The United States is leaving the World Health Organization. What could that mean for Spokane?

As of President Donald Trump’s first day back in office Monday, the United States is leaving the World Health Organization. Some local experts think such a move might leave Spokane and the United States unprepared for the next pandemic.

Trump tried to end American involvement with WHO in his first term but ran out of time before losing his re-election bid to Joe Biden. With four years of his term ahead, the chances of the United States leaving the global public health organization are much higher.

According to the executive order, America intends to leave WHO because of the “onerous payments” it is required to pay and the organization’s “mishandling of the COVID-19 pandemic.”

University of Washington professor of Global Health Carey Farquhar said the country will not keep emerging diseases at bay without WHO.

“It’s not going to be good. It’s not going to have a good effect. There’s not one good thing I can think of that will come out of this,” she said.

What is the World Health Organization?

The WHO is an agency of the United Nations tasked with coordinating responses to public health emergencies between nations. The United States is a founding member of the organization, which was set up in 1948 in the wake of World War II.

Congress approved the United States’ entry into the organization. Withdrawing from it may also take an act of Congress.

The organization does not have the authority to force any specific actions from member nations, but provides information and coordinates action against diseases that do not see political boundaries.

“Infectious diseases don’t respect borders. The U.S. is part of the globe. Inevitably what happens in central Africa may reach the U.S.,” Farquhar said.

Former Spokane Regional Health District administrator Torney Smith said diseases “don’t give a hoot” about borders.

“We will lose connectivity and understanding of what is going on around the globe. And as much as we talk about locking our borders, we can’t shut the border down from organisms. If we don’t know what’s coming, we’ll be behind the 8-ball when we try to respond,” Smith said.

To prevent these global diseases from spreading, WHO provides member states with up-to-date information on their spread, how different strains of diseases change over time and what prevention efforts have worked elsewhere.

For example, each year flu season begins in the southern hemisphere and then travels up to the United States. Through WHO as a conduit, America gets up-to-date information from the global south about which strains of the flu are prevalent in a given year. That data informs how the U.S. formulates each year’s flu vaccine. Without that data, the effectiveness the flu vaccine may go down.

That effect may be more stark when dealing with an emergent disease that requires a new vaccine. Without global data, the United States may be unable to develop new vaccines until the disease is already endemic here.

“If we had to wait until a disease happens on our shores and then we try to build vaccine, we’re going to lose a lot of people,” Smith said.

Cost of WHO

The current budget of WHO is over $6 billion. The United States provides almost 20% of the organization’s funds each year. That cost is a primary factor in the United States’ withdrawal.

“If we can prevent a disease before it gets here, that will cost us a lot less than what we pay into the WHO,” Smith said.

McBride also noted the void created by the United States’ departure may leave the door open for China to become the world’s leader in global health.

“The country that is ready to step in is China. We could be putting our national security at risk in addition to our public health,” McBride said.

Alternatively, that funding vacuum might not be filled by other countries, which could make the WHO cut back on its efforts at the same time the U.S. isolates.

Local impacts?

In a statement, the Spokane Regional Health District said it did not anticipate any immediate impacts to local public health.

“At this time, the impact of the United States leaving the World Health Organization is not something we can predict. We don’t see SRHD’s local activities being immediately impacted, and our day-to-day operations will not change,” SRHD spokesperson Kelli Hawkins said. “We do look to the WHO as a resource for timely information about emerging infectious diseases, global health trends and evidence-based practices. We don’t see that changing in the foreseeable future.”

But once the United States leaves, the work of small public health agencies may be affected, as they rely on global data to inform the public. Smith believes such an impact will be felt at SRHD if the United States does leave.

“We get information from their data sets we rely on here locally. All of that will impact our ability to respond to epidemics or pandemics. Our population is at greater risk across the country, including here in Spokane,” Smith said.