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特朗普為什么威脅要斷供世界衛生組織?

Nicole Goodkind
2020-05-21

目前尚不清楚特朗普是打算取消自愿捐款,還是計劃完全退出世界衛生大會。

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世界衛生組織是一個風平浪靜時容易被忽略、時局艱難時常常被提起的機構。

近來,美國總統唐納德·特朗普威脅要永久停止對世衛組織的資助,稱這筆錢花得毫無用處。他說得對嗎?抑或他只是在尋找替罪羊?這個龐大的組織又是怎么產生的呢?

世衛組織負責指導并幫助全球應對重大和潛在的流行疾病,比如寨卡、埃博拉、SARS、禽流感和豬流感等。以下列出了所有你需要了解的世衛組織相關信息。

世衛組織是做什么的?

世衛組織的發展史與第二次世界大戰后團結全球、維護國際安全與和平的行動密切相關。1945年聯合國成立前后,有人提議出資建立一套制度,協調處理瘧疾、結核病和婦女兒童福利等全球衛生事務。1948年,聯合國成立了世衛組織。

如今,世衛組織仍在聯合國旗下運轉。它共有194個成員國,在全球各地設有150個辦事處,每年經費預算達48.4億美元。

這些成員國共同組成的世界衛生大會是世衛組織的最高權力機構,負責制定政策、監督管理預算。世衛組織總干事也由世界衛生大會選舉產生,任期五年,現任總干事為前埃塞俄比亞衛生部部長譚德塞。

世衛組織的運轉以自愿為基礎,各國沒有義務允許世衛組織參與本國事務,也沒有義務遵守世衛組織的指導,但是成員國往往會與世衛組織合作。

誰在為世衛組織提供資金?

截至目前,美國是世衛組織最大的資金捐助國。在2018至2019兩年的預算周期中,美國共向世衛組織提供了8.93億美元。不過眼下,特朗普總統威脅要停止注資,我們后文會詳細聊到此事。

成員國中資助金額排名第二的是英國,該國承諾提供4.3億美元。中國承諾提供的資金為7500多萬美元。

世衛組織有兩種籌措資金的方式:一是“會費分攤”,即由成員國繳納會費;二是自愿捐款,這是世衛組織資金的主要來源。2018至2019年,美國承諾分攤2.37億美元會費,并提供6.56億美元自愿捐款。

世衛組織的第二大資助方為比爾及梅琳達·蓋茨基金會。2018至2019年,比爾及梅琳達·蓋茨基金會向世衛組織提供了5.31億美元自愿捐款。另外,世衛組織的許多資金來自“扶輪國際”和美國國家慈善信托基金會等慈善組織,前者捐助了1.43億美元,后者承諾捐助1.08億美元。

早先世衛組織的大部分資金來自會費,但近些年已經轉為了自愿捐款。2018至2019年會費總計9.569億美元,僅占世衛組織收到的資金總額的17%。與此同時,自愿捐款增長至44.9億美元,占到了資金總額的80%;“其他資金收入”為1.781億美元。

目前,世衛組織已經要求成員國另外募捐7億美元,用以應對新冠危機。并且據預計,世衛組織不久后還會提高資金募集數額。

世衛組織在解決過去的危機時發揮了什么作用?

成立以來,世衛組織在與各國合作根除傳染病上發揮了重要作用。然而,世衛組織取得成功的進展很緩慢。

在20世紀50年代末,世衛組織攜手俄羅斯開展了一項消滅天花的運動。但到1980年,(天花才被完全根除,)人們不再有必要接種天花疫苗。20世紀70年代,世衛組織開始在全球各地推廣計劃生育和安全性行為,鼓勵為兒童接種可預防疾病的疫苗,并制定了為所有兒童接種白喉、百日咳、破傷風、麻疹、脊髓灰質炎和結核病疫苗的崇高目標。大約四十年后的今天,世衛組織仍然在努力實現這一遠大目標。不過目前,他們已經取得了一些進展:2018年的數據顯示,有1.16億兒童完成了疫苗接種,相較2000年增加了30%。

1980年代,世衛組織開始投入精力預防孕產婦死亡。雖然未能達成最初設立的目標,但現在世衛組織希望在2030年可以將全球孕產婦死亡率降低到70/10萬活產嬰兒以下。此外,世衛組織還在著手根除小兒麻痹癥,這一目標目前也尚未達成。

