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July 08, 2020
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Experts react to ‘ruinous’ decision to withdraw US from WHO

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On Tuesday, President Donald J. Trump announced his intention to formally withdraw the United States from WHO.

Donald J. Trump

Experts have since responded to the news, highlighting the dangers of the decision while the U.S. is still in the midst of the COVID-19 pandemic, with many unknowns ahead.

“Coinciding with the highest ever single-day spikes in COVID-19 cases, Trump's move to withdraw from WHO is among the most ruinous presidential decisions in recent history,” Lawrence O. Gostin, JD, professor at Georgetown Law and director of the O’Neill Institute for National and Global Health at Georgetown University, said in a statement. “While the president's letter suggests he is withdrawing from the WHO, legally, he has no power to act unilaterally.”

Gostin continued: “Congress can and must stop such a disastrous choice by passing a resolution prohibiting U.S. withdrawal and by fulfilling its current financial obligations. In fact, Congress should increase WHO funding, especially during an unprecedented health emergency.”

Gostin and more than 700 of the nation's public health leaders — including former CDC directors — wrote a letter to Congress calling on them “to block a catastrophic decision that will threaten American health and security."

In the letter, Gostin and colleagues outline how the president lacks the legal authority to withdraw without congressional participation and approval and notes that the U.S. is best suited to lead WHO reforms, as a founding member of the agency and the largest financial contributor. The letter also outlines concerns that the withdrawal will result in the deaths of both Americans and people around the world.

Matthew M. Kavanagh, PhD, director of O’Neill’s Global Health Politics and Policy Initiative, echoed that concern in a statement.
“The WHO is indispensable for the U.S. response to COVID-19 and withdrawing is a travesty. The President's move is political, aimed primarily at a domestic audience in an election year,” Kavanagh said. “Nonetheless, leaving WHO will immediately harm public health in the U.S. during a pandemic, making Congressional action urgent. The U.S. depends every day on WHO's disease surveillance, research and emergency response. WHO is coordinating efforts to secure [a] COVID-19 vaccine and treatments to safely reopen our economy and society. Ebola was just halted in the eastern Democratic Republic of the Congo because of WHO.”

According to Kavanagh, multiple infectious diseases — including seasonal influenza, HIV, polio and others — threaten the health of the U.S. and the world if WHO is weakened.

Multiple medical societies also issued statements voicing their concern. In a joint statement from the American Academy of Pediatrics, the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP) and the American Medical Association, several experts explained the “grave risk” the withdrawal from WHO will put the U.S. in and the “major setback to science, public health and global coordination efforts needed to defeat COVID-19” that the withdrawal represents.

“The WHO plays a leading role in protecting, supporting and promoting public health in the U.S. and around the world. The agency has been on the front lines of every global child health challenge over the last 7 decades, successfully eradicating smallpox, vaccinating billions against measles and cutting preventable child deaths by more than half since 1990. Withdrawing from the WHO puts these investments at risk and leaves the United States without a seat at the table — at a time when our leadership is most desperately needed,” AAP President Sally Goza, MD, FAAP, AAFP President Gary L. LeRoy, MD, AMA President Susan R. Bailey, MD, and ACP President Jacqueline W. Fincher, MD, FACP, wrote in the joint statement, adding that a worldwide coordinated response is more vital than ever as the COVID-19 pandemic continues.

"This dangerous withdrawal not only impacts the global response against COVID-19, but also undermines efforts to address other major public health threats,” they said.

The AAP, AAFP and AMA “strongly oppose this short-sighted decision,” according to the statement.

The authors called on Congress “to reject the Administration’s withdrawal from the WHO and make every effort to preserve the United States' relationship with this valued global institution.”

“Now is the time to invest in global health, rather than turn back,” they said.

Thomas M. File, Jr., MD, FIDSA, President of the Infectious Disease Society of America, said the organization was “disappointed” with the administration’s decision to “abandon” WHO.

“Abandoning our seat at the table leaves the U.S. out of global decision-making to combat the virus and global efforts to develop and access vaccines and therapeutics, leaving us more vulnerable to COVID-19 while diminishing our position as the leader in global health,” File said in a statement. “As the daily infection rates show, America has much it can learn from other parts of the world that have reduced infection and death rates. Without the WHO, the nation is at higher risk of being inadequately prepared for many health risks of pandemic proportions. It is hard to downplay how significant and short-sighted this action is.”

Judith Feinberg, MD, FIDSA, chair of the HIV Medicine Association, continued this sentiment, saying that this decision will not only leave the U.S. more vulnerable to COVID-19 and future pandemics — is a major setback in the fight against HIV both in the U.S. and globally.

“Withdrawal will undo decades’ worth of collaborative progress and will endanger the important investments we have made in fighting the HIV pandemic,” she said in a statement. “Our country’s long-standing collaboration with the WHO has been critical to our role as a global leader in fighting HIV, saving 17 million lives thus far, and preventing millions of new HIV infections.”

According to Feinberg, recent pandemics — including AIDS, severe acute respiratory syndrome, Middle Eastern respiratory syndrome, H1N1 and influenza — make it clear that “germs get on planes and travel to new locations with impunity.”

“If we cannot work closely with the WHO, the administration’s noble goal of Ending the HIV Epidemic in the U.S. by 2030 will be at risk,” she said.

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