U.S. Should Fund Worthy Public Health Organizations, Not the WHO

Doctors Without Borders Far More Effective Than International Bureaucrats

April 24, 2020

In the name of public health, U.S. taxpayers spend nearly half a billion dollars per year funding a sprawling international bureaucracy called the World Health Organization (WHO). But questions have rightly been raised about the WHO’s handling of the Coronavirus crisis.

This is nothing new; the WHO had a similarly bungled response to the 2014 Ebola outbreak. But now, a diverse coalition including  Sen. Marco Rubio (R-Fl.) and WHO Collaborating Center on National and Global Health Law director Lawrence Gostin agree that the United Nations sub-agency is falling short of its mission, even if they don’t see eye to eye on how to fix the situation. Instead of funding the corrupt, bloated middleman that is the World Health Organization, the U.S. and allied governments should scale up funding of worthy public health organizations such as Doctors Without Borders.

Taxpayers and patients can do better than fund an organization that spends more on travel than medical supplies, pedals misleading data, and parrots Chinese Communist Party talking points.

By now, the WHO’s gross mismanagement of the Coronavirus crisis is in full public view. University of North Carolina scholar Dr. Zeynep Tufekci invites readers of The Atlantic to imagine a world where the organization did not, “stick disturbingly close to China’s official positions, including its transparent cover-ups. In place of a pandemic that is bringing global destruction, just maybe we could have had a few tragic local outbreaks that were contained.” But Dr. Tufekci and others rightly note that, in lieu of an alternative structure, doing away with the WHO tomorrow would be disastrous—especially for poor countries.

The question becomes, then, what alternative the U.S. and allied governments can provide to the failed structure of the WHO.

Policymakers can take a page out of the WHO’s own playbook and take note of how the UN sub-agency deals with small organizations fighting on the frontlines against disease and poverty. The WHO has existing agreements called “Standby Partnerships” with commendable organizations whose staff can be deployed at a moment’s notice to respond to an emergency situation.

If a local WHO office is in over their heads, they can request help, and organizations such as CANADEM and the Information Management and Mine Action Program can suggest qualified applicants that can fill the personnel gap. The WHO office then vets and selects the personnel they want and covers transportation and security clearance costs while the NGOs’ countries of origin usually pay for deployment costs. 

Similarly, organizations such as Doctors Without Borders (DWB) are doing amazing work on a shoestring budget outside the WHO—while rightly criticizing the WHO for not doing their job efficiently. In 2019, DWB accused the WHO of withholding Ebola vaccines in the Democratic Republic of Congo with emergency coordinator Natalie Roberts noting, “It’s like giving firefighters a bucket of water to put out a fire, but only allowing them to use one cup of water a day.”

Instead of having taxpayers contribute more than $400 million per year to fund the WHO’s epic ineptitude, the U.S. could cut out the middleman and redirect these resources toward groups such as DWB. This would almost immediately free up bloated administrative costs to provide for doctors and patients in need. The WHO, after all, spends roughly $25,000 per employee per year on travel costs, while DWB spends around $500 on transportation and lodging.

There is, of course, always a risk that if countries massively ramp up funding for these organizations, the recipient groups will become bloated similar to the WHO.

To mitigate this problem, America and other prominent donor countries should coordinate through a new framework and establish a revolving grant program for NGOs with strict conditions on annual funding renewals. Financial transparency would be a must, with regular audits and mandatory disclosures. In order to maintain the flow of funding from donor countries, organizations would have to demonstrate results in advancing public health while minimizing travel cost growth.

Public health experts could decide reasonable outcome and cost metrics, while an inspector general could regularly keep tabs on the disbursement of funds. Such a system would result in a well-funded global public health system that is held accountable and not beholden to repressive dictatorships. Surely this system would be better than the failed status-quo of WHO corruption and mismanagement.  

 

Ross Marchand is the director of policy for the Taxpayers Protection Alliance.