Fauci makes the Biden administration’s debut at the WHO

President Joe Biden recommitted the US to the World Health Organization within his first hours in office. On Thursday, the new administration tasked its top infectious disease expert with representing the United States at the WHO.

That person, of course, is Dr. Anthony Fauci, who became something of a celebrity during the Trump administration for his fact-based communication to the public about the Covid-19 pandemic in an administration that was anything but.

Now a leading member of Biden’s Covid-19 response team, Fauci appeared via video at the WHO’s executive meeting. Fauci reiterated that the US would remain a member of the global health agency, reversing former President Donald Trump’s attempt to withdraw from the body.

“As a WHO member state, the United States will work constructively with partners to strengthen and, importantly, reform the WHO, to help lead the collective effort to strengthen the international COVID-19 response and address its secondary impacts on people, communities, and health systems around the world,” Fauci said Thursday.

Fauci’s appearance before the WHO comes on the anniversary of the first coronavirus case detected in the United States. A full year later, more than 400,000 Americans have died from the virus, and 2 million people have succumbed worldwide.

Fauci said on Thursday that the Biden administration would cooperate with the World Health Organization, and the rest of the world, to respond to and recover from the Covid-19 pandemic.

To that end, Fauci said the Biden administration would issue a directive later Thursday that would bring the United States into Covax, the global initiative to develop and equitably distribute vaccine doses worldwide. More than 170 countries are members of the initiative, though the Trump administration had declined to join — an outlier, along with Russia.

The US Congress set aside about $4 billion for Gavi, the Vaccine Alliance, an organization that focuses on immunization campaigns worldwide. Gavi is one of the main partners in Covax (along with the WHO and the Coalition for Epidemic Preparedness Innovations) in the Covid-19 relief package passed late last year, to help in global Covid-19 vaccine distribution. Experts I spoke to say that’s seen as likely to go toward Covax funding, but it’s not yet clear exactly how much the Biden administration will commit.

A White House spokesperson said in a statement to Vox that the Biden administration looks forward “to working with partner countries, Gavi, the WHO, and other organizations to chart our next steps to join and best maximize ongoing efforts.”

Biden’s plan to retract Trump’s withdrawal from the WHO was expected, and the incoming administration had said it would take part in Covax earlier this week. But dispatching Fauci to the WHO was a subtle yet clear way for the administration to show how seriously they’re taking their international commitments and efforts to contain the Covid-19 pandemic.

The World Health Organization also seemed pretty relieved to welcome the US back into the fold, considering that it’s the single biggest contributor to the United Nations health agency. “The role of the United States, its global rule, is very, very crucial,” Tedros Adhanom Ghebreyesus, the WHO’s secretary general, said. “We have a lot of work to do, and lessons to learn to end the pandemic and meet the long list of global health challenges we face — the world will be better able to meet them with you.”

Fauci in his Thursday remarks said the Biden administration “intends to be fully engaged in advancing global health.”

That agenda is bigger than just Covid-19. It includes broader global health and health security efforts, including fighting other diseases like HIV/AIDS, and supporting women’s and girls’ sexual and reproductive health and rights. The Biden administration, Fauci said, would rescind Trump’s “Mexico City rule,” which blocked US federal government funding for any global health organizations that provided abortion or family planning services.

Again, a lot of these moves are expected, and welcome, especially by global health advocates.

But Fauci also hinted at some of the battles ahead, including over the investigation into the origins of the coronavirus pandemic, and on issues of reform at the agency.

“We realize that responding to COVID-19 and rebuilding global health and advancing health security around the world will not be easy,” he said Thursday. “And in this regard, we are committed to transparency, including those events surrounding the early days of the pandemic. It is imperative that we learn and build upon important lessons about how future pandemic events can be averted. The international investigation should be robust and clear, and we look forward to evaluating it.”

The Trump administration strongly criticized the WHO throughout the pandemic, including accusing the agency of being beholden to China.

But Trump wasn’t alone in his criticisms. China did delay warning the world about the threat, and has tightly controlled information about the origins of the virus.

As Vox’s Julia Belluz reported, “instead of calling attention to these problems, the WHO has frequently praised China, and, as the Times reported, traded moral authority for access to and leverage with a powerful country.”

WHO investigators landed in China last week to really start their probe, though China is still very much trying to control the narrative. The investigators will have to rely on China for information and access, which will likely hinder any investigation.

But the Trump administration’s response — pulling away from the WHO — did little to effectively pressure the organization, or China. The reality is that the WHO is made up of a bunch of individual member states, all of which are sovereign countries that have their own agendas. The agency’s ability to do anything relies on what the most powerful countries in the body want. If the US steps away, then of course China is going to fill that vacuum. As one expert told me, the US was losing “influence in that conversation because [it had] stepped off the field.”

The Biden administration is essentially trying to step back on the field, with the goal of pushing for accountability and transparency from within. As Fauci said, the Biden administration wants to work with the WHO on reform, and on “improving the mechanisms for responding to health emergencies.”

It’s going to take time, as a single day under a new administration probably won’t be enough to rebuild trust and repair relationships — or roll back the influence of other countries that stepped in to fill the vacuum left behind by the US.

Update, January 21, 5:50 pm ET: This post has been updated with a comment from the White House.