John Oliver discusses the crucial role of the World Health Organization, why Donald Trump is skeptical of it, and how his plans to withdraw the United States could have dire consequences.
The World Health Organization Last Week Tonight With John Oliver

Last Week Tonight with John Oliver
Season 7 Episode 26
Aired on October 18, 2020

Main segment: World Health Organization
Other segments: Danbury, Connecticut


[John] Tonight, I’d like to talk about something incredibly important that hinges on this election. Because our main story concerns the World Health Organization, or WHO. You may already be aware of it in its role as one of the president’s favorite punching bags.

[President Trump] The World Health Organization should be ashamed of themselves.

[President Trump] I’m not happy with the World Health Organization.

[President Trump] They’re a puppet of China. They’re China-centric, to put it nicer.

[President Trump] They’re literally a pipe organ for China. That’s the way I view it.

[John] Okay, the WHO is not literally a pipe organ for China, because the only thing that is literally a pipe organ for China is a pipe organ because that’s what the word “literally” means.

Over the last six months, Trump has consistently tried to deflect blame for his handling of the coronavirus onto the WHO, China, and the close relationship he claims the two have. And at the beginning of July, he turns that criticism into real action.

[Reporter] In the midst of a pandemic, Donald Trump is formally pulling out of the World Health Organization.

[President Trump] We will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving, urgent global public health needs.

[John] Now, that is very bad news, but do spare a thought there for Melania, who must have heard the sentence, “We will be today terminating our relationship.” And for the briefest of moments, felt hope. Except, I’m totally kidding, spare no thoughts for her, she’s not a baby, she’s totally complicit. And never forget that she did once say, “Who gives a fuck about Christmas stuff and decorations?” An attitude fully present in her holiday theme, best described as “What if trees got periods and hated you?”

The point is, in the midst of everything we’re going through right now, Trump has decided to withdraw the United States from the WHO. And if you’re thinking, well surely he can’t do that, right? The good news is the WHO’s constitution doesn’t include any provisions for members to withdraw. The bad news is there’s exactly one exception to that rule, and it’s the United States, which passed a resolution decades ago specifying, we actually can withdraw after giving one year’s notice. And that is a pretty weird perk for America alone to have. It’s like finding out we demanded to be the only country allowed to wax the pubes of every squirrel. Why would we want the right to do that in the first place? And more to the point, why would we ever consider actually doing it?

And the thing is, Trump is not bluffing. He’s already submitted a notice of withdrawal to the UN, to take effect next July. So the clock is ticking here.

And given that we’re now on track to leave the WHO in less than a year, tonight, let’s talk about what that actually means. How important the WHO’s work is, how valid criticisms of it are, and what we might be putting at stake.

And let’s start with what the WHO does. It was founded in 1948, and has since grown to 194 member states. That’s nearly every country on Earth. And very broadly, it coordinates global responses to a wide range of health issues including alerting the world to threats, fighting diseases, developing policy, and improving access to care. One of the biggest powers it has is the ability to declare a public health emergency of international concern. And issue recommendations on how countries should respond. But, and this is really important, it has absolutely no power on its own to enforce those recommendations. It can only act within a country to the extent that country allows it to. And yet, despite those significant limitations, it’s managed to do some incredible things in the past, with perhaps its most notable success being this.

[NBC, 1979] Today a substantial milestone in human history. The World Health Organization says smallpox has now been wiped off the face of the Earth, and will never return. It says it will never return because smallpox can only be caught from another person, and if no other person has it, there is no other way to catch it.

[John] It’s true! The WHO completely eradicated smallpox, which killed 300 million people in the 20th century alone. In the space of a decade, it took smallpox from ten million cases and two million deaths a year, all the way down to zero. And it’s amazing that something can go from being that widespread, to completely disappearing within a few years. Smallpox is basically the Circuit City of infectious diseases. And it’s equally as missed.

And it’s not like the WHO did this with a magic wand. It took a huge amount of work. Not only did they have to arrange a collaboration between America and the USSR at the height of the Cold War, one of the last big countries where smallpox had to be tackled was India. And just listen to one of the doctors involved in the effort explain what it took.

[“Invisible Killer” (2018), Science Channel]
[Dr. Larry Brilliant, Who Smallpox Eradication Program] To eradicate smallpox, it meant that we would have to visit every single house in India. And ultimately we did. We visited 120 million houses in India, every month, for about 20 months. We did more than a billion house calls.

[John] Think about that! They visited a billion houses! That’s remarkable! It’s only a few more houses than Chrishell visited on Selling Sunset. And that’s why she’s the best, you pound the pavement. You get the listings, you get the results. I don’t know where Chrishell hustles more, on the streets of LA, or on the Dancing with The Stars dance floor. Hashtag Team Chrishell.

But the WHO’s work isn’t always as lofty as door-to-door disease destruction. Some of its most important work involves the development of the seasonal flu vaccine. Twice a year, it convenes representatives from all over the world to determine what strains of the flu virus should go into the annual flu shot. Which might sound tedious, because it is, but it’s also kind of important. And that, by the way, was actually original title for this show.