近來,世衛組織重點關注了艾滋病毒/艾滋病危機,尤其是在非洲。他們建立了檢測診所,提供補貼和治療,并投入了數百萬美元開展宣傳活動,敦促人們關注艾滋的傳播方式。

“世衛組織在世界各地開展的工作是其他任何人都做不到的。”Protect Our Care的主席萊斯利·達赫說,“他們向疫情發生地提供醫生和公共衛生資源,并加強了各國自身公共衛生系統的能力。從許多層面來看,他們是我們所有人都依賴著的全球危機應對組織?!眾W巴馬執政期間,達赫曾經在美國衛生和公眾服務部擔任全球埃博拉協調員。

達赫表示,世衛組織著力全局而非局部的做法意味著,他們往往會在成功時被忽略,而在失敗時備受指責。但2014年,正是這種做法促使了埃博拉疫苗的迅速普及,從而緩解了原本可能爆發的埃博拉疫情。

達赫指出:“世衛組織在埃博拉防治問題上做出了巨大的貢獻,尤其是在加快疫苗研發和最終分配兩方面?!笔佬l組織完善的本地化基礎設施正是其能夠“發揮獨特重要作用”的關鍵所在。

“如果說我們能夠從這次新冠大流行中學到什么的話,那就是這些疾病對整個世界構成了巨大的威脅,我們所能采取的最佳措施就是從源頭上遏制它們?!边_赫解釋道,“沒有人說世衛組織是完美無瑕的,但它確實發揮了重要作用。”

世衛組織如何阻止新冠疫情蔓延?

所有會員國都必須向世衛組織報告一切來源不明且有可能造成國際傳播的疫情。2019年12月31日,中國宣布湖北省武漢市爆發新冠疫情。2020年1月4日,世衛組織警示了事故管理支援小組,并在推特上發布了事件相關信息。1月10日,世衛組織已經制定并發布了有關如何阻止新冠傳播的指導方針,并警告稱這一疾病與SARS和中東呼吸綜合征類似。

1月底,世衛組織將新冠列為國際公共衛生緊急事件。隨后,世衛組織向所有成員國收集重要資料,并根據在這些資料中的發現發表了許多內容。世衛組織已經就如何重新開放、何時佩戴口罩以及檢測方案提出了建議,還為衛生工作者提供了在線培訓。

特朗普為什么威脅要斷供世衛組織?

4月中旬,特朗普總統宣稱已經受夠了世衛組織的指導方針,將無限期凍結對世衛組織的資金支持,等待政府的進一步審查。他指責世衛組織沒有在疫情在中國出現時及時展開調查,令美國面對疫情措手不及。

特朗普的批評者表示,總統此舉是在轉移視線、甩脫指責。疫情爆發以來,美國已有超過8.5萬死亡病例被證實與新冠直接相關。

民主黨表示,總統是在“尋找替罪羊”。

“現在,白宮及其盟友正在通力合作,試圖為總統在病毒爆發早期階段犯下的致命錯誤尋找替罪羊?!眳⒆h員克里斯·墨菲說。

斷供世衛組織還面臨著法律障礙。民主黨國會議員表示,此舉是違法的,特朗普無權停止支付會費。但特朗普仍然得到了共和黨國會議員的支持,任何針對他的嚴厲措施都有可能在共和黨主導的參議院折戟。

美國眾議院撥款委員會的發言人埃文·霍蘭德表示:“特朗普總統是在違反導致他此前被彈劾的支出法律?!痹诖饲暗膹椲腊钢?,美國政府問責局曾指出,總統拖延國會批準撥給烏克蘭的資金違反了相關法律。

中日等國已經表示將增加捐款,但他們不太可能填補美國留下的巨大資金缺口。達赫認為,這一決定可能會使美國在減緩新冠傳播方面處于不利地位。

“如果你希望世衛組織盡可能發揮作用,那你就會希望坐到談判桌上和他們交談。”他說,“在埃博拉疫情期間,由于我們做出的貢獻,我們的觀點很重要,我們有能力發聲改變世衛組織行為,這也有利于美國。(我們可以讓)他們更明智地花錢,(讓)他們用我們認為最重要的方式花在我們認為最重要的地方?,F在呢,我們居然要離開談判桌了。”

