have to very much focus on specific high order priorities and some of the middle order priorities won't get done. That's the reality of any budget cut to any organisation... Low income countries that don't have the capacity to do a lot of that policy development work, that rely upon the international agency for advice - particularly around emergencies and the like - so to some extent the WHO does and should play a role of providing support to low income countries that have lesser health capacity.”
The Associate Professor says there could also be local impacts within America.
He says the US health system is already under strain - and it can't afford to isolate itself.
“The simple truth is the American health system is not an efficient one. Americans spend far more per head of population on health than any other country in the world, but they don't get the same kind of outcomes of countries that have more efficient health systems. The reason for that is healthcare is very expensive and largely available to the rich. And the rich get very good healthcare. But the poor in the US don't get anything like the same access to healthcare, so as a population have a lower life expectancy than many, many countries in the world that don't have as much money as the US.”
Lawrence Gostin shares that concern.
“Trump seems to think that this is like immigration - you can seal off the American border. But the truth is that you can't seal off a border against a pathogen. The United States is a major transport hub in the world; any virus can be here within 24 to 48 hours. We need the world and we need WHO collaboration desperately... The United States is used to being at the front of the line for lifesaving medical tools. We might found ourselves at the back of the line when we don't have access to crucial scientific information.”
For Professor Gostin, there will also be implications for the US in terms of its foreign policy with China - which to date has focused on countering Beijing's influence, especially in the Indo Pacific.
“I've worked at WHO for nearly 40 years and I can tell you, the US has been a far more influential member of WHO than China ever has. But the irony is that China might become a leader and have greater influence with the United States gone.”
If the executive order isn't rescinded, the U-S withdrawal from the World Health Organisation will take effect in 12 months' time.
The clock starts ticking once the UN has been formally notified.
But assuming it goes into effect, WHO spokesperson Tarik Jasarevic says they're already trying to work out a way forward.
“We need really to look into it, what are the implications - but we will continue our work in trying really to get that funding that we need.”
** NOTE: After the US, the biggest contributors are Germany [$856 million], the Bill and Melinda Gates Foundation [$830 million], the Gavi vaccine alliance [$481 million] and the European Commission [$468 million].
