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Despair and Disparity: The Uneven Burdens of COVID-19
Trump’s announcement that the U.S. will withhold all its contributions to the World Health Organization (WHO) is an unforgivable abnegation of U.S. responsibility at the very moment when a coordinated international public health response is most needed.
At the height of a pandemic that threatens to kill millions and capsize the global economy, the U.S. president is trying to deflect blame for his own failings by going on a public offensive against the world’s preeminent public health organization. In consequence, the ability of the world’s most powerful countries to coordinate an effective global response to the pandemic has been dramatically reduced.
Trump’s threats against the WHO had first escalated last week. As he sought to deflect blame for the U.S. government’s utterly inept response to the COVID-19 outbreak, Donald Trump first launched a fierce rhetorical attack on the World Health Organization. After denouncing it as being pro-Chinese and accusing it of having understated the threat of the new virus, Trump promised to withhold U.S. funding for the WHO.
Then, on Tuesday afternoon, in an angry, propagandistic briefing, Trump followed through on his threat and made the extraordinary announcement that the U.S. would withhold all its contributions to WHO.
Though unforgivable, none of this should be a surprise. Trump has had, from the get-go, an abysmal track record regarding international health, and an abiding hatred for any and all nonmilitary international or supranational entities.
Trump and his conservative, nationalist advisers have long distrusted international organizations and treaties that they view as tying the U.S.’s hands, be they nuclear treaties with Russia, Open Skies treaties designed to allow rival nations to monitor each other’s military build-up, or climate change agreements such as the Paris accords. They even threatened, at one point, to pull the U.S. out of a 19th–century agreement that serves as the central pillar propping up the international postal system. It has been something of a guiding principle that if the Make America Great Again crowd can shred an international agreement or obligation, they will do so.
At the same time, they have also long distrusted scientific experts, especially in the realms of environmentalism and public health, and have viewed them as being naysaying impediments to their economic growth-at-all-costs philosophy.
Since taking power in 2017, the administration has gone on a tear, defunding U.S. contributions to global health programs each year it has been in office, and proposing cuts of up to 35 percent this year, according to Foreign Affairs magazine: it has reimposed the “gag rule,” which prevents all U.S. funding for international health initiatives if the organization receiving funds in any way, shape or form links patients to abortion providers; it has cut U.S. pandemic preparedness by huge amounts — advocating a $35 million rollback of funding for the Infectious Diseases Rapid Response Reserve Fund as recently as last month; and reduced the CDC’s epidemic prevention work in 39 of the 49 countries (including China) in which it was previously operating.
That’s the context in which Trump’s attacks on the World Health Organization must be understood. Put simply, Trump believes that the U.S. can and must beat COVID-19 by going it alone, and the rest of the world be damned. That’s why he ordered the seizure, in Thailand, of medical masks en route to Germany, an act the German interior minister denounced as “modern piracy.” It’s why he tried to bar the company 3M from fulfilling contracts for masks purchased by Central American governments.
Other countries facing the pandemic are going in the opposite direction, making at least partial efforts to internationalize the response. On April 7, the EU announced that it would free up the huge sum of 15 billion euros to help poorer countries fight the novel coronavirus. It was a generous gesture but wasn’t simply altruistic: officials in Europe have repeatedly stressed the dangers of curbing the epidemic on the continent without supporting other countries’ responses, since Europe doesn’t live in a vacuum; its borders, like almost all borders, are frequently crossed.
A few days later, the U.K. announced that it would donate 200 million pounds to help poorer countries fight COVID-19; the money is to be divided up between UN agencies, the WHO, the Red Cross and miscellaneous private charities.
The U.S. government, by contrast, is retrenching at speed. Out of the more than $2 trillion Congress allocated via the CARES Act to counter the effects of the pandemic, only $350 million was set aside for the State Department to spend on assisting refugees overseas, and $363 million was allocated to the U.S. Agency for International Development to help poorer nations with their medical response. That’s only a fraction more than the U.K.’s 200 million pound donation — and the U.K.’s economy is tiny compared to that of the U.S.
The implications of Trump’s inward turn, not just for the curbing of COVID-19 but also regarding the resurgence of diseases such as tuberculosis, and the increased lethality of HIV and malaria, are huge. As the Washington Post reported, the tens of millions of patients globally suffering from these diseases are at a two-fold risk: In addition to their heightened risk of dying of COVID-19, their regular medical supplies may be disrupted during the pandemic — meaning their underlying illnesses cannot be effectively treated.
The U.S. has not always approached international public health aid with a wary eye. From 2000 through 2017, during the presidencies of George W. Bush and Barack Obama, U.S. spending on global health programs rose from $1.7 billion per year to roughly $10 billion. Obama’s final budget request, for fiscal year 2017, called for $10.3 billion in such funding. This is not to idealize the U.S.’s role in the world — after all, this country has also helped destroy national public health infrastructures in developing nations through its leadership at the IMF and World Bank. However, Trump has marked a definitive shift away from any recognition that the U.S., with its massive economy and powerful role in the world, also bears an international responsibility in terms of public health.
This year’s budget only allocated $9 billion for global health programs, and the Trump administration has asked Congress to slash that amount by an astonishing $3 billion for next year. If Congress were to approve this inane request, issued after it was clear the COVID-19 outbreak would morph into a pandemic, the $6 billion allocated for 2021 would be the lowest amount that the U.S. has spent on global health since before the Great Recession.
This is unforgivably cruel and also deeply, unfathomably, counterproductive. For, by definition, no country is safe from the ravages of a pandemic so long as the poorest and least equipped countries lack the resources to curb the disease. Even if the U.S. gets its own first-wave epidemic under control, COVID-19 could rage unabated in African countries, Central American countries or South Asia over the coming years, and — no matter how many walls Trump builds and visa restrictions he imposes — the disease could make its way back through international travelers.
If Trump were serious about containing this pandemic, he would be proposing large grants to bolster public health systems and disease containment strategies globally. Instead, all-too-predictably, as U.S. death rates from the virus soar, he seeks to score cheap political points with his base by castigating and now defunding the World Health Organization. Shame on him. And shame on those in the GOP who still, despite all the evidence of his malign nature, continue to cast their lot with this wannabe-dictator for their own short-term political gains.