By Ben Goldson
Once capable of taking a leading role in the fight against disease, the World Health Organization has struggled to replicate its early successes in recent decades, including in its response to the ongoing COVID-19 pandemic.
Earlier this year, following rising tensions of their handling of the COVID-19 pandemic, the World Health Organization (WHO) lost its largest single donor, the United States of America. Announced by President Donald Trump, the move will deprive the longtime agency of the United Nations of more than a tenth of its budget. Although Trump has justified his decision by claiming the WHO is in the pocket of China, it is hard to see how this will do anything other than push the international body further towards the People’s Republic, and toward privately-owned philanthropic groups such as the Gates Foundation. The USA’s pulling out of the WHO is likely to hasten the ongoing decline of an organisation that was once able to take the lead in disease prevention.
While Trump’s decision is unlikely to actually help Americans at risk of contracting COVID-19, it does tap into established tropes within his base. These have existed since the creation of the WHO itself, under the leadership of Canadian educational psychologist Brock Chisholm, who attracted controversy in this period of existing suspicion towards the internationalism of the wider United Nations project. Chisholm, a Yale alumnus, became briefly notorious while head of the WHO, with critics pointing to his public statements on preventing parents from passing on their beliefs to children, particularly his apparent crusade against the story of Santa Claus.
Although Chisholm’s star soon waned after he stepped down in 1953, the WHO itself would retain a key place in the conspiracy theories of conservative America, limiting the scope of the new international body. That being said, the WHO was still able to score a number of wins in the early years of the liberal optimism which followed World War Two. Despite the claims of its detractors, the WHO relied heavily on the United States for its funding, part of a charm offensive against the Soviet Union, so there was a determination to make a success of it. Along with containing a major outbreak of cholera in the Asia-Pacific region, and a surge in cases of yellow fever in Africa, a key target of the WHO in the first decades of its existence was the smallpox virus. The push took place after the body’s pan-American branch was successful in its own eradication programme during the early 1950s, with Victor Zhdanov, Deputy Health Minister of the Soviet Union, calling for these efforts to be extended around the world. As a result, Resolution WHA11.54 was passed in 1959, committing the WHO to wiping smallpox off the face of the earth.
By 1980, victory was declared over smallpox, arguably the body’s greatest triumph to date, having come at the apparent cost of a reputation for high salaries and inefficiency. Over the following years, subsequent activities would be restricted by changes to its funding model, which had initially been reliant on mandatory “assessed contributions” from member nations that could be increased at the discretion of WHO bureaucrats. Following the reforms of the late 20th century however, these contributions are now pegged to inflation, or an increase in an individual country’s wealth and population, with voluntary contributions by member nations largely unforthcoming.
Instead, privately-owned philanthropic groups have attempted to fill the gap, leading to concerns about potential conflicts of interest hurting its mission to promote health for all. Compared to its campaign against smallpox for example, a more recent push to rid the world of polio remains incomplete. Launched in 1988 with the partnership of the United Nations Children’s Fund (UNICEF) and the Rotary International, the end date was initially projected to be the year 2000 before being repeatedly pushed back as it became apparent that this was unachievable. Although the programme has seen great reductions in cases, with the WHO judging itself to be 99% complete in its goal of total eradication, the virus lingers on, particularly in Pakistan, while the necessity of dealing with COVID-19 has displaced polio as an immediate concern. Also mixed have been the results of the WHO’s fight against Malaria, with a decline of cases in the early 2010s stagnating as the decade went on. Most associated with the Bill and Melinda Gates Foundation, the programme has been accused of allowing the billionaire donors behind the philanthropic titan to influence the adoption of policies which prioritise the private sector in healthcare provision.
While it is too much to blame the current pandemic on the WHO, it is hard to imagine that COVID-19 would have proven to be such a challenge in the early years of the body’s existence, before the reforms of the later 20th century. Instead, the WHO is struggling to have any impact on the global response to COVID, which has been left to an already squabbling international community to deal with in a piecemeal and inconsistent manner that reflects the abilities of a given government. As a result, the number of confirmed cases continues to rise, with the WHO watching on as China and the United States lob accusations at each other. The solution, as it so often is in these situations, is simple in theory; the WHO needs more money, preferably without strings attached. In reality however, this would require a significant amount of goodwill from the various donors, and has yet to be achieved despite the obvious failings of the status quo. For the foreseeable future then, it appears that things will continue as they have been, a grim prospect for everyone at risk of contracting COVID-19.
Ben Goldson is a news and current affairs broadcaster at 95bFM radio in Auckland.