Criticism of the World Heath Organisation’s response to the coronavirus pandemic has highlighted a need to reform the UN agency, but any change could be limited by how much authority it is given by member countries.
That is according to Elizabeth Cousens, chief executive of the UN Foundation, an American charitable organisation that supports the United Nations.
Cousens also noted China’s growing influence in UN agencies like the WHO, and said the US should be trying to boost its influence in the global health body instead of withdrawing from it.
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“China is clearly asserting itself in a much more visible way across the UN system, including WHO, as its economy grows and its global and political aspirations grow,” she said.
But she said the perception that China had a disproportionate influence in the WHO because of its funding was not correct, noting that Beijing’s financial contribution was relatively small compared to other major donors.
The US is the WHO’s largest donor, contributing around US$420 million a year – or 18 per cent of its funding – while China is not among the agency’s top 10 donors.
Washington said early this month that it was proceeding with a one-year process to withdraw from the WHO. Nerissa Cook, deputy assistant secretary of state for international organisation affairs, said the White House would only consider changing this position if the WHO underwent reform, “starting with demonstrating its independence from the Chinese Communist Party”.
Cousens said it was unwise for the US to withdraw funding and stop seconding staff to the WHO if it wanted to reform the agency.
“It is about leverage – if you want leverage in the institution, it usually helps to invest in it, and that is everything from your financial investment, to your diplomats to your technical experts,” she said.
Cousens also said the WHO did not have the authority to do many things its critics said it should have done. “We do need to give WHO a different set of authority to be able to do the kind of things they [critics] have been asking or they wish they have been able to do. But under the present structure and the authority they are given, they do not have that power.”
But whether it could gain more authority would depend on the member states, she said.
“Countries need to decide what kind of WHO they want,” she said.
Reform of the agency should also look at how to have a system that would help countries deliver the best health services, according to Cousens.
“Fundamental tension of every multilateral system is about a balance of how much authority a country wants to give an institution,” she said.
“This [Covid-19] crisis is surfacing that question for a fresh look about where the balance is. I think it would be a mistake to look at it purely from in terms of what China wants or does not want. Or what the US wants or does not want, or other countries.”
Cousens said she hoped an independent review committee looking into how the WHO and member states have responded to the pandemic could provide direction on how the agency should reform.
She also noted that many politicians and key players were still working to try to reverse President Donald Trump’s decision to withdraw the US from the UN agency before the July deadline next year.
“I don’t think anyone wants to get the US off the hook and there is a strong desire to get the US back into WHO to reverse the step that was taken, which can be done anytime,” she said.
Her remarks follow a call early this week for sweeping reforms to the global public health system by an international body set up by the WHO and the World Bank in 2018 to monitor readiness for public health emergencies.
In a report released on Monday, the Global Preparedness Monitoring Board said Covid-19 “revealed a collective failure to take pandemic prevention, preparedness and response seriously”.
Victor Dzau, president of the US National Academy of Medicine and one of the co-authors of the report, said a lack of cooperation among countries had led to the “collective failure”.
“If countries don’t act together we fail collectively. While it is a global pandemic, countries are acting independently without essential agreement on how to act collectively,” he said.
But Dzau would not comment on the response in the initial stage of the pandemic in January, saying he would leave that to the independent panel. The Global Preparedness Monitoring Board, of which Dzau is a member, had issued a report last year warning of a public health crisis caused by an infectious pathogen.
Dzau said multilateralism was crucial for pandemic preparedness.
“We better wake up. Can we achieve multilateralism? It will take the commitments of people and governments to make it happen,” he said.
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