目前尚不清楚特朗普是打算取消自愿捐款,還是計劃完全退出世界衛生大會。前者意味著美國將保留其作為管理機構的身份,后者則意味著美國未來在世衛組織不再擁有任何發言權,也不再有義務向世衛組織報告任何信息或健康衛生統計數據。

即使世衛組織最大的擁躉也承認,世衛組織并不完美。但他們表示,如果沒有世衛組織的幫助,情況只會變得更加糟糕。

1000多名醫療專家、企業和慈善機構近來聯名上書特朗普,敦促他繼續向世衛組織提供資金。信中寫道:“在這樣一場前所未有、極其復雜的公共衛生危機中,我們肯定會面臨挑戰。”

“世衛組織已經表示,在攜手國際社會扭轉新冠疫情后,他們迫切希望評估錯誤發生在哪里,探討未來如何更好地加強世衛組織和全球應對所有國家公共衛生事件的能力?!毙胖羞€寫道,“毫無疑問……世衛組織的努力對于拉平曲線、減緩病毒傳播,并最終拯救美國和全世界人民生命安全至關重要?!?/p>

美國凱澤家庭基金會近來的一項分析研究發現,世衛組織面臨的許多挑戰根本原因在于組織的責任范圍不斷擴大,但預算卻停滯不前,而且主要依賴于通常有指定用途的自愿捐款。報告發現,世衛組織還必須努力發揮雙重職責,既要作為“具有專業衛生知識的技術機構”,又要作為“政治機構,協調各國就有時引起分歧的健康衛生問題進行辯論和談判”。這些情況再加上龐大、分散的官僚架構,最終導致世衛組織常常行動緩慢、優柔寡斷。

不過,達赫表示:“此次危機過后,我們該著手讓世衛組織變得更好。把麻煩事扔進海里,然后忘掉不去管它,這可不是個好主意。”(財富中文網)

譯者:錢功毅

世界衛生組織是一個風平浪靜時容易被忽略、時局艱難時常常被提起的機構。

近來,美國總統唐納德·特朗普威脅要永久停止對世衛組織的資助,稱這筆錢花得毫無用處。他說得對嗎?抑或他只是在尋找替罪羊?這個龐大的組織又是怎么產生的呢?

世衛組織負責指導并幫助全球應對重大和潛在的流行疾病,比如寨卡、埃博拉、SARS、禽流感和豬流感等。以下列出了所有你需要了解的世衛組織相關信息。

世衛組織是做什么的?

世衛組織的發展史與第二次世界大戰后團結全球、維護國際安全與和平的行動密切相關。1945年聯合國成立前后,有人提議出資建立一套制度,協調處理瘧疾、結核病和婦女兒童福利等全球衛生事務。1948年,聯合國成立了世衛組織。

如今,世衛組織仍在聯合國旗下運轉。它共有194個成員國,在全球各地設有150個辦事處,每年經費預算達48.4億美元。

這些成員國共同組成的世界衛生大會是世衛組織的最高權力機構,負責制定政策、監督管理預算。世衛組織總干事也由世界衛生大會選舉產生,任期五年,現任總干事為前埃塞俄比亞衛生部部長譚德塞。

世衛組織的運轉以自愿為基礎,各國沒有義務允許世衛組織參與本國事務,也沒有義務遵守世衛組織的指導,但是成員國往往會與世衛組織合作。

誰在為世衛組織提供資金?

截至目前,美國是世衛組織最大的資金捐助國。在2018至2019兩年的預算周期中,美國共向世衛組織提供了8.93億美元。不過眼下,特朗普總統威脅要停止注資,我們后文會詳細聊到此事。

成員國中資助金額排名第二的是英國,該國承諾提供4.3億美元。中國承諾提供的資金為7500多萬美元。

世衛組織有兩種籌措資金的方式:一是“會費分攤”,即由成員國繳納會費;二是自愿捐款,這是世衛組織資金的主要來源。2018至2019年,美國承諾分攤2.37億美元會費,并提供6.56億美元自愿捐款。

