[Ip-health] Senate Foreign Relations Committee questions State Department, USAID, and HHS on COVID-19 and U.S. International Pandemic Preparedness, Prevention, and Response

Thiru Balasubramaniam thiru at keionline.org
Wed Jun 24 14:15:56 PDT 2020


Senate Foreign Relations Committee questions State Department, USAID, and
HHS on COVID-19 and U.S. International Pandemic Preparedness, Prevention,
and Response
Posted on June 24, 2020 <https://www.keionline.org/33394> by Thiru

On Thursday, 18 June 2020, the Senate Foreign Relations Committee convened
a hearing on COVID-19 and U.S. International Pandemic Preparedness,
Prevention, and Response
The witnesses called to provide testimony included: 1) James L. Richardson,
Director, Office of Foreign Assistance, U.S. Department of State, 2) Chis
Milligan, Counselor, U.S. Agency for International Development, and Garrett
Grigsby, Director, Office of Global Affairs, U.S. Department of Health and
Human Services. Among the topics broached at the hearing were the World
Health Organization’s (WHO) response to COVID-19, the United
States’ relationship to WHO, US engagement with the,Coalition for Epidemic
Preparedness Innovations (CEPI), and Senator Jim Risch’s (R – Idaho) bill, the
Global Health Security and Diplomacy Act – S. 3829
introduced in the US Senate on 28 May 2020. Senator Risch’s bill,
co-sponsored by Chris Murphy (D – Conn.) and Ben Cardin (D-Md.) calls for
the establishment of a Trust Fund for Global Health Security to be housed
at the World Bank; the bill would authorize the US to contribute $3 billion
(USD) to this Global Health Security Trust Fund between 2021 to 2025. The
bill calls for the appointment of a Coordinator of United States Government
Activities to Advance Global Health Security and Diplomacy overseas (housed
within the State Department.

In his opening remarks, Senator Risch applauded the role of the WHO as the
guardian of the International Health Regulations (IHR) and commended its
efforts in combating polio and eradicating polio. However, Senator Risch
noted that the WHO”s response to fast-moving emergencies such as Ebola and
COVID-19 had exposed certain structural weaknesses. Risch advised the
Committee that the purpose of the hearing on the COVID-19 response was not
to demean, criticize, or condemn the WHO, but to conduct a fair analysis of
the response. Risch provided a brief overview of his bill S. 3829 which he
noted was a work in progress. Risch stated that his bill would provide an
international financing mechanism that would re-energize action under the
global health security agenda and create a single accountable entity at the
State Department to lead diplomatic efforts and coordinate global health
security assistance overseas.

In his opening remarks, Ranking Member, Senator Robert Mendendez (D – NJ)
castigated the administration by noting that rather than leveraging US
leadership and contributions to the WHO, President Donald Trump abruptly
announced that the US would simply pull out of WHO which would not only
threaten the United States’ ability to confront COVID-19, it would risk
decades of progress on global initiatives including combating Ebola and
polio. Senator Menendez noted that while the White House engaged in
divisive rhetoric, the rest of the world moved on ahead. He contrasted
President Xi Jinping’s announcement of committing $2 billion in the
COVID-19 response at the World Health Assembly (WHA) in May 2020 with
Secretary Alex Azar’s attack of WHO and China at the WHA. Menendez drew
attention to the non-participation of the United States in the European
Union’s global pledging marathon
<https://global-response.europa.eu/index_en> for COVID-19 in May 2020 which
raised $8 billion dollars. Senator Menendez stated, “Is this what the
Administration means by America first? Well if this EU consortium comes up
with a vaccine before we do, it will mean America last. This approach is
not only isolationist, short-sighted and foolish, it endangers American
lives.” In closing, Menendez pushed back at proposals to create a financing
facility at the World Bank on Global Health Security which would channel
all the money the United States is currently withholding from WHO.

Following the testimony of Richardson
, Milligan
and Grigsby
the Committee posed the following observations and questions.

Senator Risch noted that in his conversation with WHO Director-General Dr.
Tedros Adhanom Ghebreyesus and his team, the WHO was defensive one respect,
noting that the WHO is not a “sovereign entity” and did not have the power
to tell a sovereign entity what to do. Risch remarked that the WHO was
taken back by the rapid emergence of COVID-19.

