US returning to lead world health

• By Lin Shih-chia, Wu Yi-chin,
  Ting Wei-ming 林世嘉，吳宜瑾，丁威名

The US on Friday hosted the second Global COVID-19 Summit, with at least 98 countries, including Taiwan, and regional alliances such as the G7, the G20, the African Union and the Caribbean Community (CARICOM) attending.

Washington is also leading a proposal to revise one of the most important documents in global health security — the International Health Regulations (IHR) — which are to be discussed during the 75th World Health Assembly (WHA) that starts on Sunday.

These two actions highlight the US’ strategic move to dominate the global health agenda and return to the core of governance, with the WHA serving as a stage for its leadership.

Since US President Joe Biden took office, Washington has actively participated in the setting of the global health agenda, taking the lead in debates and discussions of the COVID-19 pandemic and the revision of the IHR.

The key points of its proposed amendments to reform the IHR are: establish a Universal Health Periodic Review mechanism; authorize the WHO to inform the world directly of risks when a state party is unwilling to provide verified information; a state party should state the reason if it refuses technical assistance from the WHO, and the WHO should notify all members of the situation; a state party should state the reasons for refusing to allow the WHO to carry out onsite assessments, and the WHO should notify members of the situation; and establish a Compliance Committee to review state parties’ compliance with the agreement, and the WHO Secretariat should inform the WHA about all relevant actions each year.

The amendments proposed by the US — from the investigation of the origin of the pandemic to a member state’s obligation to notify the WHO and compliance reviews — are clearly targerted at China. By constructing a more efficient and transparent global health governance model, there would be no way for Beijing to shirk its responsibility, and in discussing this issue, the WHA would become the stage for the US to show its power.

Just a week before the WHA starts, the US hosted the second Global COVID-19 Summit, which revolves around “ending the acute phase of the pandemic and preparing for future health threats” to discuss health system issues in the COVID-19 era, such as pharmaceutical materials (oral antivirals and oxygen), the global logistics system and infrastructure.

Under the powerful action and leadership of the US, this summit has become the highest level of global COVID-19 discussion platform outside the UN General Assembly and the WHA, with the first summit held in September last year. Given that the discussions at the UN General Assembly and the WHA still focus on the governance system and overall reform, the US-led agenda is more practical and closer to the needs of countries, making it easier to build strong partnerships.

These series of actions by the US highlight two trends. First, the conflict between the US and China has been more concretely staged in various fields, and global governance during the COVID-19 era is no exception; and second, the US intends to deal with the “China factor in the UN.” Leading the COVID-19 summit and calling on major countries to join it are pre-emptive moves outside of the UN system that manifest the US’ ambition.

In addition, the US has not given up on increasing its presence and power in setting the WHO agenda, which can be seen in its active leadership in discussions related to the pandemic treaty and its leadership in revising the IHR. While regaining the mantel of leadership, the US is also committed to creating a model of global health governance that is dominated by democratic partners in order to contain Beijing’s “China Anti-epidemic Model” propaganda in the health field.

Taiwan, as a like-minded country, should take advantage of the situation to consider what meaningful contribution it can make as the US works to return to a dominant role in global health governance and highlight the importance of its participation in the US’ ambitious agenda.

Lin Shih-chia is executive director of the Foundation of Medical Professionals Alliance in Taiwan and a former legislator. Wu Yi-chin is director of the foundation’s Global Health Research Center. Ting Wei-ming is an associate research fellow at the center.