世衛組織的第二大資助方為比爾及梅琳達·蓋茨基金會。2018至2019年,比爾及梅琳達·蓋茨基金會向世衛組織提供了5.31億美元自愿捐款。另外,世衛組織的許多資金來自“扶輪國際”和美國國家慈善信托基金會等慈善組織,前者捐助了1.43億美元,后者承諾捐助1.08億美元。

早先世衛組織的大部分資金來自會費,但近些年已經轉為了自愿捐款。2018至2019年會費總計9.569億美元,僅占世衛組織收到的資金總額的17%。與此同時,自愿捐款增長至44.9億美元,占到了資金總額的80%;“其他資金收入”為1.781億美元。

目前,世衛組織已經要求成員國另外募捐7億美元,用以應對新冠危機。并且據預計,世衛組織不久后還會提高資金募集數額。

世衛組織在解決過去的危機時發揮了什么作用?

成立以來,世衛組織在與各國合作根除傳染病上發揮了重要作用。然而,世衛組織取得成功的進展很緩慢。

在20世紀50年代末,世衛組織攜手俄羅斯開展了一項消滅天花的運動。但到1980年,(天花才被完全根除,)人們不再有必要接種天花疫苗。20世紀70年代,世衛組織開始在全球各地推廣計劃生育和安全性行為,鼓勵為兒童接種可預防疾病的疫苗,并制定了為所有兒童接種白喉、百日咳、破傷風、麻疹、脊髓灰質炎和結核病疫苗的崇高目標。大約四十年后的今天,世衛組織仍然在努力實現這一遠大目標。不過目前,他們已經取得了一些進展:2018年的數據顯示,有1.16億兒童完成了疫苗接種,相較2000年增加了30%。

1980年代,世衛組織開始投入精力預防孕產婦死亡。雖然未能達成最初設立的目標,但現在世衛組織希望在2030年可以將全球孕產婦死亡率降低到70/10萬活產嬰兒以下。此外,世衛組織還在著手根除小兒麻痹癥,這一目標目前也尚未達成。

近來,世衛組織重點關注了艾滋病毒/艾滋病危機,尤其是在非洲。他們建立了檢測診所,提供補貼和治療,并投入了數百萬美元開展宣傳活動,敦促人們關注艾滋的傳播方式。

“世衛組織在世界各地開展的工作是其他任何人都做不到的。”Protect Our Care的主席萊斯利·達赫說,“他們向疫情發生地提供醫生和公共衛生資源,并加強了各國自身公共衛生系統的能力。從許多層面來看,他們是我們所有人都依賴著的全球危機應對組織?!眾W巴馬執政期間,達赫曾經在美國衛生和公眾服務部擔任全球埃博拉協調員。

達赫表示,世衛組織著力全局而非局部的做法意味著,他們往往會在成功時被忽略,而在失敗時備受指責。但2014年,正是這種做法促使了埃博拉疫苗的迅速普及,從而緩解了原本可能爆發的埃博拉疫情。

達赫指出:“世衛組織在埃博拉防治問題上做出了巨大的貢獻,尤其是在加快疫苗研發和最終分配兩方面?!笔佬l組織完善的本地化基礎設施正是其能夠“發揮獨特重要作用”的關鍵所在。

“如果說我們能夠從這次新冠大流行中學到什么的話,那就是這些疾病對整個世界構成了巨大的威脅,我們所能采取的最佳措施就是從源頭上遏制它們?!边_赫解釋道,“沒有人說世衛組織是完美無瑕的,但它確實發揮了重要作用?!?/p>

世衛組織如何阻止新冠疫情蔓延?

所有會員國都必須向世衛組織報告一切來源不明且有可能造成國際傳播的疫情。2019年12月31日,中國宣布湖北省武漢市爆發新冠疫情。2020年1月4日,世衛組織警示了事故管理支援小組,并在推特上發布了事件相關信息。1月10日,世衛組織已經制定并發布了有關如何阻止新冠傳播的指導方針,并警告稱這一疾病與SARS和中東呼吸綜合征類似。

1月底,世衛組織將新冠列為國際公共衛生緊急事件。隨后,世衛組織向所有成員國收集重要資料,并根據在這些資料中的發現發表了許多內容。世衛組織已經就如何重新開放、何時佩戴口罩以及檢測方案提出了建議,還為衛生工作者提供了在線培訓。

特朗普為什么威脅要斷供世衛組織?

