Briefing With Nerissa Cook, Deputy Assistant Secretary of State, Bureau of International Organization Affairs; Garrett Grigsby, Director of the Office of Global Affairs, Department of Health and Human Services; and Dr. Alma Golden, Assistant Administrator for Global Health, USAID On the U.S. Government's Next Steps With Regard to Withdrawal From the World Health Organization
Nerissa J. Cook, Deputy Assistant Secretary
Bureau of International Organization Affairs
Garrett Grigsby, Director of the Office of Global Affairs, Department of Health and Human Services
Dr. Alma Golden, Assistant Administrator for Global Health, USAID
September 2, 2020
MS ORTAGUS: Thank you so much and good afternoon, everyone, and thank you for joining us today for this on-the-record briefing regarding next steps in the U.S. withdrawal from the World Health Organization. Just a reminder that the – while this call is on the record, the contents of this call are embargoed until the end of the call. Also a reminder if you have a question to ask, you can go ahead and get in the queue at any time by dialing 1 and then 0.
So I'm joined today by briefers from the three agencies that are most relevant to this effort. For the Department of State, we have Deputy Assistant Secretary of State Nerissa Cook from the Bureau of International Organizational Affairs. From HHS we have Garrett Grigsby, director of that agency's Office of Global Affairs. And from USAID we have Dr. Alma Golden, assistant administrator for global health. Each of these experts will have a very brief opening remarks outlining recent decisions regarding the World Health Organization, and then we will turn to your questions. We'll begin with remarks from Deputy Assistant Secretary of State Nerissa Cook.
MS COOK: Thank you very much and good afternoon to all, and thank you for joining us today for this briefing. As mentioned, I'm Nerissa Cook and I'm a deputy assistant secretary for international organizations at the Department of State, and I help oversee the institutional relationship between the United States and the World Health Organization.
As you all know, in May the President announced that the United States would terminate its relationship with WHO and redirect its global health resources to other, more credible partners. This step was taken after the President gave WHO the opportunity to embrace crucial reforms, most notably to demonstrate its independence from the Chinese Communist Party. WHO leadership declined to take that opportunity, resulting in the President's decision. On July 6th of this year, the United States submitted its notice of withdrawal from the WHO effective on July 6, 2021. Today we are announcing significant steps to complete that process in and on that timeline, and including on matters related to funding.
I am pleased to be joined today by colleagues from USAID and HHS. Dr. Alma Golden and Director Garrett Grigsby are true experts on questions related to America's global health leadership and will address some of the specific actions we are announcing today.
Before we proceed, let me note in advance that the information we are providing today was also presented to WHO Director General Tedros during a meeting earlier today with our U.S. ambassador in Geneva, Andrew Bremberg.
To begin, I would like to discuss the status of U.S. assessed contributions to the WHO. These are the annual dues that member-states are required to pay as the price of membership. As with many UN organizations, the U.S. is assessed at 22 percent of the WHO's regular budget, which typically totals more than $100 million a year. For Fiscal Year 2020, the U.S. assessment was just over $120 million, of which 58 million had already been contributed at the time of the President's April decision to suspend additional funding. Today we are announcing the remaining portion of the 2020 assessment, slightly more than $62 million, will be reprogrammed to the UN to pay other assessments.
I would like to turn now to my colleagues to discuss some of the specific steps their agencies are taking to implement the President's decision, but let me make one additional comment about the U.S. institutional relationship with the WHO going forward: There may be instances in the future when the United States wishes to participate in particular meetings of the WHO's governing bodies and technical and advisory committees where we believe American interests need to be represented. We will consider those instances on a case-by-case basis.
Now for additional detail on questions related to funding of global health priorities, let me turn first to HHS and Doctor Garrett Grigsby.
MR GRIGSBY: Thanks, Nerissa. To correct the record, I'm actually not a doctor.
MS COOK: Director.
MR GRIGSBY: (Laughter.) Yeah, this is Garrett Grigsby with HHS. Good afternoon, everybody. A number of operating divisions of the Department of Health and Human Services traditionally have engaged with the World Health Organization and some of these interactions have included voluntary contributions. In the case of voluntary program funding, operating divisions of HHS have in some cases – many cases, really – found other recipients to carry out activities moving forward. As you know, the U.S. Government is the most generous funder of global health activities on Earth and has been for decades, with extensive partnerships all around the world working in virtually every issue area.
