LONDON - The director general of the World Health Organization has given a dignified and measured response to President Donald Trump’s decision to halt U.S. funding of WHO, pending a review of its handling of the coronavirus pandemic.

“We regret the decision of the president of the United States to order a halt in funding to the World Health Organization,” said Tedros Adhanom Ghebreyesus. “The U.S. has been a longstanding and generous friend to us and we hope it will continue to be so.”

WHO will monitor the effect of any withdrawal of U.S. funding and will work with other partners to try and fill any gaps “to ensure our work continues uninterrupted,” Ghebreyesus told attendees of a teleconference streamed from WHO headquarters in Geneva on April 15. “Our commitment to public health, science and to serving all the people of the world without fear or favor remains absolute,” he said.

When the crisis is over, there will be a review of WHO’s performance by member states. “No doubt, areas for improvement will be identified and there will be lessons for all of us to learn. But for now, our focus – my focus – is on stopping this virus and saving lives,” said Ghebreyesus.

Tedros Adhanom Ghebreyesus, director general, WHO

There is widespread concern from politicians and public health experts across Europe to President Trump’s announcement. “I deeply regret the U.S. decision to suspend funding to WHO,” said Josep Borrell, head of the EU’s foreign service. “There is no reason justifying this move at a moment when [WHO’s] efforts are needed more than ever to help contain and mitigate the coronavirus pandemic,” Borrell tweeted.

Similarly, Simon Coveney, Ireland’s foreign minister, called it an “indefensible decision,” tweeting that it is “shocking” to be deliberately undermining trust in WHO in the midst of a global pandemic.

Peter Piot, director of global health at the London School of Hygiene & Tropical Medicine, said cutting funding to WHO is dangerous and shortsighted. “We need WHO now more than ever. Its technical expertise, guidance and leadership is supporting countries to implement optimum science-based strategies to prevent and control COVID-19,” Piot said, adding, “Strong support from the U.S. has always been key for WHO’s effectiveness and must continue.”

Michael Head, senior research fellow in global health at Southampton University, said it is a two-way street and the U.S. needs WHO to help deliver the fruits of U.S. research in coronavirus research. Head recently published an analysis of $105 billion of grants for infectious disease research from G20-based public and philanthropic funding bodies between 2000 and 2017, showing U.S. organizations provided 78% of the total. For coronavirus research specifically, 77% was from the U.S.

“The WHO is taking new knowledge from research and creating policies, guidance and surveillance,” Head said. If the U.S. withdraws support from WHO, the effects would be seen worldwide, but also could rebound in the U.S., where “high-threat pathogens would be more likely to occur in future,” he said.

The U.S. is the biggest donor to WHO, giving $400 million in 2018-2019. That is followed by the Gates Foundation and the U.K. government, which each donated $220 million.

“Halting funding for WHO during a world health crisis is as dangerous as it sounds,” Bill Gates tweeted in response to the news.

In his statement, President Trump said WHO is “severely mismanaging” the pandemic and “covering up” the spread of the coronavirus.

That assessment came as WHO published an update to its COVID-19 preparedness and response plan, based on evidence it has accumulated in the past three months about how COVID-19 spreads, the severity of the disease it causes, how to treat it and how to stop it.

“We have learned so much about this virus, and we’re still learning,” Ghebreyesus says in the foreword to the plan.

Lifting restrictions

For WHO, the pandemic has three defining characteristics: its speed and scale, which has overwhelmed even the most resilient health care systems; its severity, with more than 20% of cases being severe or critical and a death rate of 3%; and the huge socioeconomic impact the coronavirus is exacting.

Based on experience to date, the WHO plan provides guidance for countries preparing to lift restrictions to do it in a way that will keep transmission at a low level whilst enabling some parts of economic and social life to resume.

That, too, is the theme of an EU roadmap published by the European Commission on April 15, setting out guidelines for a coordinated lifting of COVID-19 containment measures. All EU member states have prohibited public gathering, closed schools, universities shops and businesses, and introduced travel restrictions.

The commission calls on member states to increase COVID-19 testing and tracing capacity in order to be able to lift control measures gradually. However, Stella Kyriakides, commissioner for health, said, “Until effective treatments and a vaccine are found, we will have to learn to live with this virus.”

Given that, any move to return to normality after the coronavirus lockdowns will require a carefully coordinated approach based on science. “It is crucial that our health care systems have the capacity to treat increases in new cases, that essential medicines and equipment are available and that we have large-scale testing and tracing capacity in place,” Kyriakides said. “We know that this road will be long and gradual and that the consequences of this unprecedented health crisis will be long lasting.”

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