The WHO is also currently tracking and responding to dozens of infectious disease outbreaks around the world, including Monkeypox, Yellow Fever, and an ongoing Ebola outbreak. And when, let’s say hypothetically, a pandemic breaks out, the organization can provide a critical role as a central clearing house of information conducting investigations and releasing information to the public. And it does all of this on a current budget of 2.4 billion dollars a year. Which might sound like a lot, but it’s around the same amount it costs to run a single U.S. hospital, which is wild! It’s like finding out the U.S. Navy runs on the same budget as Typhoon Lagoon at Disneyworld. I’m not sure if Typhoon Lagoon’s budget is way too high, or the Navy’s is way too low, but something is definitely off there.

So, at its best, the WHO does vitally important work for shockingly little money, which is not to say that it is perfect. There are legitimate criticisms of how it’s behaved in the past. Among them, that during the Ebola outbreak in 2014, they acted too slowly to declare a public health emergency, which had major consequences.

But the truth is for Trump, past performance is really the issue here. For him, there are two insurmountable problems with the WHO. And the first is how much of its budget the U.S. pays.

[President Trump] We pay 400 to 500 million dollars a year. China’s paying 38, 39, and 40 million dollars a year. And it’s like they control this group. […] There’s something very bad going on, and you know what? I’ve gotten very much involved. It’s been going for a long period of time, and we don’t want to be the suckers anymore.

[John] Now, you’re probably already assuming it’s more complicated than that, and it is. The problem is Trump is uncapable of acknowledging nuance. In his world, you’re either fucking someone or you’re getting fucked. And that’s not a great perspective when it comes to cooperating on global health. It’s not even a great perspective at an orgy. ‘Cause sure, there’s gonna be a lot of both going on, but those can’t be the only options. Someone’s gotta make sure everyone’s staying hydrated. Someone’s gotta be available to tip the pizza delivery person. Someone’s got to disinfect the coffee afterwards. It can’t all be just fucking and getting fucked, or there’s going to be chaos. That’s basic orgy management.

Now, what is true in Trump’s argument there is that there is a big discrepancy between what the U.S. and China give to the WHO. In 2019, the U.S. paid just over 446 million dollars, and China, the second largest economy in the world, paid just 43 million. That is a striking disparity. But it’s rooted in how the WHO is funded because the fact is only around 17 percent of its funding comes through accessed contributions, which are basically membership dues based on the size of each country’s economy and population. Almost all of the rest comes through voluntary contributions. That’s where a country donates money, but in doing so, can earmark exactly what they want it used for. And most of what the U.S. pays each year is voluntary contributions, whereas China chooses to pay almost nothing. And you could argue that this is a dumb way to fund an organization. It’s essentially the global health equivalent of underfunding a public school and expecting it to hold a bake sale to make up the difference.

But the thing is this whole mess is almost entirely America’s fault. Back in the 1980s, “the Reagan administration pushed a ‘zero-growth’ policy for WHO’s regular budget” which eventually froze states’ assessed contributions at 1990s levels. So, with those contributions unable to go up, the WHO has naturally needed more and more voluntary donations as the years have gone by. And I would say that this was the worst decision of the Reagan White House were it not for Iran-Contra, the war on drugs, trickle-down economics, and failing to publicly say the word AIDS for four years. I’m not saying everything is Reagan’s fault. All I’m saying is if I found out tomorrow that murder hornets are only here because he started breeding them in 1988, I can’t say I’d be entirely surprised.

The point is that is why we pay so much relative to China. It’s mostly because we choose to because the WHO is underfunded because of something we did.

So, what about Trump’s second big complaint, that the WHO is a literal pipe organ for China, which again, it literally isn’t. That is an idea that he and his supporters have hammered hard.

[Tucker Carlson, Fox News] The World Health Organization’s subservience to their masters in Beijing has only become obvious or naked.

Allowing the World Health Organization to investigate China is like having El Chapo investigate the Mexican drug cartels.

I mean, China lied, the World Health Organization complied, and as a result, many Americans died.

[John] Okay, now, I know that rhyme sounded compelling, but it is important to remember not everything that rhymes is true. Here, I’ll show you. In 1981, James Comer was up to no good. He stood on a boat and pushed as hard as he could. And that’s how James Comer killed Natalie Wood. That is a fantastic rhyme. No questions there. But I do have to accept that it might be untrue.

Now, what they’re essentially arguing there is the WHO mishandled the pandemic because they’re deferential to China. And while there is some truth is each half of that statement, they’re not true together. And let’s start with the allegation that the WHO is deferential to China. That can be true. For instance, its member states have consistently acquiesced to China’s insistence that Taiwan not be allowed to join the organization as a separate entity. And WHO leadership praised China early in this pandemic, citing its bold approach to contain the rapid spread of the coronavirus, which does not date well.