4月中旬,特朗普總統宣稱已經受夠了世衛組織的指導方針,將無限期凍結對世衛組織的資金支持,等待政府的進一步審查。他指責世衛組織沒有在疫情在中國出現時及時展開調查,令美國面對疫情措手不及。

特朗普的批評者表示,總統此舉是在轉移視線、甩脫指責。疫情爆發以來,美國已有超過8.5萬死亡病例被證實與新冠直接相關。

民主黨表示,總統是在“尋找替罪羊”。

“現在,白宮及其盟友正在通力合作,試圖為總統在病毒爆發早期階段犯下的致命錯誤尋找替罪羊?!眳⒆h員克里斯·墨菲說。

斷供世衛組織還面臨著法律障礙。民主黨國會議員表示,此舉是違法的,特朗普無權停止支付會費。但特朗普仍然得到了共和黨國會議員的支持,任何針對他的嚴厲措施都有可能在共和黨主導的參議院折戟。

美國眾議院撥款委員會的發言人埃文·霍蘭德表示:“特朗普總統是在違反導致他此前被彈劾的支出法律。”在此前的彈劾案中,美國政府問責局曾指出,總統拖延國會批準撥給烏克蘭的資金違反了相關法律。

中日等國已經表示將增加捐款,但他們不太可能填補美國留下的巨大資金缺口。達赫認為,這一決定可能會使美國在減緩新冠傳播方面處于不利地位。

“如果你希望世衛組織盡可能發揮作用,那你就會希望坐到談判桌上和他們交談?!彼f,“在埃博拉疫情期間,由于我們做出的貢獻,我們的觀點很重要,我們有能力發聲改變世衛組織行為,這也有利于美國。(我們可以讓)他們更明智地花錢,(讓)他們用我們認為最重要的方式花在我們認為最重要的地方?,F在呢,我們居然要離開談判桌了?!?/p>

目前尚不清楚特朗普是打算取消自愿捐款,還是計劃完全退出世界衛生大會。前者意味著美國將保留其作為管理機構的身份,后者則意味著美國未來在世衛組織不再擁有任何發言權,也不再有義務向世衛組織報告任何信息或健康衛生統計數據。

即使世衛組織最大的擁躉也承認,世衛組織并不完美。但他們表示,如果沒有世衛組織的幫助,情況只會變得更加糟糕。

1000多名醫療專家、企業和慈善機構近來聯名上書特朗普,敦促他繼續向世衛組織提供資金。信中寫道:“在這樣一場前所未有、極其復雜的公共衛生危機中,我們肯定會面臨挑戰?!?/p>

“世衛組織已經表示,在攜手國際社會扭轉新冠疫情后,他們迫切希望評估錯誤發生在哪里,探討未來如何更好地加強世衛組織和全球應對所有國家公共衛生事件的能力。”信中還寫道,“毫無疑問……世衛組織的努力對于拉平曲線、減緩病毒傳播,并最終拯救美國和全世界人民生命安全至關重要?!?/p>

美國凱澤家庭基金會近來的一項分析研究發現,世衛組織面臨的許多挑戰根本原因在于組織的責任范圍不斷擴大,但預算卻停滯不前,而且主要依賴于通常有指定用途的自愿捐款。報告發現,世衛組織還必須努力發揮雙重職責,既要作為“具有專業衛生知識的技術機構”,又要作為“政治機構,協調各國就有時引起分歧的健康衛生問題進行辯論和談判”。這些情況再加上龐大、分散的官僚架構,最終導致世衛組織常常行動緩慢、優柔寡斷。

不過,達赫表示:“此次危機過后,我們該著手讓世衛組織變得更好。把麻煩事扔進海里,然后忘掉不去管它,這可不是個好主意?!保ㄘ敻恢形木W)

譯者:錢功毅

The World Health Organization (WHO) is an agency that tends to be ignored during good times and talked about incessantly during bad times, and what we’re seeing during the current COVID-19 crisis certainly fits that bill.

President Donald Trump recently threatened to defund the agency permanently, essentially calling it useless. But is he correct or just scapegoating? And how did this huge organization even originate?

Below is everything you need to know about the agency that issues guidance and help for disastrous pandemics and potential pandemics like Zika, Ebola, SARS, bird flu, swine flu, and others.

What does the WHO do?

