Global health and development are too dependent on Western charity. The status quo was always going to unravel eventually. Since President Trump took office for the second time more than 100 days ago, he has initiated the largest remaking of this system in decades — beginning with the announcement that the United States will withdraw from the World Health Organization and the dismantling of the United States Agency for International Development. The consequences are dire.
The United States has been the largest funder of global health since at least 2000 and is a key source of research and development and technical expertise. As a former adviser to the W.H.O.’s director general, I’ve seen how vital these contributions are. That’s why I believe the W.H.O. should try to make a deal with Mr. Trump — not because the current system is ideal but because the stakes are too high to let the United States walk away. Until a more resilient system is built, the W.H.O. should work to secure U.S. membership and make the global health ecosystem stronger in the process. This includes addressing Mr. Trump’s concerns about the Covid-19 response, the U.S. footing an outsize share of the global health bill and the need for institutional reform.
Mr. Trump has accused the W.H.O. of being slow to declare a public health emergency and not doing enough to investigate the origins of the pandemic. But the W.H.O. declared a public health emergency in January of 2020 and has kept both natural origin and lab leak hypotheses on the table. It has also repeatedly pressed China for transparency on the virus’s origins.
Still, the W.H.O. can do more to assuage concerns about its pandemic response. The organization and its members could call for a moratorium, which people close to Mr. Trump support, on risky virus research. Doing more to recognize potential missteps — like not emphasizing airborne transmission of Covid early on — can help regain trust. When it comes to future pandemic responses, the W.H.O. should adopt the U.S. military’s approach of red teaming, in which groups are tasked with role-playing as an enemy to identify weaknesses in an organization’s operation. A version of this approach could help the W.H.O. identify flaws in how it responds to public health emergencies.
Mr. Trump has often criticized the fact that the United States contributes much more to global health efforts than other countries. U.S. funding makes up around 15 percent of the W.H.O.’s budget. The W.H.O. could agree to a reduction in America’s contributions and make up some of the difference by asking other countries to increase theirs.