Although, it is important to remember that WHO needs to be exceedingly diplomatic with its member countries to gain the access it needs for on-the-ground investigations as an outbreak emerges. Also, for what it’s worth, it’s not like it was alone in praising China’s coronavirus response. Back in February, Trump was working out a trade deal with China and he said this:

[President Trump] China’s working very, very hard. I have spoken to President Xi, and they’re working very hard. And if you know anything about him, I think he’ll be… in pretty good shape. They’re, uh… They’ve had a rough patch, and I think, right now, they have it– it looks like they’re getting it under control more and more.

[John] Oh, and that was by no means a one-off. Trump praised China’s response so many times, Politico made it into an actual listicle. And that a serious unit of measurement. Trump is joining the ranks of “15 Hedgehogs With Things That Look Like Hedgehogs,” or “Top 10 Actors Who Died in Fires,” or “16 People Who Were Literal Children In 2010 But Full-Grown Adults Now” which I have to assume was written by someone who just emerged from a coma and forgot how time works. Incidentally, making them eligible for TIME magazine’s very realistical “Top 10 Comas.”

Now as for the question of whether the WHO made mistakes early on, it definitely did. It arguably took too long to advise universal mask wearing and to clearly acknowledge the threat of indoor airborne transmission. But there is no evidence at all this was done to appease China so much as in the early stages of a pandemic, even experts tend to, and I’m gonna use a technical term here, not know the fuck is going on.

But look, let’s say, just for the sake of argument, that you agree with the president, that we just simply pay too much to the WHO and that China is calling all of the shots there. The question then becomes, what then? And if you listen to Mike Pompeo, which you absolutely never should, he would argue the U.S. could go it alone.

[Mike Pompeo, Secretary of State] If there was a function that only the WHO can do and we think it is important for American national security because we are good humanitarian partners around the world, I’m confident we will find a way to deliver that outcome.

[John] Okay. That is just ridiculous. The U.S. cannot do what the WHO does for many, many reasons. For a start, if we try and go into another country for a public health mission, chances are we’re gonna get greeted far less warmly because the WHO has never, you know, invaded a nation or funded a coup. As one former U.S. representative to the organization has said “People coming into countries in WHO shirts to work on polio or AIDS are less threatening,” adding “No one is looking for U.S.-based alternatives to WHO” which of course they’re not. Especially having seen the way that we’ve handled the coronavirus. Nobody wants a U.S. based alternative here for the same reason nobody’s looking for a Joe Exotic based alternative to Jeopardy. I’m not saying he doesn’t think he can do it, but everyone likes the way it works now and his alternative might be actively dangerous.

Also when it comes to global health, the U.S. has a checkered past. Before the killing of Bin Laden, one of the ways the U.S. verified he was in Abbottabad was by staging a fake vaccination campaign in that town as a rouse to gather DNA samples from the people living at his compound. Something which not only put health workers in the region at risk, but also contributed to a “major setback in the efforts to vaccinate people in Pakistan against… polio.”

And it is not like we’re gonna make friends by suddenly walking away from the WHO and cutting off its funding especially in the middle of a global pandemic. As one official puts it, the U.S. decision to leave is almost impossible to get your head around.

[Dr. David Nabarro, Special Envoy, WHO] And sometimes it feels like a bad dream. And for staff inside the organization, they feel dumbfounded. […] Can somebody explain to me why? Really, why? Why take the fire engines away in the middle of fighting a fire?

[John] Exactly. It’s taking the fire engines away in the middle of fighting the fire or getting rid of the lifeboats while the boat is sinking or choosing to edit Kevin Spacey into a movie just weeks before its release date. It’s the worst possible decision at the worst possible time.

And it gets even worse here because the WHO is right on the edge of doing to polio what it did to smallpox and eliminating it. Just two months ago, it was finally wiped out in Africa and “We are 99 percent of the way” to global eradication with a current goal for it to happen in 2023. Unfortunately, the U.S. is the second largest funder of the Global Polio Eradication Initiative, and that money suddenly disappearing is likely to set everything back. And while it feels almost inappropriate for polio not to make a comeback during this fucking nightmare of a year, we should still probably try to prevent that from happening.

And look, it is fine if the U.S. has problems with the WHO. It has problems. But the solution clearly isn’t to walk away. It’s to try and fix them. But the only way for the U.S. to have a say in how that happens is to have a seat at the table, and we’re about to just give that up.

And the thing is this is yet another depressing example of Trump seeing something that involves shared sacrifice, trade-offs, and complexity and decides to just blow it up because he either doesn’t understand it, doesn’t care or both. We’ve seen this with the Paris Climate Agreement and the Iran nuclear deal, and now he’s doing it with the World Health Organization. And this is incredibly dangerous because the fact is we’re currently on track to leave the WHO on July 6th of next year if, that is, Trump is re-elected. And this means our membership in the WHO is yet another important thing on the ballot this year. And even though Trump likes to pretend that we can insulate ourselves from the rest of the world, if the coronavirus has shown us anything, it’s that diseases don’t recognize borders and we’re only as strong as our worst prepared country. And pulling out of the WHO at any time, but especially in the midst of a pandemic that’s killed over 200,000 Americans and a million people around the world, is one of the most ill-advised dumbest things we could possibly do. And I mean that fucking literally.


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