US President Donald Trump and China’s President Xi Jinping meet business leaders at the Great Hall of the People in Beijing, China, November 9, 2017. Photo: REUTERS/Damir Sagolj/File Photo.

The US is the most significant single contributor to the World Health Organization (WHO). US taxpayer-funded contributions total approximately $2 billion — or roughly half — of the WHO’s budget. On May 18, 2020, President Donald Trump launched a campaign in which he threatened to pull all US funding from the WHO. On May 29, he delivered a blistering attack on China, stating, “The world needs answers from China on [the] COVID-19 virus. We must have transparency.” Trump added that “Chinese officials ignored their reporting obligations to the World Health Organization and pressured the World Health Organization to mislead the world when Chinese authorities first discovered the virus.”

Trump expressed his decision in a letter he sent to WHO Director-General (D-G) Tedros Adhanom Ghebreyesus. The letter said, “It is clear the repeated missteps by you and your organization in responding to the pandemic have been extremely costly for the world. The only way forward for the World Health Organization is if it can demonstrate independence from China.”

Trump charges not only that the WHO is in China’s sway, but that it ignored credible reports of the COVID-19 virus spreading in Wuhan in early December 2019 or even earlier. He objects to the WHO’s persistent wasteful spending, disregard for transparency, pervasive incompetence, and failure to adhere to basic democratic standards. He has also said that if the WHO had acted appropriately, he would have instituted a travel ban on people coming into the US from China sooner.

The WHO Constitution came into force on April 7, 1948. It states the organization’s primary objective as “the attainment by all peoples of the highest possible level of health.” The WHO’s broad mandate includes advocating for universal healthcare, monitoring public health risks, coordinating responses to health emergencies, and promoting human health and well-being. The organization grossly failed to uphold its mandate during the COVID-19 pandemic.

Wasteful spending at the WHO did not start in 2019. According to internal documents obtained by the Associated Press, the UN health agency routinely spends about $200 million a year on travel expenses — more than what it doles out to fight some of the biggest problems facing public health, including AIDS, tuberculosis, and malaria, combined. In 2018, the WHO spent about $71 million on AIDS and hepatitis, $61 million on malaria, and $59 million on tuberculosis. The previous D-G of the WHO, Dr. Margaret Chan, preferred to fly first class and spent a night in the top-tier presidential suite at the beachside Palm Camayenne hotel, all on the WHO account. The suite, equipped with marble bathrooms and a private dining room that seats eight, costs 900 euros ($1,008) per night. “When you spend the kind of money WHO is spending on travel, you have to be able to justify it,” Dr. Ashish Jha, director of the Global Health Institute at Harvard University, said. “I can’t think of any justification for ever flying first class.”

Reform is not going to come from within the WHO itself. The latest evidence of this was the election of an unqualified non-physician to hold the D-G position: Ethiopian politician Ghebreyesus (PhD) Tedros was selected over an eminently qualified British candidate, David Nabbaro, MD.

Tedros is a leader of Ethiopia’s minority party, the Tigray People’s Liberation Front, a wing of the ruling Marxist-rooted Ethiopian People’s Revolutionary Democratic Front. He served the violently repressive regime as minister of foreign affairs from 2012 to 2016, after a stint as health minister. Tedros, who is now in charge of making life or death decisions on a global scale, has been accused of covering up three cholera epidemics in Ethiopia, supporting a terrorist organization, and inflating his resume with the false claim that he conquered malaria and HIV.

Tedros was foreign minister of one of the world’s most repressive regimes, one that holds many thousands of political prisoners. That part of his record was suppressed by China, which highlighted his alleged heath credentials in an effort to make him appear suitable for the D-G position at the WHO. Beijing leveraged its investments across Africa to pressure the African Union to back Tedros.

The WHO needs a new D-G to lead discussions on the organization’s role in a world that has changed dramatically since the 1940s. Global health is now the business of many NGOs, private foundations, corporations, and academic groups. Reforming the WHO requires a D-G who can work with diverse players and governments to tackle norms and standards. Wherever possible, operational functions should be spun off to other organizations within the UN, or to NGOs that are better qualified than the WHO to execute them.

Dr. Frank Musmar is a financial and performance management specialist and a non-resident research associate at the BESA Center, where a version of this article was first published.