The WHO activities that HHS will support this year are one-time exceptions for funding, up to $40 million, in the program areas of immunization and influenza. These contributions would be to ensure continuity of activities important to the health security of Americans for which there was not immediate alternative programmatic partners. They'll ensure that activities critical – of critical concerns to the health of Americans will continue until appropriate alternative partners are secured. The one-year timeline for U.S. withdrawal from WHO allows time to find and secure partnerships to fund critical programs. HHS is well underway with this process to make this happen in advance of the one-year anniversary of Secretary Pompeo's letter to the UN Secretary-General making known U.S. intentions with regard to WHO.
Finally, HHS has a number of individuals detailed to WHO working on technical health issues. We're working with these individuals to bring them home or to send them to their next assignment in advance of 2021 when the U.S. will no longer be a member of WHO. So that's what I've got. Back to you, Nerissa.
MS COOK: Thank you very much, Garrett. And now I would like to turn to USAID and Dr. Alma Golden.
MS GOLDEN: Thank you so much. We appreciate you joining us this afternoon. I'm Dr. Alma Golden. I'm the assistant administrator for global health at the United States Agency for International Development, USAID. I'm pleased to join my colleagues from the Department of State and Health and Human Services to speak with you today.
As my colleague Garrett Grigsby just noted in his remarks, USAID has funded our work with the World Health Organization through voluntary contributions. My colleagues and I at the agency have worked diligently to identify appropriate partners to carry out this urgent and complex work on which we previously collaborated with WHO. Despite progress on the humanitarian reform, it is critical that the WHO better prepare for, prevent, detect, and respond to outbreaks of dangerous pathogens with transparency and with accountability. While in the vast majority of cases, USAID has identified strong and appropriate partners to carry forward this work, we will make a one-time disbursement of up to $68 million to the WHO to support humanitarian health assistance in Libya and Syria as well as efforts to eradicate polio in priority countries. These exceptions reflect the few cases in which WHO has the unique capabilities that an alternate partner could not replicate at this time.
Since 2001, the U.S. Government has contributed more than $142 billion to help prevent, detect, and treat HIV/AIDS, malaria, tuberculosis, Ebola, and other dangerous diseases and conditions. We give an average of $10 billion per year for global health, and this year, it will be double that as we surge to fight COVID-19 worldwide.
USAID is determined to ensure that our withdrawal from WHO does not affect the level of our overall health assistance to the most vulnerable. The United States leads the world in health and humanitarian aid through an all-of-America effort, and we are committed to ensuring that our generosity directly reaches people around the world. We and the rest of the U.S. Government will continue to engage the WHO on a limited basis during this coming year of our withdrawal.
On a case-by-case basis, the United States will participate in specific meetings of the WHO's governing bodies and technical and advisory committees. Our priorities will be events and processes of a normative, regulatory and standard-setting nature that have a direct impact on Americans, on U.S. national security, on U.S. economic interests, U.S. companies, and on the U.S. Government's global health investments.
Thank you very much. Back to you, Nerissa.
MS COOK: Thank you, and I think we'll turn it back to Morgan to begin the Q&A.
MS ORTAGUS: Great. So we do have some people in the queue. We'll take as many questions as we can with the time allotted. Reminder to dial 1 and then 0 if you'd like to get in the queue. First up is Nick Wadhams from Bloomberg.
QUESTION: Hi, thanks very much. I had a couple questions. The first is: Is there any circumstance under which the U.S. would consider rejoining the WHO if it enacted reforms that the administration seeks? And then also, just to follow up on something you said, if the U.S. believes that the WHO is such a failed institution, why do you believe that you should stay involved with the organization?
And then secondly, in March, the Secretary said Americans "should be aware and proud of our vast commitments to [these] important institutions" – that's a direct quote – including the WHO. That was March 31st after the extent of the virus was largely known, so I'm curious what changed between March 31st when Secretary Pompeo said that and July when the President decided to pull out of WHO. Thank you.
MS COOK: Well, let me take some of those questions and then open it up to my colleagues from HHS and USAID.
In terms of whether we would reconsider the decision, I think it's best to quote from the President. He did say in June that he was not reconsidering the decision unless WHO gets its act together, and he was not sure at that time that they can. He has also indicated in July that our withdrawal doesn't mean that someday we won't go back in. As he said, maybe we will when it is correctly run. The position of the White House is that the WHO needs to reform, and that is starting with demonstrating its independence from the Chinese Communist Party. And it needs to make improvements in its ability to prepare for, to prevent, to detect, and to respond to outbreaks of dangerous pathogens.
