The Trump Administration’s Ignominious Exit at the 2020 World Health Assembly

On the occasion of the 73rd World Health Assembly (WHA), the Trump administration consciously chose to escalate its confrontation with both the World Health Organization (WHO) and China. The alternative was a path of constructive collaboration in the face of the coronavirus pandemic, the Assembly’s singular focus and the hope of the overwhelming majority of the 194 countries in virtual attendance. Ultimately, any thoughts within the Trump administration about the pursuit of a common purpose—as suggested in a draft presidential letter leaked to Fox News on Friday, March 15—lost out to far more powerful considerations driving White House calculations.

A rapidly unraveling U.S.-China relationship has seen a sharp descent across all dimensions—technology, security, intellectual property, trade—into unprecedented levels of mutual rancor and recriminations. Responding to the pandemic has been no exception. Moreover, unbridled U.S.-China toxicity is blended with, and given additional energy and focus by, the president’s increasingly anxious search for a path to reelection. That is a highly uncertain enterprise in the face of 36.5 million unemployed, 1.5 million confirmed Covid-19 cases, and over 91,000 dead in the United States. Deflecting blame outward to China, and casting WHO as a captive accomplice, is believed within the White House to fire up the president’s base, please the “China hawks,” and strike a mighty blow against multilateralism.

The administration’s ignominious exit in Geneva from any global leadership role in the pandemic response was a two-step escalation.

Secretary of Health and Human Services Alex Azar delivered videotaped remarks on May 18 alleging that WHO’s “failure” to warn the world about the pandemic “cost many lives.” In becoming a tool of China, Secretary Azar claimed, WHO “failed at its core mission of information sharing and transparency when member states do not act in good faith.” He ended by calling “the status quo . . . intolerable” and called for more transparency and accountability from the WHO.

Following Secretary Azar’s remarks, President Trump tweeted a letter addressed to WHO Director General Dr. Tedros Adhanom Ghebreyesus. The president’s letter was a hastily composed, lengthy charge sheet marred by factual errors, blatant falsehoods, and dubious interpretations of ambiguous evidence. It concluded with the threat to terminate all assistance and withdraw U.S. membership from WHO if within 30 days there are no “substantive improvements” in unspecified areas.

Most importantly, these moments exposed WHO’s structural weaknesses: its lack of any inspection authority or independent source of intelligence and its secretariat’s abject subordination to powerful member states, China and the United States alike, among others. 

At the heart of the dual assaults on WHO is legitimate frustration and anger that it was excessively deferential and unquestioning toward China at critical moments in early January, when the discovery of the virus first unfolded and when China was inclined to obfuscate and delay, particularly in acknowledging human-to-human transmission. Most importantly, these moments exposed WHO’s structural weaknesses: its lack of any inspection authority or independent source of intelligence and its secretariat’s abject subordination to powerful member states, China and the United States alike, among others. 

Trump and Azar’s actions, and China’s equally virulent retorts, created an air of existential crisis surrounding WHO, caught as it is in the middle, and cast a dark shadow over the WHA. However, in the end, the WHA was damaged but not derailed. Taiwan withdrew its appeal for a vote by member states on its observer status to WHO. That step removed one flashpoint that could have potentially ruined the WHA. Taiwan realized it had fewer than 30 votes out of 194. Besides, the logistical challenges of voting remotely in a virtual session were reportedly insurmountable (an in-person WHA session may be held in the fall of 2020.)

The European Union solidified its leadership role in the global pandemic response at the WHA, building on the successful $8.2 billion pledging summit for Covid-19 vaccine and therapeutics it led in early May, which was attended by 40 countries, foundations, and private industry leaders—but not the United States. The European Union garnered support from over 100 countries for a draft resolution that was ultimately adopted, allowing the WHA to achieve consensus in favor of a future independent review of the international response to the coronavirus pandemic. The detailed communiqué also addressed vital issues of how to guarantee access, transparency, and affordability as safe and effective vaccines become available.

By the conclusion of the WHA, the Trump administration had wantonly withdrawn the United States from any meaningful leadership role in the international response to the coronavirus pandemic. 

China benefited to some degree at the WHA, as it sought to recover from widespread anger across the world at its mishandling of the virus. In his statement, President Xi glided past China’s actions in early 2020, responded in kind to Trump and Azar’s charges, and looked forward with a $2 billion pledge to the global Covid-19 response and a commitment to pursue a “common public good approach to the delivery of an eventual vaccine.”

Dr. Tedros kept cool throughout this dark and disturbing moment. On May 18, he made an appeal for pragmatism, solidarity, and commitment: “the world doesn’t need another plan, another system, another mechanism, another committee or another organization. It needs to strengthen, implement and finance the systems and organizations it has – including WHO.” German chancellor Angela Merkel and French president Emmanuel Macron each voiced strong support for WHO in their remarks.

By the conclusion of the WHA, the Trump administration had wantonly withdrawn the United States from any meaningful leadership role in the international response to the coronavirus pandemic. It was a form of self-immolation, a willful regression that now confines the United States to an isolated corner, the object of pity, sadness, scorn, anger, and contempt.

J. Stephen Morrison is senior vice president and director of the Global Health Policy Center at the Center for Strategic and International Studies (CSIS) in Washington, D.C.

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