An American withdrawal from the World Health Organization could wreak profound damage on the global effort to eradicate polio and could undermine the world’s ability to detect and respond to disease threats, health experts warned.

The experts, from the United States and beyond, are aghast at President Trump’s announced intention to leave the organization, which he publicly blames for not being tougher on China in the early days of the Covid-19 pandemic — at a time when he himself was praising China’s unprecedented efforts to control the SARS-CoV-2 virus.

The agency has not yet commented on Trump’s announcement.

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If it leaves the organization, which was established in 1948, the United States will give up an outsized role in the global health agency and the setting of global health priorities. While Trump has accused the WHO of kowtowing too much to China, in reality, experts acknowledge, other countries have sometimes bristled at how much sway the U.S. has at the Geneva-based agency.

“The U.S. has always had an extraordinary influence at the WHO — I mean to the extent that other countries have complained about American influence,” Ilona Kickbusch, a long-time former WHO official and chair of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva.

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In fact, when the WHO underwent a series of reforms following its catastrophic early response to the 2014 West African Ebola outbreak — including setting up a permanent health emergencies program — a lot of the changes implemented were made at the behest of the United States, said Ashish Jha, director of Harvard’s Global Health Institute.

The ranks of WHO’s staff are swollen with Americans, some hired directly — such as Stewart Simonson, one of the agency’s assistant director generals — others on secondment from the Centers for Disease Control and Prevention or other agencies. Were the U.S. to pull out of the WHO, it’s unclear what would happen to the Americans in its ranks —including Maria Van Kerkhove, the WHO’s leading expert on coronaviruses, who flanks Director General Tedros Adhamon Gheybreyesus during the agency’s three-times-weekly Covid-19 press conferences.

“Just think of it: Maria Van Kerkhove, would she have to leave the WHO now?” asked Amanda Glassman, executive vice president of the Center for Global Development. “Is that what our goal is? Because those U.S. employees are not going to be there. U.S. nationals would not be eligible for employment. So we are giving up leadership of the Covid-19 response, basically.”

American experts also play key roles in most WHO advisory committees; the country has a seat on the WHO’s executive board. As well, when the WHO has established emergency committees to determine whether this or that disease outbreak constitutes a global threat — a public health emergency of international concern, or a PHEIC — there is virtually always at least one American on the panel. Whether American expertise would be so central after the country’s withdrawal is unclear.

“The U.S. has played an outsized role in global health … across a range of issues,” Jha said. “And I think its absence at the WHO would really harm the organization.”

Withdrawing during a pandemic — or even threatening, should the president back down, or Congress find a way to block the move — is unconscionable, said Tom Bollyky, director of the global health program at the Council on Foreign Relations.

Fending off incoming attacks from a U.S. president during a pandemic is a harmful distraction for the agency at a time when it is being stressed like never before, he suggested. If the U.S. withdraws and weakens the WHO, that in turn will undermine the health agency’s ability to respond to the Covid-19 pandemic, potentially prolonging it.

While the U.S. has placed high hopes on early access to vaccine for Americans, the reality is that as long as Covid-19 rages around the world, supply chains will be disrupted, the global economy will be stressed and international travel will remain perilous. Until the outbreak is contained globally, the risks the virus poses will be felt everywhere — among the vaccinated and the unvaccinated.

“If we were to bring this about, we would diminish funding, but we would also diminish any international coordination on the response to this pandemic, which again will make every day Americans’ lives less safe. It’s a disastrous decision,” Bollyky said.

Beyond the pandemic, health programs that the U.S. has long championed — whether that’s combatting the spread of drug-resistant tuberculosis, trying to stop the spread of HIV, or slowing the assault of antimicrobial-resistant bacteria — will be weakened by a U.S. withdrawal from the WHO, said David Heymann, a long-time former WHO official, who lead the agency’s response to the SARS outbreak in 2003.

Heymann, who for a time oversaw the global polio eradication program, fears that effort in particular will suffer if the U.S. leaves the WHO. It is a critical time for the long-standing effort to rid the world of polio; while only two countries — Afghanistan and Pakistan — continue to see spread of wild polio, vaccination efforts have been halted because of the pandemic.

“The polio eradication program is very near completion, with many strong donors to it, and the U.S. has been one of the most faithful and strong. And it would be a shame not only for the United States, but for Rotary International, which has provided so much funding for that as well,” said Heymann, an American who heads a committee that advises the WHO’s health emergencies program.

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