On President Trump’s dangerous decision to freeze funding of the World Health Organization (WHO)

Richard Horton, the editor-in-chief of the Lancet medical journal, described Trump’s decision as “a crime against humanity,” tweeting “every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity.”(HuffPost)

The Trump administration’s decision to halt funding of the World Health Organization (WHO) is as—if not more than—politically, morally, and legally irrational, reckless and dangerous than its 2018 decision to no longer honor the promises made by the U.S. in The Joint Comprehensive Plan of Action (JCPOA), commonly known as the Iran nuclear deal. No such global entity is flawless (that is, beyond this or that criticism) in a post-Westphalian world order of nation-states subject to the cycles, manias, and crashes endemic to capitalist globalization and marked by post-imperialist world powers competing for hegemony. But WHO’s mandate, purposes, and programs are absolutely essential for all countries and peoples of the world, serving as a vivid reminder of our shared vulnerabilities, capacities, and powers as human animals on this planet. The desiderata of public health* cannot be satisfied by any nation alone, as diseases, epidemics, and pandemics do not respect geopolitical borders, and global coordination of the requisite scientific and medical expertise has long been demonstrated absolutely necessary to achieving the common goals of health and safety, human welfare and well-being, as well as human development and flourishing.

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Here is an introduction to WHO from Wikipedia:

“The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. It is part of the U.N. Sustainable Development Group. The WHO Constitution, which establishes the agency’s governing structure and principles, states its main objective as ensuring ‘the attainment by all peoples of the highest possible level of health.’ It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide.

The WHO was established in 7 April 1948, which is commemorated as World Health Day. The first meeting of the World Health Assembly (WHA), the agency’s governing body, took place on 24 July 1948. The WHO incorporated the assets, personnel, and duties of the League of Nations’ Health Organisation and the Office International d’Hygiène Publique, including the International Classification of Diseases. Its work began in earnest in 1951 following a significant infusion of financial and technical resources.

The WHO’s broad mandate includes advocating for universal healthcare, monitoring public health risks, coordinating responses to health emergencies, and promoting human health and well-being. It provides technical assistance to countries, sets international health standards and guidelines, and collects data on global health issues through the World Health Survey. Its flagship publication, the World Health Report, provides expert assessments of global health topics and health statistics on all nations. The WHO also serves as a forum for summits and discussions on health issues.

The WHO has played a leading role in several public health achievements, most notably the eradication of smallpox, the near-eradication of polio, and the development of an Ebola vaccine. Its current priorities include communicable diseases, particularly HIV/AIDS, Ebola, malaria and tuberculosis; non-communicable diseases such as heart disease and cancer; healthy diet, nutrition, and food security; occupational health; and substance abuse.

The WHA, composed of representatives from all 194 member states, serves as the agency’s supreme decision-making body. It also elects and advises an Executive Board made up of 34 health specialists. The WHA convenes annually and is responsible for selecting the Director-General, setting goals and priorities, and approving the WHO’s budget and activities. The current Director-General is Tedros Adhanom, former Health Minister and Foreign Minister of Ethiopia, who began his five-year term on 1 July 2017.

The WHO relies on assessed and voluntary contributions from member states and private donors for funding. As of 2018, it has a budget of over $4.2 billion, most of which comes from voluntary contributions from member states.” [….]

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Here are a handful of titles that help one understand the immense importance of this UN agency’s mandate and responsibility for international public health, whatever our specific criticisms or list of shortcomings (e.g., Farmer, et al. below):

• Farmer, Paul, Jim Yong Kim, Arthur Kleinman, and Matthew Basilico. Reimagining Global Health: An Introduction. Berkeley, CA: University of California Press, 2013.
• Fidler, David P. International Law and Infectious Diseases. Oxford, UK: Clarendon Press, 1999.
• Fidler, David P. International Law and Public Health: Materials on and Analysis of Global Health Jurisprudence. Ardsley, NY: Transnational Publ., 2000.
• Fidler, David P. The Challenges of Global Health Governance. New York: Council of Foreign Relations, 2010.
• Fidler, David P. and Lawrence O. Gostin. Biosecurity in the Global Age: Biological Weapons, Public Health, and the Rule of Law. Stanford, CA: Stanford University Press, 2008.
• Gostin, Lawrence O. Global Health Law. Cambridge, MA: Harvard University Press, 2014.

* Please see the following titles by Lawrence O. Gostin:

• Public Health Law: Power, Duty, Restraint (University of California Press, 3^rd ed., 2016)
• Public Health Law and Ethics: A Reader (University of California Press, 3^rd ed., 2018)
• Human Rights in Global Health: Rights-Based Governance for a Globalizing World (Oxford University Press, 2018)
• Principles of Mental Health Law & Practice (Oxford University Press, 2010).
• Global Health Law (Harvard University Press, 2014)