Let me see if either Garrett or Alma would like to add to that.
MR GRIGSBY: No, I think you covered it well, Nerissa.
MS GOLDEN: I agree. Thank you, Nerissa.
MS ORTAGUS: Great, thank you. Let's now turn it over to Toby Burns from NHK.
QUESTION: Hi there, thanks very much. I appreciate the briefing. The first question is for Ms. Cook. It's about the $62 million that were going to be reprogrammed to the UN. Do you have more details on how that money is going to be reprogrammed and what it's going to go to?
And then the second question is for Ms. Golden, which is just a clarification on the 68 million in contributions that you announced to Libya and Syria. How specifically – who's going to get that money specifically and how is it going to be deployed? Thank you very much.
MS COOK: Thank you for the question. The reprogramming of the balance of the FY 2020 assessed will be reprogrammed to partially pay an assessment to the UN. Right now, the department is in the process of notifying Congress of the reprogramming of the funds and we will have more specifically once that process is complete.
MS ORTAGUS: Great. Thank you. Over to Will Mauldin from Wall Street Journal.
QUESTION: Thank you so much. That previous question was along the lines of mine. But if you had any further – I just wanted to follow up if you had any further color on the 68 million one-time WHO support for humanitarian assistance in Syria plus polio. That's going to the WHO in addition to what was previously budgeted? How exactly does that work? Thank you.
MS GOLDEN: This is Alma Golden. Basically, USAID will provide up to 44 million for the eradication of polio. Particularly, we are concerned about assuring that Afghanistan and Pakistan, which have endemic polio, will be reached in this important campaign.
And then secondarily, there – we will – USAID could provide support to the WHO in Libya where it is the only organization able to manage the large-scale procurement of the essential pharmaceuticals for the humanitarian health response in that country.
And similarly, USAID could also provide support in Syria where the organization's cross-line and cross-border access are critical to the response for the humanitarian crisis, as well as what we're seeing in the COVID-19 pandemic in that area. Thank you.
MS ORTAGUS: Great. Thanks. Now let's turn it over to Jennifer Hansler, CNN.
QUESTION: Hi. Thank you for doing this. I was wondering if you could go into more specifics of what demonstrating independence from China would look like. And do you believe that Dr. Tedros is still the appropriate leader for the WHO? And then if I might on COVAX, can you explain why the U.S. feels that this is the most productive path, to not be involved with this global initiative? Thank you.
MS COOK: On the China issue, our view is that the WHO needs to be independent in its processes and procedures in dealing with pandemics. So we are advocating for greater transparency and greater accountability. And we want to see speedier and higher quality of communications in the face of pandemics. We want decision-making to be based on science and not on other considerations. And we want to see very strong management and a focus on the prevention and detection and response to pandemics.
Let me turn now on COVAX to Garrett Grigsby.
MR GRIGSBY: Thanks, Nerissa. I don't think it's actually well understood that the U.S. on a technical level is really in constant contact with countries that are participating in COVAX on these issues as well as the organizations like Gavi. In fact, we're a very generous funder of Gavi. So that really needs to be taken into account and understood. And as Secretary Azar has said on a number of occasions, once the American people – their needs with respect to the vaccine are met, hopefully, depending on how the vaccine trials turn out and the rest of it, there will be a good excess of vaccines and we certainly will be looking to do our fair share in terms of supporting the global need for vaccinations. And in addition to that, there's going to be significant manufacturing capacity that has been built because of this whole process, and of course that is going to remain available to the world as well. Over.
MS ORTAGUS: Great, thank you. I'm trying to squeeze in a few more questions here before we have to go. Carmen Paun, Politico. Carmen? Okay. Can we try Narise from NPR? AT&T, are we having trouble getting these? They're in our queue. Am I still on? Hello?
OPERATOR: Yes, I am. That's Narise.
MS ORTAGUS: Okay. We have Carmen and Narise in the queue. Can we unmute either one of their lines?
OPERATOR: Carmen is – your line is now open, please. Oh, she's dropped. What's going on here?
MS ORTAGUS: Why don't we try – I think I have Michelle Nichols up next from Reuters.
OPERATOR: Okay, your line is now open.
QUESTION: Oh, great. Thanks so much for this briefing. I'm just trying to harp on this. I just wanted to clarify some of the numbers. According – when was the $58 million paid earlier this year? Because I'm looking at a statement from the 31st of January which shows that the U.S. also owes about $80 million for last year. So what's your understanding of how much in arrears the U.S. was in assessed contributions to WHO, and will that be paid?
