It’s time to rethink who represents the U.S. at the WHO

In June 1948, Congress enacted a joint resolution authorizing U.S. participation in the World Health Organization. In addition to outlining the rules for ending membership in the WHO — language which became relevant to President TrumpDonald TrumpRobert Gates says ‘extreme polarization’ is the greatest threat to US democracy Cassidy says he won’t vote for Trump if he runs in 2024 Schiff says holding Bannon in criminal contempt ‘a way of getting people’s attention’ MORE’s intended withdrawal in July 2020 — Public Law 80-643 also dictates the qualifications of the individual selected to represent the United States at the WHO executive board. 

The WHO Constitution notes that the representative to the executive board must be technically trained in health. The U.S. 1948 resolution interpreted this requirement to mandate that whomever represents the United States be a graduate of a recognized medical school and have no less than three years of experience practicing medicine or surgery. 

This rule has stood for 73 years. It is time to change the rule.

Every year, the executive board of  the WHO meets to review the most important topics in global health, set the agenda for the World Health Assembly, and guide the management of the WHO secretariat. The 34 Members of the executive board hail from every region of the world, including six representatives from the Americas. Members serve on a rotating basis, but the United States has held a seat at the table almost every year possible. (After three year cycles, members rotate off of the executive board for a minimum of one year.)

The issues debated at the WHO executive board are diverse and complex.  In January 2021, there were 47 agenda items. These ranged from discussion on budget and organizational structure of the international organization, to reform agendas, universal health coverage, patient safety, and not least of all, governing the multi-sectoral response to the COVID-19 pandemic, which has to date impacted over 235 million people and been responsible for over 4.8 million deaths worldwide. 

The United States has been privileged to have had many excellent representatives to the WHO executive board over the past 70 years. Some have been exceptional diplomats, others have successfully negotiated reforms, and all have worked with global partners in a highly politicized organization to try to improve population health around the world. But it is safe to assume that it was not their training to perform surgical procedures or high marks in anatomy class that qualified them for success. 

A lot has changed since 1948. Medical doctors are not the only professionals working in global health, so what does it now mean to be “technically qualified in the field of health?” Thousands of people every year are graduating from schools of public health with advanced degrees, including in epidemiology. Lawyers are navigating complex international law impacting global governance of disease. Veterinarians, disease ecologists, environmental health experts, medical anthropologists, data scientists, communications experts, modelers, sociologists, virologists, microbiologists, biochemists, economists,…