The WHO has also become more action-oriented, so it’s not just committees classifying diseases. WHO does a lot of work with disease-eradication and disease-control programs. The most successful one was smallpox, a disease we no longer have. It’s the biggest achievement in the history of the WHO. Some say the biggest achievement of humanity in the 20th century was the eradication of that disease.
Polio is the disease that the WHO has been focusing on now. It’s something like 98 percent eradicated, but there are small pockets in countries where it’s very difficult to access the cases, like Afghanistan, Pakistan, and Nigeria. Health workers have been attacked and killed trying to find these last cases and vaccinate children. And now we have COVID-19, so that’s kind of shut down the polio-eradication efforts.
James Hamblin: What is the total budget of the World Health Organization?
Lee: WHO is funded for about $2.2 to $2.3 billion a year. That’s about the size of one medium-size hospital, and it has to cover 194 countries. The objective of WHO, as stated in its constitution, is the attainment by all peoples of the highest possible level of health. That’s a huge goal, and you’re spreading this budget extremely thin.
The budget is made up of two pots of money. The first part is a membership fee, so every country that wants to be a member of WHO pays a certain amount depending on their population and on their wealth. That’s why the U.S. pays more than, say, Sierra Leone. The second part of the budget is paid for by voluntary contributions. Member states or charities or even individuals can step up and put money into WHO. But the people that give the money decide what the money is spent on. It’s not necessarily the most important things; it’s just the favorite things. WHO doesn’t really have a lot of control over most of its budget.
Hamblin: What is the U.S. contributing to the WHO annually?
Lee: The U.S. is the largest donor. It gives around, like, a third of the budget, so these threats about withdrawing money are very worrying. It’s going to hurt WHO and now is not the best time to do that. If the U.S. stopped funding WHO, it would hurt. I would hope that other countries would step up and fill the gap.
But if the U.S. withdraws its voluntary contributions, all these programs which the U.S. government earmarked these funds for will lose out. The U.S. gives something like 25 percent of the money for polio eradication. So that program is going to really suffer. In my decades studying WHO, I’ve seen ups and downs, but I have not seen this kind of existential threat.
Hamblin: What do you make of President Trump’s accusations about China? Is it just scapegoating, or is there something there?
Lee: We’ll know who knew what when in due course, once there is an investigation, which everyone agrees is going to happen. There’s just a lot of innuendo and accusations flying around right now, and this is not the time.