US Gives Formal Notice On Withdrawal From WHO – Critics Say It Leaves America ‘Sick And Alone’
Donald Trump gives a speech in Arizona, the state with one of the fastest rising coronavirus caseloads in the US, on 23 June 2020.

BREAKING – The United States on Tuesday gave formal notice to the United Nations and the US Congress that it intends to withdraw from the World Health Organization as of  6 July 2021, following President Donald Trump’s announcement after the World Health Assembly on 18 May.

The administration first notified the United Nations, and sent letter to Congress shortly after. Although some senior legal experts have said the move would still require Congressional approval, others have said the question remains “murky”.

“Congress received notification that POTUS officially withdrew the U.S. from the @WHO in the midst of a pandemic,” said US Senator Bob Menendez in a Tweet. “To call Trump’s response to COVID chaotic & incoherent doesn’t do it justice. This won’t protect American lives or interests—it leaves Americans sick & America alone.”

The move was quickly denounced by political leaders and public health experts.

“US withdrawal from WHO is a setback for international cooperation. Global infection dynamics show that coordinated action is required. We need more international cooperation to fight pandemics, not less,” Jens Spahn, Germany’s Minister of Health, tweeted. Spahn added that European states were looking to “initiate WHO reforms.”

“The president of the United States does not represent the interests of the United States nor the world. He only represents his own personal and political interests. This appeases his base. That is all,” said Howard Forman, a professor of public health at Yale University.

Trump had previously said that he was withdrawing from WHO due to its alleged “China-centric” bias in its responses to the COVID-19 pandemic, as well as its failure to recommend stiff measures such as travel bans, in the early days of the virus’ spread.  But political analysts said that the real motive was to divert attention from the administration’s own botched coronavirus response, leading the US to claim the unenviable title as the country with the most COVID-19 cases and deaths in the world.

It’s Unclear Whether Trump Requires Congressional Approval To Withdraw From The WHO
The United States Capitol Building, seat of the US Congress (Photo: Daniel Mennerich)

If, indeed, the move turns out to require Congressional approval, as some senior legal experts contend, then the withdrawal process could be tied up for many more months in controversy, leading up to the US Presidential elections in November.

Lawrence Gostin, director of the O’Neill Center at Georgetown University School of Law, called the move “unlawful & dangerous” in a tweet from May, when Trump first expressed intentions to withdraw from the WHO.

“Let’s start w/ fact that Secretary of State Mike Pompeo sent [the withdrawal] letter to the UN without first notifying WHO or Congress. They weren’t informed until a day later. No press briefing or media scrutiny. This lack of transparency & accountability is exactly the unfounded charge the President of the US made against Dr Tedros,” Gostin tweeted in recent reaction to the official withdrawal announcement.

“Trump cannot unilaterally withdraw from WHO without Congress,” Gostin further tweeted.

“The US entered WHO under a Joint Congressional resolution. [The president] cannot withdraw without consent of Congress. US also owes all past & current WHO dues through July 2021,” Gostin added.

Gostin, along with 749 other experts in global health law, US Constitutional law, and international relations had submitted a letter to Congress detailing that under the US Constitution’s “mirror principle,” the same process used to ratify an international treaty must be used to withdraw from it. Therefore, because Congress had approved the treaty to join the WHO, it must also approve a withdrawal from the agency.

However, other legal experts say the situation is more unclear.

“Legally it’s murky if the President can withdraw. While [the executive branch] has power to sign treaties, ratification follows advice & consent of Senate. Some argue [the executive branch] thus retains power to exit treaties – Others argue it requires Congress consent,” Alexandra Phelan, global health policy expert at Georgetown Law tweeted.

“Politics likely matter more,” she added.

Impacts on the WHO Operations – Funding and Morale
WHO Director-General Dr Tedros Adhanom Ghebreyesus delivers the closing speech for the World Health Assembly

While the US move cuts off a major source of funding to the Geneva-based Organization, particularly for African emergency disease control activities where much of US funds were traditionally directed, in fact the Trump administration had already begun to close the tap earlier this year. Funding for 2020 was only expected to be about one-half of the estimated US$ 553 milllion contributed in 2019.

Fortunately for the Geneva-based headquarters, Germany last month stepped up to the bat with an unprecedented commitment of € 500 million (US$ 561 million) just last month.  However, WHO’s America’s Regional Office, which operates as an independent legal entity, under the name of the Pan American Health Organization (PAHO), remains in dire financial states – with its budget entirely separate from Geneva’s and heavily dependent on funds from Washington as well as Brazil, another big donor.

While WHO insiders say that the United States appears poised to remain part of the PAHO regional office based in Washington DC, and therefore may eventually resume that line of financial support, monies are likely to come with many strings attached. Potentially, that could translate into demands that the fiercely independent PAHO administration treads more in line with US policies on issues ranging from the treatment of rival states such as Cuba and Venezuela, to controversial US positions on access to sexual and reproductive health services.

Meanwhile, other big countries such as Brazil, today the world’s second-largest centre of the COVID-19 outbreak, are also in arrears on payments, exacerbating PAHO’s financial woes.

The situation in PAHO is so dire that a number of the organization’s senior technical advisors took the highly unusual step of publishing a letter about the crisis in The Lancet.

The letter, entitled Financial Crisis at PAHO in the Time of COVID-19: a Call for Action, said, “Due to non-payment of Member States’ contributions, PAHO stands on the brink of insolvency…Health security in the western hemisphere would be severely threatened without a functioning PAHO. Reserve funds will be exhausted by September, 2020.”

Most of the non-payments, the letter says, are attributable to the United States, which accounts for 67% of missed or late payments to PAHO. Along with Brazil, Venezuela, Mexico, Argentina, Colombia, Chile, and others also have late payments totaling US$164·6 million.

 

Image Credits: WHO / Antoine Tardy, Gage Skidmore, Daniel Mennerich.