WASHINGTON — The international COVID-19 response, President Donald Trump’s announcement that the U.S. would withdraw from the World Health Organization, and how the U.S. should address global health security moving forward were the focus of an at-times heated Senate Foreign Relations Committee hearing Thursday.
While some Republicans were critical of WHO, and some of the administration officials testifying defended Trump’s decision, committee chairman Sen. James Risch, a Republican from Idaho, offered a somewhat different perspective.
WHO does “great work in many respects” and “play[s] a key role as a guardian of international health regulations” but its response to fast-moving emergencies “has exposed significant weaknesses,” Risch said.
Noting that he has been briefed by WHO leadership, Risch said the agency would be the first to admit that it should have done some things differently.
“Coordination is not about control, it’s about empowerment.”— Jim Richardson, Office of Foreign Assistance director, U.S. State Department
“There is some reform that’s needed and it should be done, as I said without demeaning, criticizing, or condemning, but rather in the kindest way possible to make it work better,” he said.
Democrats senators at the hearing said that while China should answer for its failures regarding its response to the coronavirus, the WHO response should be examined and the organization reformed, the United States should stay in the organization — so it can influence necessary changes and not cede power to China.
The tensest exchange on the subject was between Sen. Bob Menendez, the top Democrat on the committee, and Garrett Grigsby, director of the office of global affairs at the U.S. Department of Health and Human Services, after Menendez asked why WHO should listen to the U.S. about any issues if Washington is terminating the relationship. Grigsby said that the U.S. is still a WHO member now and it is using its G-7 presidency to regularly convene health ministers to discuss the COVID-19 response, including WHO reforms.
WHO has become too close with China and failed to strongly push the country to report accurate data during the early days of the outbreak, Grigsby said. Several Democrats pushed back by noting that Trump routinely praised China’s response through at least March.
They pointed to a January 24 tweet where Trump wrote “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”
Administration officials were also pressed about the pace at which funding for the COVID-19 response approved in supplemental appropriations bills was being spent, an issue several implementing organizations have raised. The U.S. has committed about $1.3 billion of the nearly $1.6 billion that was appropriated, and of that, $500 million has been obligated or disbursed, said Jim Richardson, director of the Office of Foreign Assistance at the State Department.
The U.S. Agency for International Development obligated $267 million of the humanitarian assistance funding, but plans to distribute the remainder of the $535 million allocations by mid-July, said Chris Milligan, counselor at USAID.
Milligan said he’s particularly concerned about secondary and tertiary impacts of the coronavirus crisis and that the U.S. must have a holistic approach to addressing health crises that take into account governance and other development factors.
“Taking health out of a broader development approach and isolating it will not lead to success,” he said. “It is imperative that we act proactively and address many ways this crisis has cost lives and threatened development outcomes.”
Looking ahead to addressing future outbreaks, the U.S. will need more data, more coordination, a better early alert system, and more response functions, Richardson said.
The administration has proposed setting up a new global health security coordinator at the State Department as part of a new global health security initiative. But there are concerns about how the plan might consolidate international pandemic preparedness and impact USAID.
In an apparent nod to those concerns, Richardson said that “coordination is not about control, it’s about empowerment.”
The proposals from the Trump administration about global health security, which Menendez called “eerily similar” to some congressional proposals, are “ill-thought, destructive, and dangerous in so far that they would cripple USAID and create a mechanism ... through which the administration could channel all of the funding it is withholding from the WHO,” he said.
Menendez also called for Risch to have more hearings and ensure a sustained focus on U.S. foreign policy and oversight. Secretary of State Mike Pompeo “is refusing to appear to defend the foreign aid budget,” Menendez said, adding that it could be the first time in 20 years that a secretary of state has not testified about the administration’s priorities. “The lack of engagement fundamentally undermines our work,” he said.
Risch, who recently introduced the Global Health Security and Diplomacy Act of 2020, said he was open to working with others on the committee to improve the bill and find the right way to address global health security. A group of Senate Democrats has also introduced a COVID-19 international response bill.
While there are differences in opinion on how the U.S. coordination should be organized, there is at least one common proposal in both the Senate bills — that the U.S. should join the Coalition for Epidemic Preparedness Innovations, CEPI. Sen. Chris Murphy argued at the hearing that the U.S. should be involved in CEPI and asked for the administration officials’ opinion.
Richardson’s response was that Gavi, the Vaccine Alliance, also plays a significant role in vaccines and the U.S. recently committed $1.6 billion to that initiative and has spent billions more on research and development in the COVID-19 response. When pressed, he said he would be “happy to look at” the idea of the U.S. joining CEPI.
Update, June 22, 2020: This article has been updated to clarify that the U.S. government has already obligated or disbursed $500 million of the emergency COVID-19 supplemental funding.