(From L): World Health Organisation Health Emergencies Programme Director Michael Ryan, Director-General Tedros Adhanom Ghebreyesus and Technical Lead Maria Van Kerkhove attending a virtual news briefing at the headquarters in Geneva. Agence France-Presse

Nick Wadhams, Tribune News Service

President Donald Trump’s decision to halt funding to the World Health Organisation has sown confusion within his administration, as staff members argue over what the decision means and whether some programmes that the agency oversees should be protected from the cut.

In the days since Trump suspended funding to the WHO for a review period of “60 to 90 days,” some administration officials have argued that, no matter what, the organisation should get far less than the $400 million to $500 million it receives each year from the US. They see the review as a way to redirect money permanently to other organisations focused on health care issues.

Others insist the halt is aimed — as the president said when he announced the cuts last week — at seeking reforms from the WHO and cleaning up what the administration sees as the pro-China bias it showed during the early stages of the coronavirus pandemic. They believe the agency has a crucial role to play fighting the virus and also in programmes that receive the bulk of the US funding, such as eradicating polio, fighting HIV and combating measles.

The internal debate, described by a dozen people familiar with the deliberations, underscores the turmoil surrounding Trump’s abrupt decision to pull funding from the WHO at the height of the COVID-19 outbreak in the US. The move has attracted criticism from the United Nations and partners in Europe and around the world.

“The administration is right in its criticisms of the WHO, but announcing the withholding of funding at this point impedes the ability to get other member states to support the reforms that the administration would want,” said Brett Schaefer, a senior research fellow at the Heritage Foundation in Washington.

Trump’s decision has provoked a rush to figure out how much money is actually affected by the funding halt. The US isn’t required to make its next payment of about $65 million in obligatory dues until after the review period is over.

According to WHO figures obtained by Bloomberg News that haven’t yet been made public, the organisation’s budget for the years 2020 and 2021 is already 81% funded as of March 31. According to those figures, the US has already made $316 million in voluntary contributions for that cycle, though the exact breakdown of that figure isn’t clear.

With Trump’s order in place, what’s being diverted now are voluntary contributions the US makes to specific World Health Organisation appeals and ongoing campaigns. In years past, the US has contributed $300 million to $400 million in voluntary spending.

“It is a bit of a head-scratcher,” Richard Gowan, the United Nations director at the International Crisis Group, said of the amount of money at stake. “There may be a certain sleight of hand here, which is the review period Trump is putting in place. The US can still come in later in 2020 and make payments that it was going to do anyway.”

But it may never do that. For now, the US Agency for International Development, the Department of Health and Human Services and the Centers for Disease Control are all shifting money elsewhere.

One of the programmes caught in the lurch is a polio surveillance effort for which USAID was set to contribute $43 million. That money has been frozen, according to one person familiar with the matter. The WHO also supports polio-vaccination programs in Pakistan, Afghanistan and Nigeria, the last three countries where the disease is endemic.

US officials from Trump on down have defended the WHO cuts, arguing that the organisation has strayed from its intended non-political nature and has become too biased toward China. Trump has signalled his frustration that WHO reaffirmed its opposition to travel bans just as he announced restrictions on travel from China.

He also has said the organisation echoed for too long China’s assertion that there was no evidence the virus spread from person to person. “World Health covered up for China,” Trump told reporters Monday evening.

It’s not the first time WHO’s operations have faced scrutiny. The organisation was accused of mishandling the response to the Ebola crisis in Africa, chiefly by not raising the alarm quickly enough. It has also gained a reputation for bureaucratic excess: In 2017, The Associated Press reported that it was spending about $200 million a year on travel expenses, more than it spent on AIDS, tuberculosis and malaria combined.

“We’ve had problems with them for years,” Trump has said. “We’re doing a very thorough investigation right now as we speak.”

Since the start of the outbreak, the US has committed almost $508 million in emergency health and economic aid to international organizations, according to the administration.

Yet while US officials publicly defend the halt to funding for the WHO, privately some within the administration are more cautious.

Some officials at the State Department and the National Security Council have argued for exceptions to the funding cut. Programmes they believe should be spared include the polio-vaccination drives and efforts to fight the coronavirus in the world’s poorest countries.

So far, Trump has rebuffed pleas to spare the WHO cuts from leaders including United Nations Secretary-General Antonio Guterres and French President Emmanuel Macron.

In a phone conversation last week, Macron asked Trump not to halt spending on the organisation, according to two people familiar with the call, arguing that global cooperation in the fight against coronavirus was too important. Trump, according to one of those people, assured Macron that it was only a 60-day pause, and then the US would reassess.

Two people familiar with the matter said there has been some internal discussion at the U.N. on how the organisation might get back in Trump’s good graces. Almost 20 Republicans in Congress offered one way: In a letter to Trump after his decision, they argued he should seek the resignation of the organisation’s director-general, Tedros Adhanom Ghebreyesus.

“It is imperative that we act swiftly to ensure the impartiality, transparency and legitimacy of this valuable institution,” they wrote.

With the cuts now in place, private actors have jumped in to fill the gap. On April 15, a day after Trump made his announcement, the Bill and Melinda Gates Foundation pledged an additional $150 million in funding for the organization.

Then on Saturday, musicians including the Rolling Stones, Lady Gaga and Celine Dion performed in the “One World: Together at Home” concert, which was organised by Global Citizen. The event, simulcast on three US TV networks, featured an appearance by Tedros, and it helped raise about $130 million for the WHO.