Amanda Glassman: Trump’s WHO pullout will have substantial impacts on Sub-Saharan Africa

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President Donald Trump’s decision to cut U.S. funding to the World Health Organization (WHO) will have substantial impacts on health delivery in Sub-Saharan Africa, Amanda Glassman, a global health expert and executive vice president of the Center for Global Development, a think tank based in Washington, DC, said on Monday.

“Much of the US voluntary contribution of approximately 350-400 million USD per year goes to WHO programs on infectious diseases that are most prevalent in sub-Saharan Africa – HIV/AIDS, malaria, vaccine-preventable diseases. Efforts to combat the new DRC Ebola outbreak and other threats will also be affected,” Glassman told TODAY NEWS AFRICA‘s Simon Ateba in an interview.

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According to her, assistance to Sub-Saharan Africa is in the interest of the United States as COVID-19 has illustrated “perfectly how a virus can move around the world, back and forth between and within countries.”

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But the bilateral relations between the United States and Sub-Saharan Africa will continue, she said, noting that “most of the money spent on health delivery in Africa comes from the region’s own governments and the pockets of its citizens”.

“In most countries, total health aid is less than 30% of total health spending.  In addition, regardless of WHO, the US continues to provide bilateral aid to 34 countries in SSA,” Glassman added.

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Can you please react to the decision by U.S. President Donald Trump to cut ties with the World Health Organization?

The seemingly offhand decision to withdraw from the WHO in the midst of a pandemic is inexplicable and counter to US interests. Beyond the formal inclusion of Taiwan, specific reforms were never named by the Administration and the decision did not even respect their own previously announced timeline for reforms (11 vs 30 days).

How will cutting U.S. funding to the WHO impact countries in Sub-Saharan Africa in particular?

Much of the US voluntary contribution of approximately 350-400 million USD per year goes to WHO programs on infectious diseases that are most prevalent in sub-Saharan Africa – HIV/AIDS, malaria, vaccine-preventable diseases. Efforts to combat the new DRC Ebola outbreak and other threats will also be affected.

The U.S. contributes about $450 million to the WHO annually, how much of that money is redirected to the Sub-Saharan African region and what is it used on?

Hard to know exact amounts, but I expect that most of the voluntary contribution is targeted towards SSA, with smaller amounts going to Afghanistan, Iraq, Pakistan and Venezuela.

Can the WHO and health delivery in Africa continue without U.S. funding?

Of course. Most of the money spent on health delivery in Africa comes from the region’s own governments and the pockets of its citizens – in most countries, total health aid is less than 30% of total health spending.  In addition, regardless of WHO, the US continues to provide bilateral aid to 34 countries in SSA – see table 2 for amounts by country. The US also provides support to the World Bank and the African Development Bank who provide budget support and health programs in most countries.  The WHO is most important for vaccination programs and for outbreak response, but it is marginal in terms of the amount that it represents as a share of total health spending.  

What are some of the pressing health needs in Sub-Saharan Africa at the moment amid COVID-19?

The usual disease burden continues and could potentially worsen given less access and use of health services – malaria, pneumonia, risky maternity, non-communicable diseases all contribute. COVID-19 will add to this burden — see tables 1 and 2 here 

Speaking more broadly, what complications has COVID-19 brought upon global health delivery in Sub-Saharan Africa?

Effects are most pronounced in South Africa and Nigeria so far where urban hospitals and crowded neighborhoods are seeing more cases and feeling pressure. Limits in access to oxygen are concerning.  However, the age distribution is protecting the region – there are fewer vulnerable groups – and many countries have been vigilant in testing and isolating.  The big issue is the drop in access and use of non COVID health services – because people are under stay-at-home orders, or because they have less money to spend on health, or because health services are closed. We are already seeing signs of declines in vaccination rates and TB screening, among other efforts.

And why should the U.S. assist Sub-Saharan African in the first place?

There are multiple reasons why —

Moral reasons – health and economic needs are great and aid has a good track record of working in the region

Health reasons – an infectious disease threat anywhere is an infectious disease threat everywhere

Economic reasons – SSA markets were growing before this crisis, and there are investment and profit opportunities, raw commodities were demanded by US markets and firms

Security reasons – region is strategically important

Is President Trump not right that U.S. money should just be spent on the United States and nowhere else?

It’s not an either/or choice, it has to be both for the well-being of US.

Can a health emergency in Africa affect people in the United States?

Obviously yes – COVID-19 itself illustrates perfectly how a virus can move around the world, back and forth between and within countries.

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Simon Ateba
Simon Ateba
Simon Ateba covers the White House, the U.S. government, the International Monetary Fund, the World Bank and other financial and international institutions for Today News Africa in Washington D.C. Simon can be reached on simonateba@todaynewsafrica.com

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