Trump's cuts to the WHO are self-serving, but he also has a point: WHO has become a bloated bureaucracy riddled with politicking

While Trump’s cut-off of the WHO was mainly to save his skin, the health watchdog is surely not above criticism. To repair its reputation, it should stop meddling in lifestyles & focus on health issues, and tackling pandemics.

Earlier this week, President Donald Trump announced: “I am directing my administration to halt funding while a review is conducted to assess the World Health Organization’s role in severely mismanaging and covering up the spread of the coronavirus.” 

The US is the biggest funder of the World Health Organization and his announcement drew widespread criticism. Microsoft co-founder Bill Gates, whose foundation was the second-biggest funder of the WHO in 2018-19, called the decision “as dangerous as it sounds.” 

Trump also faces a battle with Congress, which is actually responsible for allocating funding. I'm not a fan of Trump, but to some extent he has a point.

There have been plenty of critics of the WHO's handling of the outbreak. The organization’s initial response is now seen as far too accepting of the official Chinese government line in the first few weeks. In particular, a single social media message has come back to haunt it. On January 14, the organization said on Twitter: “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China.”

Defenders of the WHO point to guidance sent to governments on January 10 and 11, outlining the way the virus spreads and asking health officials to be alert to any 'evidence of amplified or sustained human-to-human transmission.' Those WHO supporters also note that Trump himself had tweeted support for Beijing's handling of the situation in the early days of the outbreak. For many observers, Trump's attacks on the WHO are self-serving, designed to deflect criticism away from his initially slow and skeptical response to what he calls the “Chinese virus.”

While the WHO was perhaps too slow on the uptake,  we should be wary of critics' implication that it should be given the job of policing national governments. For now, the WHO is in an awkward position of having to deal with the politics of different member countries while responding to health emergencies. Moreover, the WHO ‘cried wolf’ over the 2009 swine flu pandemic. The WHO's director general at the time, Margaret Chan, famously said “All of humanity is under threat” from the outbreak, but it proved to be far less deadly than feared. A bit more caution over the new coronavirus was probably sensible.

But let's not get too sympathetic. There is little doubt that the WHO has become, like any other part of the United Nations, a bloated bureaucracy riddled with politicking. Only politicking could explain why the current director general, Tedros Adhanom Ghebreyesus, briefly appointed Robert Mugabe as a WHO 'goodwill ambassador' in 2017, only to swiftly withdraw the title under a barrage of criticism. 

While the WHO has undoubtedly done valuable work in coordinating and implementing efforts to tackle serious diseases - such as polio, smallpox and TB - it has also become, to some extent, the plaything of its big donors - Western governments and billionaire philanthropists. It still does very laudable work on its traditional goals of improving health and most of its budget goes to these projects. Yet the cash comes with strings attached, these days - namely, to reflect the concerns of the rich and meddlesome. That means obsessing about climate change and regulating lifestyles - hardly the most pressing concerns in very poor countries where lack of food, decent sanitation and electricity are much bigger issues.

Supporters of the WHO love its turn towards lifestyle meddling. They think one of the WHO's greatest achievements is the Framework Convention on Tobacco Control (FCTC), signed in 2003 and which came into force in 2005. The FCTC promotes all the anti-tobacco measures we have become familiar with in recent years, including tax hikes, restrictions on sale and promotion, and much more. As such, the ideas and values of Western activists - and wealthy individuals like Bill Gates and Michael Bloomberg - are promoted with the reach and kudos of the WHO. 

Smoking is obviously a serious health issue. On average, lifelong smokers die several years earlier than non-smokers. However, it is not clear that smoking is an issue for a public health organization. Before the FCTC, framework conventions were largely limited to 'environmental issues that were outside the control of individual nations.' Smoking policy is entirely controllable by individual nations, so why the need for an international convention? Moreover, smoking is a matter of individual choice. Shouldn't public health organizations stick to dealing with problems that are not a matter of individual choice, from infectious disease to air and water pollution - problems that can only be dealt with by public action?

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The WHO has in recent years also campaigned against e-cigarettes, arguing that vaping is as dangerous as tobacco smoking. But this flies in the face of claims from other health experts - for example, within the UK government - that vaping is an alternative to tobacco cigarettes with much lower health risks that has helped millions of people to quit smoking or at least to cut down. Could the obsessions of big donors leave the WHO promoting policies that actually make health worse? Moreover, it seems like the WHO's leaders and supporters do indeed want it to become a global health policeman, undermining its credibility as a neutral body.

At the very least, these lifestyle obsessions appear to have been an important distraction for the WHO's leaders. In October 2014, while the WHO was allowing the Ebola crisis to get out of control in Africa, Margaret Chan was speaking at a tobacco-control conference in Moscow. The WHO is the foremost international institution for tackling epidemics - yet on one of the most terrifying and deadly outbreaks of recent times, it was absent without leave.

Trump's defunding announcement may have been motivated by trying to save his own skin. But that doesn't mean that the WHO is above criticism - far from it. If it wants to repair its tattered reputation, it could start by leaving the lifestyle-meddling alone and concentrate on its invaluable core function: to protect the health of the world in situations where no one else can.

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