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As the world seeks to join together to bring the novel coronavirus under control, President Trump has sent a letter to the World Health Organization threatening that the U.S. will halt all funding and consider leaving the agency, pending an assessment of its response to COVID-19.

The timing of the letter added to its shock value: Trump sent out a tweet at 10:55 p.m. Monday, in the midst of WHO's annual assembly, announcing that he'd sent the letter. The tweet included the letter's full text and stated that his allegations of incompetence on the part of WHO were "self-explanatory."

WHO responded cautiously: "We have of course received the letter, and we are looking into it," Tedros Adhanom Ghebreyesus, director-general of WHO, said at a

Pressed by NPR on what exactly the Trump administration is asking for in terms of changes at WHO to keep the U.S. from leaving the organization, Michael Ryan, executive director of WHO's Health Emergencies Program, said, "I think you might want to point that question to them."

Other global health researchers were more direct. 

"I found the letter full of unsubstantiated interpretations of certain events," said 

, a global health professor at Simon Fraser University. A U.S. withdrawal from WHO would seriously compromise efforts to unite and provide proper funding for a global response in a "profoundly important moment," Lee said. 

NPR spoke to global health experts in the U.S., Canada and Switzerland and examined the public record to provide context for some of the assertions in Trump's letter (reprinted in bold below). The full text of the letter can be read at the end of this post.

China's delays in providing information and lack of sharing are what 

, a global health professor at Georgetown University Law Center, calls  "two truths in the president's letter."

First, Gostin said China was not transparent early on in the outbreak.

"China was anywhere from two to even up to six weeks' late in reporting to the World Health Organization," Gostin said, noting there's evidence that Chinese health authorities knew the coronavirus was circulating in December and that their delays in reporting likely "seeded the epidemic" through East Asia, Europe and the United States.

Second, while China quickly shared the genome sequence for the coronavirus, "it has not been as forthcoming with sharing biological samples which are needed for epidemiology and also for vaccines and treatments," Gostin said. 

But Gostin said blaming WHO for China's reporting delays and sample hoarding is misdirected. Of these charges by Trump, he said: "They're valid critiques of China but not the World Health Organization.

 a respected medical journal, said: "This statement is factually incorrect." In a note 

, the journal said it published its first papers on the novel coronavirus on Jan. 24. In two papers published that day, researchers from China and Hong Kong described the first 41 patients in Wuhan and provided scientific evidence for human-to-human transmission. 

WHO also disagrees with the charge that information relevant to the coronavirus was reported in early December. 

its representatives first learned of a cluster of pneumonia cases of unknown cause in Wuhan 

, which gathers reports and rumors of outbreaks. 

"There are literally millions and millions of cases of atypical pneumonia around the world every year, and in the middle of an influenza season sometimes it's very difficult to pick out a signal of a cluster of cases," WHO's Ryan said at a press conference 

. "In fact it's quite remarkable that such a cluster was ultimately picked out of 41 confirmed cases in Wuhan."

WHO has repeatedly said this assertion is false. Taiwan's health authorities 

 they did not officially report to WHO that human-to-human transmission was happening by Dec. 31.

sent to WHO on Dec. 31: "News resources today indicate that at least seven atypical pneumonia cases were reported in Wuhan, CHINA. Their health authorities replied to the media that the cases were believed not SARS; however, the samples are still under examination, and cases have been isolated for treatment. I would greatly appreciate it if you have relevant information to share with us. Thank you very much in advance for your attention to this matter."

 from Taiwan made no direct references to human-to-human transmission and simply requested clarification on reports Taiwan's health officials were seeing about a pneumonia cluster from China.

The World Health Organization did praise China at that point. "The United States was equally praising China at the time," Georgetown Law's Gostin pointed out.

, Trump tweeted: "China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!"

This demand comes with no specifics,  global health observers said. "What exactly does the Trump administration want WHO to do?" Simon Fraser's Lee asked. It's not clear what "action" the U.S. is asking for, or how WHO could demonstrate "independence from China," because no solutions are outlined in the letter. 

As for the threat of U.S. withdrawal, Gostin said he thinks the U.S. is unlikely to follow through with leaving WHO, because he does not believe Congress would approve such a move.

Still, Trump's threats are already causing substantial damage to the global agency tasked with coordinating the world's response to the pandemic, said 

, associate professor of global health policy at the University of North Carolina at Chapel Hill.

"For the United States to blame the World Health Organization for its own months and months and months of inaction seems factually untrue and designed to divide the world at a moment when global solidarity is needed most," Meier said. "It undercuts the World Health Organization's efforts to provide a collective response to this common threat [of the COVID-19 pandemic]."

Jason Beaubien and Pranav Baskar contributed to this story.

Politics and Government News

Pien Huang

Author

In his letter threatening to withdraw the U.S. from the World Health Organization and halt all funding, Trump made a number of charges about WHO's handling of the coronavirus crisis.

Fact-checking and assessing Trump's letter of rebuke to WHO

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