Wednesday, April 15, 2020

ER doctor and Ebola survivor to Trump: Build World Health Organization, don't tear it down

Dr. Craig Spencer, Opinion contributor, USA TODAY Opinion•April 15, 

President Donald Trump has halted U.S. funding for the World Health Organization and is reviewing how it has handled the coronavirus. As an emergency room doctor in New York City, a global health expert and an Ebola survivor, I welcome the chance to weigh in.

The president may remember me from 2014. He was still a private citizen, and I was recently returned from Guinea, where I contracted Ebola while treating sick patients with Doctors Without Borders. Thanks to the world-class care I received from my medical team, I recovered from the deadly disease and have spent the past six years advocating for greater investment in global health infrastructure.

I am no stranger to the consequences of the WHO's inefficiencies, having personally witnessed its slow response to the Ebola epidemic in West Africa. Saddled by an ambiguous mandate and the competing demands of its donor countries, the organization is forced into a near-constant state of reaction rather than preparation. Limited funding leads to limited capacity, which leads to suboptimal operations; in this case, suboptimal is often the difference between life and death.

But to doubt the importance of the World Health Organization is to misunderstand the nature of our international health system and its connection to global stability.

10 ventilators for an entire nation

Today, America — the most powerful country in the world — finds itself woefully underprepared to fight a disease that we have known about for four months. I have personally witnessed the devastating impact this virus has had on the most expensive health care system in the world.

Critical missteps in testing allowed the disease to spread quickly. Our supply of essential supplies, like personal protective equipment and ventilators, are dangerously strained. Our emergency rooms have become intensive care units.

World Health Organization headquarters in Geneva.

What happens when COVID-19 reaches countries with health systems less advanced than ours?

The spread of coronavirus will undoubtedly accelerate as it hits developing nations, where handwashing and physical distancing are luxuries affordable by few. In Burundi, a nation of nearly 11 million people, health care workers and communities are bracing for the first wave of coronavirus. A close friend working there estimated they have 10 ventilators. That’s for the entire country.

Sidelined in an emergency: I'm a physician assistant on furlough when I could be helping coronavirus patients

In the meantime, export restrictions in Europe are preventing medical aid organizations like Doctors Without Borders from shipping personal protective equipment and other vital supplies to countries in need.

In those places where contagion will be rampant and resources are most scarce, it is the World Health Organization that has boots on the ground and will be a vital partner in saving lives. Its teams will work to flatten the curve from Burundi to Bolivia, and in so doing, help prevent the continued transmission of the novel coronavirus across borders. They will stymie the progression of second waves like those we are actively suppressing in Asia. And they will keep the disease from coming back to America’s shores, where we have already sacrificed so much to defeat it.

Build up WHO, don't tear it down

On a good day, the World Health Organization manages to support national health plans and emergency responses in more than 150 countries with an annual global budget smaller than that of one New York City hospital system. It is also the only organization in the world with the infrastructure and ability to identify emerging diseases, as it did with COVID-19 and every major health threat in modern history. They are our eyes and ears around the world.

So I’m ready to follow President Trump’s lead, albeit from a different angle. Let’s really look at the World Health Organization and what it does for us.

Let’s talk about strengthening — not diminishing — our collective ability to shorten this pandemic and prevent the next.

Let’s clarify the World Health Organization’s mandate as an international network for disease surveillance and an operational partner for pandemic response.

And let’s agree that we must align our expectations with our investment. If we truly want to anticipate public health threats and save lives, we must build up in the World Health Organization, not tear it down.

Craig Spencer, MD MPH, is the director of global health in emergency medicine at New York-Presbyterian/Columbia University Medical Center and an assistant professor of emergency medicine and population and family health at the Columbia University Mailman School of Public Health. He serves on the board of directors of Doctors Without Borders/Médecins Sans Frontières USA. Follow him on Twitter: @Craig_A_Spencer

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to letters@usatoday.com.

This article originally appeared on USA TODAY: Coronavirus highlights why we need World Health Organization: ER doctor

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