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WHO: Virus drug distributions must be equitable
The World Health Organization says the world is close to seeing the end of the COVID-19 pandemic but warned that inequalities in distributing a vaccine and other therapeutics could have deep economic and social consequences. (Dec. 4)
The scientific community applauded President Biden’s decision to rejoin the World Health Organization and other global efforts designed to stop and prevent COVID-19.
«This is very good news for America, for WHO and the world,» said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University.
«Obviously, I’m delighted,» added Barry Bloom, an immunologist at the Harvard T.H. Chan School of Public Health. «If we want to retain leadership in global health in the world, we can’t not play with the rest of the world.»
The move had both symbolic and practical implications, said Jen Kates, senior vice president and director of Global Health & HIV Policy at the Henry J. Kaiser Family Foundation.
Practical, because U.S. funding will help the agency balance its budget, fulfill its commitments to boost public health, and protect Americans from new strains of COVID-19 and future disease threats. And symbolic, because the United States was the agency’s largest funder and has long been a key player on the global health stage.
In one of his first official acts as president, Biden signed letters retracting his predecessor’s decision to withdraw from the WHO. He also appointed Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Disease, to represent the United States on the WHO’s executive committee.
In comments to that committee Thursday, Fauci said the United States would immediately recommit to being a full participant in WHO, fulfilling its financial obligations to the agency and stop withdrawing U.S. staff from agency projects.
Fauci also committed to helping to vaccinate people across the globe and to «seek an improved, shared system for early warning and rapid response to emerging biological threats.»
The WHO expressed gratitude for Biden’s decision.
«This is a good day for WHO, and a good day for global health,» WHO Director-General Dr. Tedros Adhanom Ghebreyesus told his executive board.
US is an important WHO member
The World Health Organization, founded in 1948 as an agency of the United Nations, consists of 194 member states and focuses on providing health care, coverage and protection against health emergencies. Headquartered in Geneva, Switzerland, the organization has an annual budget of about $2.4 billion, contributed by its member states.
Fully withdrawing from WHO would have been a disaster, said Thomas Bollyky, who directs the Global Health Program at the Council on Foreign Relations and is an adjunct professor of law at Georgetown University.
«It would have done tremendous damage to the international institution charged with protecting us from this pandemic and future dangerous disease outbreaks,» he said. «U.S. interests are better served inside WHO than outside it.»
Countries need to give the WHO a year’s notice if they wish to withdraw; the Trump administration gave that notice last July and stopped paying annual dues to the agency some time earlier.
In 2019, before it stopped paying, the U.S. provided WHO about $419 million, according to the Kaiser Family Foundation – approximately 20% of the agency’s budget. Before it stopped providing money to WHO in April 2020, the U.S. had contributed $58 million.
«That we are listed among the deadbeats in the world struck me as appalling, as someone who believes we could provide and should provide leadership in how to do global health well,» Bloom said.
In the short term, the United States retracting its notice of withdrawal means that it will fulfill its financial obligations to the organization and stop its drawdown of U.S.-provided staff at WHO.
In the longer term, U.S. participation means it will help advance pandemic preparedness, reverse the health consequences of climate change, and promote better health globally, the Biden administration said.
“The U.S.’s commitment to strengthening the International Health Regulations not only reinforces the U.S.’s return to multilateralism, but is also important to rebuild the norms of acceptable conduct by countries in responding to global health security threats,» said Alexandra Phelan, a member of Georgetown University’s Center for Global Health Science and Security.
It will help efforts to understand the origins of the virus, she said in an emailed statement. “Committing the U.S. to a robust and clear investigation into the outbreak’s origins is critical political weight for WHO right now.»
China has been criticized for not being more transparent about the pandemic. After a year of negotiations, a WHO team of scientists arrived in China only last week to better understand the origins of the SARS-CoV-2 virus, which was first detected in Wuhan, China, in late 2019.
Gostin said the WHO must be reformed to give it more power to monitor threats, including emerging viruses, like SARS-CoV-2, «to call out nations that don’t cooperate with the global community or don’t share their viruses.»
If WHO had been on the ground in China in force in late 2019, «we would have had a real shot at preventing this global catastrophe,» he said. «That never happened.»
Instead, the WHO had little choice but to accept China’s claims that the virus wasn’t serious and wasn’t spreading within the community.
Rejoining the WHO also must be followed by an agreement to provide more financial support, Gostin added, noting its budget – comparable to one large U.S. hospital – is «completely unsustainable financially.»
«Right now, the world and America has the WHO we deserve,» he said. «We underfund it, we don’t politically support it, we turn our back when countries violate WHO norms. The fact that WHO isn’t as strong as we want it is our own fault.»
Global vaccine efforts also get help
In addition to rejoining the WHO, Biden announced that the United States would participate in the COVID-19 Vaccine Global Access (COVAX) Facility and donate any surplus vaccines to the global effort.
COVAX, which includes 190 members countries, has pledged to purchase vaccine and arrange to vaccinate 20% of the most vulnerable people in the world’s low- and middle-income countries.
Bloom said the move to join COVAX comes at a crucial time. Although COVAX has secured promises of 2 billion doses of vaccine at a reduced price, countries wouldn’t be able to vaccinate the majority of their population until 2022 or later.
Consequently, many countries have started to seek their own sources of vaccine, he said, buying, for example, Chinese and Russian vaccines not scientifically proven to be safe and effective, or paying companies a premium to climb higher on their priority list.
«People don’t want to wait,» Bloom said. Biden’s decision, he said, «may be what’s required the keep the countries patient enough to wait their turn.»
The move also serves American self-interest, Kates said. As long as the SARS-CoV-2 virus is circulating somewhere in the world, particularly as new strains emerge, it is likely to come back to the United States.
«Infectious diseases don’t respect or care about borders,» Kates said. «Whether the U.S. decides to approach this from a moral perspective of ‘it’s the U.S.’s role to ensure access,’ or approaches it from a self-interest perspective or somewhere in between, to end this pandemic, we truly need a global solution.»
While rejoining WHO, COVAX and the global health community is crucial, Bloom said the U.S. lost credibility by failing to contain the COVID-19 pandemic. Providing cash and rejoining conversations won’t be enough to restore that global authority.
«We have a long way to come back,» he said.
Contact Karen Weintraub at email@example.com
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