In his response, Mr. Garrett Grigsby acknowledged that the WHO did not have
a police force or a standing army to enforce the obligations of the
International Health Regulations. Grigsby remarked that rather than
“calling China out”, the leadership of WHO praised China for their actions
in the COVID-19 response. Grigsby declared, “We’ve been in this movie
before” alluding to SARS. Grigsby remarked that in contrast to the COVID-19
response, WHO was bolder during the “SARS situation” in 2003 and called the
leadership of China out.

In a fiery exchange with Grigsby
<https://www.keionline.org/wp-content/uploads/Menendez.mp4>, Ranking
Member, Senator Menendez quoted Grigsby’s testimony that “WHO’s praise of
China exacerbated the pandemic because it did not pressure China to be more
transparent”. Menendez countered that “President Trump himself praised
China’s response multiple times – in speeches, public statements, and
tweets. Quite explicitly in one tweet on January 24th, ‘China has been
working very hard to contain the coronavirus. The United States greatly
appreciates the efforts on transparency. It will all work out well, in
particular, on behalf of the American people, I want to thank President
Xi.’ On February 6th, at the WHO Executive Board meeting, Ambassador
Bremberg who represented the United States, was similarly effusive saying,
‘We deeply appreciate all that China is doing on behalf of its own people
and the world’.”

“Was the WHO’s praise of China the fatal flaw which necessitated the US
withdrawal from the WHO and if so, why did the US make similar statements
in praise and support for China at the same time if this was detrimental to
the global pandemic response?” Menendez queried.

Grigsby responded that early on in the COVID-19 response, the United States
received information that China was being cooperative. Grigsby noted that,
“[w]hat happened was that we received more information later, and as that
information changed, the tone changed.” Grigsby briefly described the WHO
negotiations on resolution WHA 73.1
<https://apps.who.int/gb/ebwha/pdf_files/WHA73/A73_R1-en.pdf> on the
COVID-19 response which called upon an independent review of WHO’s handling
of COVID-19. In his description of the WHO, Grigsby glossed over the WHO
negotiations on the COVID-19 resolution, he glossed over the fact that the
United States disassociated itself from language referring to sexual and
reproductive health and rights TRIPS flexibilities. As reported in Le Monde
during the negotiations, the United States was unsuccessful in its 11th
hour attempt to water down the resolution’s references to TRIPS

Senator Menendez asked Grigsby how the United States expected to reform the
WHO, including ensuring better compliance with the International Health
Regulations, if it had “relinquished its seat at the table.”

Grigsby responded, “The United States is a member of the World Health
Organization. The President has announced that relationship is being

Menendez interjected, “If I’ve said if I’m terminating my relationship with
you, why should I listen to you? Can you explain that to me? If you tell me
you are terminating your relationship with me, why should I listen to you
about anything you want to do with an organization that I no longer am
going to have a relationship with.”

Grigsby countered: “Why don’t I tell you about what we’re actually doing.”

Menendez retorted, “No, why don’t you answer my question?”

Grigsby continued, “I am doing that, Sir. As you know the United States has
the presidency of the G7 this year. This provides us the opportunity to
speak with health ministries. In fact, since early on in the pandemic,
Secretary Azar has had once a week telephone conversations with all health
ministers of the G7. As the situation with COVID-19 became more apparent,
there was a focus on reform of the WHO…It’s in the interest of the United
States whether or not we are a member – to have a WHO that performs better.”

Menendez interjected, “I appreciate your lengthy answer which is a
non-answer as far as I am concerned. The reality is you have not made it
clear to me how you are going to effect change at the WHO when you’ve
terminated your relationship.

Let me ask you one final question. If we create a new global trust fund at
the World Bank as I understand it from reading Senator Risch’s bill, would
we just be going it alone? The rest of the world, they may be seeking
change at the WHO, but they are behind the WHO. So help me understand why
other countries would support a new mechanism at the World Bank. Wouldn’t
just this create a parallel mechanism to the World Health Organization?”

Grigsby responded noting that his team had just received the text of
Risch’s bill a few days before the hearing and would study it in greater

Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International
41 22 791 6727
thiru at keionline.org

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