The Complicated Relationship Between China and the WHO

The Complicated Relationship Between China and the WHO

I wanted to take some time to answer some of the common questions I’ve been seeing about China’s relationship with the World Health Organization (WHO), and possible US retaliatory actions against both.

What would happen to the WHO if the US did indeed pull its majority funding?

There’s a bit more to it than funding, but let’s start there: The 194 member countries fund the WHO in two ways; assessed contributions (set expected amounts scaled by income and population) and voluntary contributions which are usually earmarked for certain activities. The US taxpayer is consistently the lead funding source, accounting for 22% of total funding (the maximum allowed rate), and among only 17 countries whose funding exceeds the 1% mark. The next highest contributor is Japan, funding approximately 9.7 of the total. China comes in at about 8%. US voluntary contributions support efforts such as polio eradication; maternal, newborn, and child health programs; food safety; and regulatory oversight of medicines. 

The US is also very involved in governance of the organization, being one of a few actively engaged members of the World Health Assembly, and holding a seat on the Executive Board. The US Department of Health and Human Services lends much needed leadership and vision to the organization. 

U.S. experts and resources provide technical assistance by supporting WHO research and lab work. They also fill the WHO advisory panels, and some are liaison officers at WHO headquarters and regional offices, working daily shifts.

Withdrawal of financial support from the United States would equate to a loss of almost a quarter of the funding the WHO depends on to operate. It is unlikely they would be able to continue to operate in any meaningful way, and the likelihood of another country filling that void is low. They would be forced to narrow their operations and focus on efforts considered their core mission and competencies which would be difficult to adjudicate with so many member states and such a broad mandate (“act as the directing and coordinating authority on international health work” within the United Nations system”.) The loss of the directional leadership guidance the United States provided will affect decision making and implementation. Arguably equally as important as funding, a loss of the technical support and expertise the US lends to the organization will impact their ability to generate meaningful outcomes, and reflect on the organization’s professional credibility as a whole.    

Source: The U.S. Government and the World Health Organization, Kaiser Family Foundation, 24 January 2019.

Can other countries fill the void? What would the impact be on world health?

Other countries and/or organizations could hypothetically step up and fill the void but it would be a large undertaking. The next three largest donors (Japan, China, Germany) would have to double their contributions – it’s not likely that the budget is readily accessible. The load of this question is the correlation between public health and the efficacy of the WHO – is that really the case? Where has the WHO been in regards to the outbreaks the US has faced during its tenure?  The polio vaccine came out of American academia, the mid-80s measles outbreak was handled by the CDC, and the AIDS cocktail was produced by the private American pharmaceutical industry. To reboot Jed Babbin’s infamous quote, it seems that responding to a pandemic without the WHO is like going deer hunting without an accordion. The American people, in particular, would be far more protected if the money was redistributed to the Centers for Disease Control and Prevention (CDC) and especially the little-known National Center for Medical Intelligence, which is a component of the Defense Intelligence Agency that applies espionage tradecraft to collect intelligence on a wide range of health issues that can impact United States interests. 

Has the WHO become more or less inclined to criticize China over the years?

It does appear that they have become less inclined to criticize China over the years. A 1992 WHO bulletin mentions the correlation between Chinese rabies rates and the consumption of dogs by humans. The 2000 WHO World Health Report called the equity of financial contributions in the Chinese health system poor. A 2008 WHO bulletin admitted that “Since the 1980s, the Chinese health system has not been performing well.” Fast forward to today and the WHO Director-General is saying the CCP should be congratulated for their expert response to the outbreak and subsequent information sharing, but in reality, leaked Chinese reports indicate Chinese doctors were ordered to destroy samples and suppress the details. 

Has the organization leveled blame at other governments over the years for their handling of certain issues?

Yes, in a 2014 assessment, the WHO blamed Israel for the health crisis in Palestine. Just this past September the WHO accused Tanzania of covering up an Ebola outbreak. 

Is the WHO/China issue merely symbolic of a deeper issue plaguing the UN system?

Yes. The United Nations is an ineffective bureaucracy that wastes money that would be far more effectively spent by the independent members reinvesting their contributions domestically. 

In what other ways is China given different/or inappropriate access and treatment in the UN as a whole?

First off, China is the only permanent member of the Security Council that is a one-party socialist republic. They are also getting away unchallenged with blatant human rights violations (Uighur internment) and getting awarded a seat on the Human Rights Council on top of it.

Where does the security council currently stand in terms of holding China accountable? 

There is no accountability. China is a permanent member and there just isn’t effectual impact in reality.

What countries are backing the US in trying to put forward a resolution and who is standing with China?

The United Kingdom and Australia are backing the United States in highlighting the culpability of the CCP. China is doing masterful political strategizing by supplying medical supplies to nations in crisis so few others are standing up against them, and many are lauding the support. China is doing what they do best: information warfare through propaganda. First, they attempted to frame themselves as a victim of the outbreak (even going so far as saying it was a US Army operation) and now they are doing the next best thing – showing how they can rise from the crisis as a resilient hero who is able to lend support to other countries in need. They want to demonstrate that they are the true global logistical superpower.  

Can the US act on those standing with China?

The United States has many economic levers they can pull by restricting trade, incentivizing manufacturing to return, levying tariffs, and even implementing sanctions. 

Thanks for reading.

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