And also, regarding the withdrawal, the resolution by Congress on the withdrawal saying you have to give a year's notice also says that you have to pay what you owe. So how are you hoping to sort of satisfy that requirement? Is that why this money, the 62 million, is being redirected to just normal UN assessments? Thanks.
MS COOK: I would have to get back to you on the exact date when the 58 million was paid. So we will – we will look to do that. On the – could you repeat the question again, please, the second half? On the 62.
MS ORTAGUS: Yeah, AT&T, I think we'll need you to unmute Michelle again for her to repeat that question.
MS COOK: Yes.
MS ORTAGUS: Yes, Michelle, we can hear you. Go ahead. She just was asking –
QUESTION: Yes, sorry, sorry. Just how much – how much in arrears is the U.S., not counting what you owe for this year? How much do you owe in arrears? And the 62 million, what – is that being redirected to just the usual United Nations here in New York assessed contribution? Is that what you're talking about? And under the decision by Congress on a withdrawal from WHO, the U.S. has to pay what it owes to WHO to be able to withdraw. So how are you sort of getting around that?
MS COOK: The – right. I think you referred to there's about 18 million in FY19 funding and 62 million in FY20, and those together are being reprogrammed to the UN to pay the regular UN assessment.
MS ORTAGUS: Great, thank you.
MS COOK: Yeah.
MS ORTAGUS: Okay. We have time for one more question, and it will come from the line of Tom Howell from The Washington Times.
QUESTION: Thank you for doing the call. You just talked about the regular dues, but I want to – I had a question about the other numbers, the 40 million for immunization and influenza, and the 68 million in the humanitarian aid. I just want to make sure I'm using the right terms. Is that what's called voluntary contributions? Are you saying that those monies will go to WHO partners, but in the future you hope to find other, non-WHO partners for that – those kind of missions? Do I have that right?
MR GRIGSBY: Yes, that's right. Those –
QUESTION: All right. Thank you.
MR GRIGSBY: Yeah.
MS ORTAGUS: All right. Well, since that was quick, I think we can sneak in one more. Conor Finnegan.
QUESTION: Hey, can you hear me?
MS ORTAGUS: You're good to go, Conor.
QUESTION: Good. So just to follow up on Jennifer's question, the specific reforms that you laid out, why was the – why would the administration think it's sort of realistic for WHO to make those reforms on its own in the middle of this crisis? And why do you believe that leaving the organization now gives you leverage to effect those changes? Thank you.
MR GRIGSBY: Nerissa, do you –
MS COOK: What? Yes, go ahead.
MR GRIGSBY: In terms of leaving the organization, I mean, that's – the U.S. has traditionally been, I think since the very beginning, the largest donor to WHO. And so I believe that we have actually a tremendous amount of leverage. And we will – we have been and we'll continue to work with other countries during this period where – before it's – we officially pull out of WHO to try to seek reforms. Because if WHO works better, that's – that'll be good for everybody. But I just – I guess I fundamentally disagree with your premise. We actually do have quite a bit of leverage, and if they're interested in seeing the United States stay, they will take that seriously and negotiate seriously.
What was your first – your first question? The first part of your question? Repeat that.
MS ORTAGUS: AT&T, that's Conor Finnegan. He'll need to be unmuted, please.
MS COOK: What I might just add as we're waiting for that to happen is that within the WHO membership, there was a lot of consensus back at the time of the May World Health Assembly about the need for reform and to do a better job in terms of the response to COVID-19. And this resulted with U.S. leadership in the World Health Assembly resolution that, among other things, called for the establishment of an inter – independent panel to evaluate the global response, including WHO's performance, and to investigate the origin and the spread of the coronavirus.
So there was consensus among WHO membership that changes needed to be made, and if you recall during the West Africa Ebola outbreak, there were also midterm reviews done with an – with the intent to strengthen the response at that time. So that is the idea of reforming and strengthening in the middle of a pandemic, is something that is part of public health policy.
MR GRIGSBY: Thanks, Nerissa. You actually did answer the first part of his question. And it – that's the same as what I would have answered. So, thanks.
MS ORTAGUS: Wonderful. Well, everybody, we're over our time limit. We'd just like to thank all of our reporters for dialing in, and thank you to our briefers. Have a wonderful afternoon.
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