For most of the last half century the United States has been, by far, the leading provider of health aid to developing countries. That assistance has helped Thailand and the other nations of Southeast Asia develop effective programs dealing with malaria, HIV-AIDS, pandemic flu and a long list of other diseases. American expertise and financial support have won appreciation and respect throughout the region.
Unfortunately, the seemingly selfish, confused and ineffective effort of the current US administration against the Covid-19 pandemic risks losing that historical good will.
The decision this month to halt funding for the World Health Organization in the midst of a global health crisis has become the bizarre hallmark of Washington’s policy towards international cooperation on the disease. That decision has overshadowed announcements that nearly $500 million has been allocated by the State Department and the US Agency for International Development to fight Covid-19. The halt to funding for WHO comes on top of the administration’s proposal to cut foreign aid by 23% in its 2020 budget, including large reductions to well-regarded programs dealing with AIDS and malaria in developing countries.
Through most of my 19 years with the Kenan Institute Asia, the institute worked closely with USAID to bring American medical and public health expertise to the region. That American assistance was greatly appreciated. Public health authorities throughout the region, even in Communist countries like Vietnam and Laos, learned from and worked with the US Centers for Disease Control, the National Institute for Allergy and Infectious Diseases and USAID. The US Armed Forces Research Institute of Medical Science maintains a research facility in Bangkok with a staff of more than 400 in partnership with the Royal Thai Army.
Health officials in Laos preparing for a disease outbreak investigation managed by KIAsia and funded by USAID in 2008.
Now, however, there is confusion about American actions and objectives – not only in the region, but in Washington. Press reports this week say USAID officials are scrambling to get details about the halt in US funding for WHO. As recently as April 15, the USAID website touted its partnership with WHO to strengthen medical laboratories in Vietnam under the Global Health Security Program. Aid officials are struggling to find alternatives to WHO, not just for Covid, but for other diseases.
The lack of a USAID member on the White House task force on Covid-19 is one indication of the low priority given to developing country needs. Reports say working-level aid officials have had difficulties getting clear guidance from the administration, delaying urgent work on the pandemic.
In March USAID began cancelling shipments of medical supplies abroad because they were needed in America. Worse, USAID dipped into its disaster relief supplies stored overseas for international crises to send masks, protective clothing and face shields back to the US. The US failure to ensure sufficient domestic supplies may have made these shipments understandable, but the signal to other nations is that the health of the rest of the world is not a priority.
Although the United States is still providing more international assistance on the pandemic than any other country, that is not generally recognized. World attention is focused on the confusing statements from the White House, the US failure to control the disease domestically and the cuts to international assistance.
Two years ago, the journal Health Affairs warned: “If we cut our aid and leave a vacuum, it will be filled by US rivals, starting with China. Chinese foreign aid is growing fast, at an annual rate of more than 20 percent per year, and is rapidly catching up with US assistance.”
Protective equipment provided to Thailand by the United States for the fight against Covid-19
That is exactly what is happening now.
After initial problems in Wuhan, China has won favorable attention for donating protective equipment to countries hard-hit by the virus. Chinese billionaire Jack Ma has added to official donations with some 1 million test kits and 600,000 surgical masks for Africa. Between March 1st and April 4th China exported nearly $1.45 billion of medical supplies to countries in need. Chinese telecoms giant Huawei has already delivered much of its promised 500,000 masks, 50,000 goggles, 30,000 gowns and 120,000 gloves to hospitals in New York.
China has not limited its assistance to equipment, but has also provided expertise, sending doctors and nurses to several countries. As Thailand began its Covid-19 vaccine effort, it looked not to the United States but, as the Bangkok Post reported, to China as a technical partner.
The first team of Chinese doctors and nurses to be sent to Southeast Asia landed in Cambodia on 23 March. The headline in the local paper was “Chinese experts to the rescue”.
China also drew attention to the US cut in funding to the WHO by offering to donate an additional $30 million to the agency.
China’s “coronavirus diplomacy” may be intended to avoid blame for its initial fumbling response to the virus, but Its donations of equipment have contrasted with the US effort to grab international supplies for itself. Just as important has been the apparent success of China’s measures, however belated, to get the pandemic under control. Reports of dropping infection rates in China have contrasted with daily hikes in the number of infections and deaths in the United States. As of April 20, the United States reported 764,000 infections and more than 40,000 deaths compared to just over 82,000 infections and 4,600 deaths in China’s far larger population.
People in Southeast Asia, where the number of infections is far lower, must wonder how the self-proclaimed global leader in health became the country with the most pandemic deaths in the world.
A recent study by researchers at Stanford University found that favorability ratings of the United States increased in proportion to its delivery of health aid. President Bush’s Emergency Plan for AIDS relief and the President’s Malaria Initiative were particularly well received. How will the Covid-19 pandemic affect favorable views of the United States?
Hopefully, the US administration will rapidly improve its response to Covid-19 both in the US and around the world. America’s advanced medical research capability will be crucial to the development of treatments and vaccines against the virus. But to be effective, the US government should not seek to go it alone. Much improved international cooperation will be necessary and that must include cooperation with China. Historical health linkages should make this achievable, but the administration’s mindset of “America First” must be replaced by “People First.”
If nothing else, the Covid-19 pandemic has made it even more obvious that the American people cannot be healthy if the rest of the world is sick. American expertise and financial resources must be shared around the world. That will be good for the world and good for the United States. There is a long way to go before this crisis is over, but a big change in the mindset at the top of the American government will be needed to overcome a disastrous start.