The history of the WHO goes hand in hand with the post–World War II move to unite the globe and maintain security and peace internationally. Around the time the United Nations (UN) was founded, in 1945, the idea of funding a system to coordinate global health affairs like malaria, tuberculosis, and women and children’s well-being was proposed. By 1948, the UN had created the WHO, with the principal thought that health care is a human right—an issue still being debated across political stages in the United States.

Today, the WHO, still operating under the larger umbrella of the UN, has 194 member countries, 150 offices around the world, and a biannual budget of $4.84 billion.

Together these member states form the World Health Assembly, which is the guiding body of the organization. They set policy and supervise the budget. They also elect a director-general to a five-year term. Tedros Adhanom Ghebreyesus, a former minister of health in Ethiopia, is currently in charge of the program.

The WHO operates on a voluntary level, and countries are under no obligation to allow the organization in or to follow its guidance, but member states tend to cooperate.

Okay, so who funds it?

The United States is currently by far the largest supplier of WHO funding. The U.S. contributed about $893 million during the two-year budget cycle spanning 2018 to 2019. The President has threatened to end that, but more on that later.

The next largest member-contributor is the United Kingdom, which pledged about $430 million. China pledged just over $75 million.

But there are two ways the WHO collects money: One is through “assessed contributions,” which are the dues member countries pay, and the other is through voluntary contributions, which is the major driver of funds. From 2018 through 2019, the United States pledged $237 million in assessed contributions and $656 million in voluntary contributions.

The second-largest funder of the WHO is the Bill & Melinda Gates Foundation, which granted the organization $531 million in voluntary payments over that same period. Much of the WHO’s funds come from charity organizations like Rotary International, which donated $143 million, and the National Philanthropic Trust, which pledged $108 million.

In its earlier years, most of the WHO’s funding came from assessed contributions, but as of late that has shifted to voluntary cash infusions. From 2018 through 2019, assessed contributions totaled $956.9 million—just 17% of revenue. Voluntary contributions, meanwhile, added up to $4.49 billion or 80% of revenue. “Other revenue” provided an additional $178.1 million.

The WHO has requested another $700 million from donors to help with the COVID-19 crisis and is expected to increase that ask shortly.

What role has the WHO played in solving past crises?

Since its founding, the WHO has played a critical role in partnering with countries to eradicate infectious ailments. Its successes, however, have come slowly.

In the late 1950s, the organization began a campaign with Russia to end smallpox, but by 1980, the vaccination for the illness was deemed no longer necessary. In the 1970s, the WHO moved to promote family planning and safe sex, as well as vaccinating children from preventable illnesses around the world. The organization set a goal of vaccinating all children against diphtheria, pertussis, tetanus, measles, poliomyelitis, and tuberculosis. The goal was very lofty, and so, some 40 years later, the WHO is still working on achieving it, but some progress is being made. According to 2018 data, the most recent available, 116 million children have completed vaccinations, up 30% since 2000.

In the 1980s the organization set its sights on preventing maternal mortality, and while it missed its initial goalposts, it now hopes to reduce the global maternal mortality rate to less than 70 per 100,000 births by 2030. Additionally, the WHO began its goal of eradicating polio, also yet to be achieved.

More recently, the WHO has focused largely on the HIV/AIDS crisis, particularly in Africa. They have established testing clinics, subsidized and provided treatments, and poured millions into awareness campaigns that focus on how the disease is spread.

“They do work around the world that no one else will do,” explains Protect Our Care chair Leslie Dach, who served as the global Ebola coordinator for the Department of Health and Human Services under the Obama administration. “They put doctors and public health resources on the ground and also strengthen the ability of countries’ own public health systems. They are in many ways the global response organization that we all rely on.”

Dach says that while the organization’s “forest for the trees” viewpoint means that it tends to get ignored for successes and blamed for failures, it was essential in procuring a quick vaccine that tempered what could have become an Ebola pandemic in 2014.

“On Ebola, they made significant contributions, particularly on speeding up the development of a vaccine and its ultimate deployment,” he notes. It’s the well-established localized infrastructure of the WHO that enables it to “perform a unique and critical role.”

“If we’ve learned anything from this car crash [the COVID-19 pandemic] it’s that these diseases pose a huge threat across the entire world, and the best thing we can do is contain them where they start,” Dach explains. “No one is saying that the organization is perfect, but it does an essential job.”

