WHO exit looms over pandemic response reforms

The Senate Foreign Relations Committee is considering various proposals to change the way the United States handles future outbreaks.

Senate Foreign Relations Committee Chairman Sen. James Risch (right) elbow bumps James Richardson, director of the State Department's Office of Foreign Assistance, prior to the start of a June 18 hearing.
June 25, 2020, 8 p.m.

With the United States still in the midst of the coronavirus pandemic, lawmakers on the Senate Foreign Relations Committee are already plotting reforms to deal with the next global outbreak.

President Trump’s decision to exit the World Health Organization looms over the debate.

Chairman James Risch introduced legislation late last month with Democrats Ben Cardin and Chris Murphy to authorize $3 billion between 2021 and 2025 for global health security. The legislation establishes a Senate-confirmed coordinator at the State Department to manage global health-security policy—which is buried within the oceans, environment, and science bureau—and would encourage the president to appoint someone within the National Security Council to coordinate the interagency process.

The Trump administration is reportedly moving in a similar direction.

Committee Democrats plus Sen. Ron Wyden, meanwhile, are pushing legislation that would require the U.S. to release 2020 funding for the WHO and pay arrears from 2019. The measure would also mandate the appointment of a pandemic-response coordinator within the NSC, but would make U.S. Agency for International Development the “operational lead” for pandemic response, rather than the State Department.

“You have [debate] on the issues of bureaucratic organization and funding, and [in] which part of the U.S. government this is created,” said Thomas Bollyky, director of the global-health program at the Council on Foreign Relations. “Everybody agrees it is important … but the bills currently don’t agree about where that should reside, and they don’t necessarily agree as to what the WHO’s role should be.”

Trump announced that he was cutting off funding for the WHO in mid-April, pending the outcome of an investigation into the organization’s relationship with China. He announced on May 29 the U.S. would exit the WHO.

The State Department has yet to pull the trigger. Office of Foreign Assistance director James Richardson said during a June 19 conference call with reporters that the State Department was “in the process of notifying the WHO” about the United States’ withdrawal. On Wednesday, a State Department spokesperson told National Journal that the department “will be sending a formal, written notification to the WHO regarding the United States’ intent to withdraw from the organization.”

The timeline is important—as former State Department legal adviser Harold Koh wrote for Just Security last month, Trump’s announcement may not take effect until one year after the notification. Upon joining the organization in 1948, President Truman acknowledged that he was joining “subject to the provisions” of a joint resolution that required “a one-year notice.” No country has ever left the WHO.

“This is not a light-switch moment. It’s more like unscrewing a light bulb, so it does take a little bit of time,” Richardson said.

One SFRC aide said that the WHO withdrawal has “complicated” discussions on legislation, but suggested that the drawn-out period may give Washington leverage over reforms at the organization.

“The announcement was the first point of leverage, saying we’re serious and things have got to change. And now the ball is in WHO’s court. If nothing meaningful happens over the next several days, weeks, months, … they file the paperwork. If there’s not satisfactory action after that, then, we are formally negotiating our withdrawal,” said the aide, who was granted anonymity to discuss the bills.

The committee will meet virtually next week to hear expert testimony on pandemic response after hearing from State Department and Health and Human Services Department officials last week, when Democrats grilled officials about the WHO pullout and plans to influence the organization through the G7. At that hearing, ranking member Menendez expressed concern about language in the Risch proposal setting up a health infrastructure at the World Bank, which he said could create “parallel bureaucracy” to the WHO.

“There is concern as to whether that’s a cover-type operation to divide the international community,” said Cardin, who cosponsored the legislation. Murphy, the second Democratic cosponsor, said the provision was “not an attempt to replace what WHO does,” but would mirror the Millennium Challenge grant program, which conditions aid money to developing countries on domestic reforms.

While Republicans and Democrats disagree about leaving the WHO, lawmakers from both parties have concluded that pandemic-reform legislation ought to address China’s influence at the organization. The Democrats’ bill directs the U.S. representative at the WHO to push for an “interim assessment” by outside experts of the organization’s response to the COVID-19 outbreak.

And some Democratic proposals could make it into Risch’s bill, which the chairman said last week was “written on paper, not in stone.” Congress provided $1.6 billion for the State Department and USAID through the CARES Act, but subsequent coronavirus relief packages did not provide additional funding.

The State Department spent over $500 million of the supplemental funding so far, Richardson testified last week.

While Republicans endorsed Trump’s suspension of funding for the WHO, a few broke with his decision to leave the organization altogether. Senate HELP Committee Chairman Lamar Alexander said in a statement last month that the pullout could interfere with clinical trials and “make it harder to work with other countries” on stopping viruses outside the United States.

House Foreign Affairs Committee ranking member Mike McCaul said in a scathing report into China’s influence over the WHO that a withdrawal was not “the correct path forward.” McCaul previously lobbied Trump to suspend funding until director Tedros Adhanom Ghebreyesus steps down.

“We should always be looking at reforming international organizations,” Cardin told National Journal. “Times change, the circumstances change, the World Health Organization needs to learn from its shortcomings in this pandemic.”

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