The glass and metal headquarters of the World Health Organisation (who), the un’s health agency, contrast starkly with their bucolic surroundings in the hills around Geneva. The only dabs of colour are the flags of its 194 member-states. For now the American flag still flutters beside the rest. But if President Donald Trump has his way, by July 2021 it will be gone. America is the who’s biggest donor. A tenth of its staff are American. Its influence runs through the agency, right down to the peanut-butter cups in the staff vending machine.
It is an odd time to cut ties with the world’s foremost public-health body. There is a pandemic going on. Mara Pillinger, a health-policy researcher at Georgetown University in Washington, dc, says the who has done a “pretty remarkable job” of coping with covid-19, given the constraints built into the way it works. Nonetheless, the twin threats of Trumpism and coronavirus have illuminated both the agency’s strengths and its weaknesses, and raised questions about its future.
The who’s emergency work is governed by a legal framework known as the International Health Regulations, the current version of which has been in force since 2005. They spell out how public-health emergencies should be handled. They set the rules for how nations should behave. And they constrain the who. Member-states are bound to report outbreaks of diseases as soon as they can, but if they fail to do so, or delay as China did with covid-19, the organisation has no way of compelling them.