How is the WHO working to stop the spread of COVID-19?

All member countries are required to report any disease outbreaks of unknown origin that seem as if they may spread internationally. On Dec. 31, 2019, China declared an outbreak of what it called pneumonia cases in Wuhan, Hubei province. The organization alerted its incident management support team and tweeted about the incidences on Jan. 4, 2020. By Jan. 10, the WHO had set up and posted guidelines on how to stop the spread of the disease, warning that it was similar to SARS and MERS. .

By the end of January, the WHO had labeled the disease a Public Health Emergency of International Concern. Since then, the organization has gathered vital information from all member countries and has published much on what it has found in that data. The agency has issued recommendations on how to reopen, when to wear masks, and testing protocol. It has also provided online training for health care workers.

Why is President Donald Trump threatening to defund the WHO?

In mid-April President Trump declared that he’d had enough of the WHO’s guidelines and would freeze its funding indefinitely, pending further review from his administration. He blamed the WHO for not investigating the disease quickly enough when it originated in China, leaving the U.S. unprepared.

Critics of Trump say the President’s actions were intended to deflect any blame. There have since been more than 85,000 confirmed deaths directly related to COVID-19 in the United States.

Democrats called the President out for “scapegoating.”

“Right now, there is a very coordinated effort amongst the White House and their allies to try to find scapegoats for the fatal mistakes that the President made during the early stages of this virus,” said Sen. Chris Murphy. “It is just wildly ironic that the President and his allies are now criticizing China or the WHO for being soft on China when it was in fact the President who was the chief apologist for China during the early stages of this crisis.”

Legal roadblocks also lie ahead. Democrats in Congress called the move illegal, saying that Trump couldn’t stop the payment of that assessed contribution. The President, however, still has the support of congressional Republicans, and any serious action taken against him would likely be blocked in the Republican-led Senate.

“President Trump is violating the same spending laws that brought about his impeachment,” said Evan Hollander, spokesman for the House Appropriations Committee. During the impeachment fight, the U.S. Government Accountability Office said that the President was in violation of the law by delaying funding that Congress had approved to go to Ukraine.

Countries like China and Japan have said they will step up their donations, but it is unlikely that they would be able to fill a void as large as the one left by U.S. funding. Still, Dach says, this decision could leave the U.S. at a disadvantage in slowing COVID-19’s spread.

“If you want WHO to do the most effective job it can, you want to be at the table, you want to be able to have a conversation with them,” he says. “During Ebola, because of our contribution, our opinions mattered, and it was to America’s benefit to be able to have its voice change the behavior of WHO. They spent their money more wisely, and they spent it in places and ways we thought were the most important. Now we’re just taking that off the table.”

It’s unclear if the President intends to pull voluntary funding or to leave the World Health Assembly altogether. The former would mean that the U.S. would retain its role as a governing body, but the latter would mean the country no longer had any say in the future of the organization. It would also no longer be obligated to report any information or health statistics to the group.

Even the WHO’s biggest advocates admit that the organization isn’t perfect, but they say that things would be much worse without its help.

“During an unprecedented and hugely complex public health crisis like this, there are bound to be challenges,” wrote over 1,000 health care experts, companies, and charities in a recent letter to President Trump, urging him to continue with funding.

“After WHO and the global community turn the tide against COVID-19, WHO has signaled an eagerness to assess where mistakes occurred and how best to strengthen the institution and global public health response capacities of all countries in the future,” they continued. But, they added, “it is without question…that WHO efforts have been vital to flattening the curve, slowing the virus’s spread, and ultimately saving lives in the U.S. and around the world.”

A recent analysis by the Kaiser Family Foundation found that many of the organization’s challenges stem from its growing scope of responsibility coupled with a stagnant budget that largely relies on voluntary donations often earmarked for specific issues. The WHO must also grapple with the dual mandate of being both a “technical agency with health expertise and a political body where states debate and negotiate on sometimes divisive health issues,” the report found. That, along with a large, decentralized, and bureaucratic structure, often leads to slow, indecisive actions by the agency.

Still, says Dach, “the time to work to make them better is after the crisis. It’s not a good idea to drop the thing into the ocean and forget about it.”

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