Penny Unwise and Pound Foolish
President Trump announced on the day of his inauguration that he was withdrawing the U.S. from the World Health Organization, a process that takes a year under a joint resolution of Congress passed in 1948. The stated reason was the WHO’s failure to quickly sound the alarm about COVID-19.
In fact, the WHO’s general director told the world to get ready on Jan 23, 2020, and a week later declared a world-wide public health emergency. It was the Trump administration that down-played the pandemic and delayed the U.S. response, leading to hundreds of thousands of avoidable deaths.
On March 28, the Trump administration announced it was shutting down the US Agency for International Development (USAID), including all its disease-fighting initiatives around the world.
Do either of these decisions help the U.S.?
U.S. foreign aid in all its facets accounts for some 1% of the federal budget, and health-related spending is only a fraction of that.
What do we get for our financial support?
A global vaccination campaign led by the WHO led to the elimination of smallpox from the world. Global efforts have produced a 99.9% reduction in yearly polio cases, with polio now endemic only in Pakistan and Afghanistan. American support has led to a dramatic reduction in AIDS in South Africa. Malaria and tuberculosis deaths will both rise because U.S. aid has been stopped, and American tourists will also suffer.
With the world totally connected by trade and tourism, outbreaks in a distant country will inevitably reach the U.S. and strain our health system. When a few imported cases of Ebola occurred in 2014, 45 health centers here spent over $53 million to gear up. Since the question is not “if” but “when” the next pandemic arises, do we want to fight it alone?
WHO initiatives have directly benefitted Americans. Efforts by the WHO led to the discovery and standardization of oral fluid replacement for children suffering severe diarrhea, and this treatment is now widely used in the U.S.
Cutting American support for the WHO and reducing our support of health efforts around the world will save us a little money in the short-run but at the cost of millions of deaths in less-developed countries and in the long-run will end up costing us more as diseases first spread abroad and then reach American shores.
Write your Representatives and Senators and beg them to reverse this short-sighted decision.
Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.
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By Dr. Edward Hoffer