 Hello and welcome to People's Dispatch. Today, we're joined by Dr. T. Sundar Raman of the People's Health Movement and the Jan Swastia Pyan. And we're going to be talking about the World Health Organization in the light of Donald Trump's announcement that he's going to cut funding pending a review. Thank you so much Dr. Sundar Raman for joining us. So the first thing we wanted to know was, of course, we've seen the political aspect of it. Trump has been trying to find a scapegoat. He's blamed China. He's blamed WHO. He threatened last week that he would withdraw and finally two days ago he did withdraw support to WHO that is. But in technical terms for the World Health Organization, what is a funding cut of this size and at this point of time mean? It is a serious setback because many of the WHO funds are tight funds. I can't use that liberally. When an emergency arises and much of their core works out of something called the CES funds, where each nation which is a member pays something in proportion to its GDP. So not surprisingly, the largest single donor will be the US. The US has already got arrears even before it has the tune of $200 million. And it has chosen from the 1980s, mid-1980s to freeze its contribution initially or to a percentage and then later in nominal terms also so that it pays the same amount instead of letting it float with the GDP. So therefore the US instead of paying as part of the CES, it moves its contribution to what are called voluntary donations which are basically bilateral agreements which are signed with WHO which have very project specific and very clearly earmarked so that it in fact in effect and doesn't allow WHO autonomy on display using its funds. In effect it means the autonomy of the WHO to spend that money on its sense of priorities is completely abridged and there are certain vertical programs that they each choose to focus on. It also means that in a number of systems development areas the WHO will be subcritical in its function. Now as it stands, the US and its allies, especially in the developed world, who not only mechanisms of funding but mechanisms of bilateral negotiation and by its overall influence, dominate every key appointment and decision making, all the resolutions are meted by it and therefore it is very surprising for them to actually be seen as having been not supporting them enough. The point is that currently there is a great perception of threat within the US with respect to its own rather poor performance which is now being increasingly compared to China much to its own. So whereas we are now exceeded in deaths and in a number of cases far beyond the Chinese, they need to now point fingers and say no the Chinese under reported. They may have, they may not have that's beyond the point but it's really not in WHO's remit. Does the WHO stand guarantee to the US figures or the India figures or the figures of any country? It's not within its scope. There is a diplomatic protocol. It can persuade, it can negotiate. It is not like the IAEA, the atomic energy regulation that it can go in and command an inspection and demand papers. It has to go by the record. But in terms of its international commitments, it had raised it to a global pandemic by January 30th. It had already called upon isolation and identification and contact tracing as mandatory requirements. Now remember if you actually freeze international contact travel, then there are huge economic implications and countries do not like that being done easily nor is it necessary unless you are unable to restrict flow from a particular country. Otherwise, and WHO has sort of quietly maintained it even as compared to lockdowns, what are really required is the process of identifying, of quarantining, of contacting. These are what is really going to sustain you in the wrong level. Anytime now international travel will restart and with it when it starts the virus will restart. The world has lived yellow fever for years. It has lived with Zika virus. It has lived with Ebola. We don't have to have complete star cessation of international travel. This is a new virus but precautions are needed and to that extent the WHO had warned. So I don't think the WHO can be faulted on its performance. What is really there is a delayed response from the US in starting up contact tracing, in being serious to the thing. They first started with suspending flights but even after that more than 3000 flights have come in from China and that was anyway not the main way. Trump himself came to India on February 24th. He had a major event over here with lakhs of people attended. Obviously that sense that you need an international travel restriction had not happened at that time and it's not anybody's particular fault because the focus of the epidemic in any way shifted to Europe by then. China, even China's distant provinces have not really gone into the epidemic. The epidemic has been largely confined in the Hubei province. So it was what measures were taken are adequate as of today. So also to continue a bit more on the WHO aspect itself. So you mentioned about how say the funding has now been connected to certain programs and certain verticals and how it's very almost corporate in terms of deliverables in terms of performance measurement metrics and issues like that. So what is the more problematic aspect of this kind of a model of working when you keep say public health as a concept on the other side? Essentially that your autonomy in terms of prioritization in terms being able to build capacities of member states or being able to support a higher degree of self-reliance approached. You are not able to work within a health systems understanding rather than a vertical understanding. So you have the GFATM will support your interventions in tuberculosis and HIV but when it comes to larger disease surveillance for example that sort of support is not forthcoming and this is within that sort of area or if you are supporting nations to be more self-reliant in essential health commodities the WHO is not in much of a position to do that. It has done some important work in pooling of for example for flu pandemics to create a patent pool it has taken such measures but those are precisely the measures. So behind the US insistence is also that potentially as the US overcomes the hum the developing nations are going to need a lot of the supplies and other than China the next big supplier is the US and at some point the building of US monopoly in testing kits and in vaccines and in ventilators are things that we need to worry about a lot of patents have been released for 3M on the ventilator side a lot of patents have been released on the testing kits side. Now at some point whereas the US the WHO is going with the Costa Rican proposal for patent pooling for being able to have a pooled resource these areas of the future play out of COVID-19 and corporate profits may be some of the concerns so it may not just be anger and distraction it may also an attempt to monopolize the global supply chain in a post COVID-19 pandemic phase and also question the authority of the Chinese who are now in effect commanding 80% of the supplies saying roughly for example almost all the supplies of PPEs testing kits the orders that we have placed are gone to China right and identify mass so and finally as far as the countries of the global south are concerned and for a matter for that matter when you look at say India's role in an organization like WHO at this point what are the possibilities they have to sort of say shore up the position of this organization when the US is taking such a stand. So the positive news is that the African countries have tended to strong stand up strongly to the US and being able to express their dissatisfaction with what the US has done. Some of the European nations have also expressed it and his credit Gates Foundation has also expressed it but the Asian nations have been remarkably silent and India as a major player has been remarkably silent in this particular role and that is a serious failure. So too have nations like Brazil been very silent in this issue and I think it is important to recognize that without this oxygen of support the WHO will be even more stressed after all whatever the US is unhappy with it is Lisa V the way WHO reaches out to the LMICs the low and middle income nations and in fact the LMICs will become far more dependent on US hegemony if the WHO is not there to act as a barrier and it is in their interest to speak out but unfortunately except for select African nations we do not yet see a response from other nations. Thank you so much Dr. Shankar, I am going to talk into this.