The Main Point: In addition to supporting work on AIDS, tuberculosis, malaria, and maternal and child health in Africa, funding the WHO lets the U.S. engage in global health diplomacy in the region. This collaboration is vital for coordinating a worldwide response to COVID-19.
This policy memo is part of a series explaining the WHO. Read more here.
Our research on health governance in Africa illustrates how funding cuts to the WHO will negatively affect U.S. health partnerships in the region.
During both the Obama and Trump administrations, the U.S. partnered with WHO to promote the Global Health Security Agenda. Spearheaded by the CDC Division of Global Health Protection, the global program is designed to boost global health security via strong and resilient public health systems that can prevent, detect and respond to infectious disease threats worldwide. The U.S. CDC collaborates with 12 African countries in the effort. In its 2019-2021 Global Health Strategy, the U.S. identifies WHO as a strategic partner in efforts to strengthen the capacity for timely and effective responses to outbreaks.
The African Union relies on WHO assistance in global health outbreaks. As the result of a WHO-AU agreement in 2019, the WHO has helped train health care providers, established coronavirus testing labs, and delivering needed supplies to African countries most hit by COVID-19. WHO funding cuts could erode operational capacity for testing and contact tracing, and slow down the attempts by WHO to accelerate research and development towards the creation of a COVID-19 vaccine. These activities will also be critical in the future, as experts now predict that the virus will linger worldwide until at least 2022.
Over the last two decades, the U.S. has spent significant funds on AIDS, tuberculosis, malaria, and maternal and child health in Africa. For example, PEPFAR has spent over $90 billion on HIV prevention and AIDS treatment programs in 50 countries since 2003. PEPFAR collaborates with WHO to deliver HIV prevention messages, ensure quality medications and design global standards for the rapid expansion of the healthcare workforce. PEPFAR’s ability to provide treatment to 14.6 million people and prevent millions of HIV infections in 2018 depends in part on leveraged partnerships like those with WHO.
Similarly, U.S. maternal and child health projects (slated to receive over $1 billion in 2020) rely on collaboration with WHO. The U.S. and WHO have developed guidelines and training packages for postnatal care and preterm birth, and the U.S. is a major contributor to vaccine-preventable disease programs. These efforts help to decrease the estimated 15,000 children and 800 women who die each day from preventable causes, over 80 percent of whom live in Africa. Erosion of the U.S.-WHO partnership could have unanticipated spillover effects on non-health programs, including the White House’s Women’s Global Prosperity and Development Initiative, which seeks to promote entrepreneurship for 50 million women in poor countries by 2025. Studies indicate that women’s health – including access to reproductive and family planning programs – matters for their economic advancement.
African leaders are concerned about potential U.S. funding actions. They have voiced support for the WHO and stressed that cooperation is essential in health. They recognize that the WHO brings technical expertise and diplomatic skills to global health, often working behind the scenes and on issues the U.S. has not prioritized in Africa, such as noncommunicable diseases (diabetes, heart disease, and hypertension) that cause most deaths worldwide and also increase the risk of death from coronavirus. Defunding the WHO undermines the U.S. ability to engage in global health diplomacy at just the moment when global interdependence challenges population health and economic survival.
Amy Patterson is a professor of politics at the University of the South.
Emmanuel Balogun is an assistant professor of political science at Skidmore College.
For more read the authors’ piece in the Washington Post (May 5, 2020)