ARI SHAPIRO, HOST:
This week, President Trump signed an executive order pulling the U.S. out of the World Health Organization. Much of the president's frustration with the WHO revolves around its relationship with China. His critics say China is exactly why the U.S. shouldn't pull out. To unpack all of this, NPR's Gabrielle Emanuel is here. Hi, Gabrielle.
GABRIELLE EMANUEL, BYLINE: Hi there.
SHAPIRO: What are Trump's accusations about China and the WHO?
SHAPIRO: So the president has been talking about pulling out since his first term. One main argument he often makes is that China doesn't pay its fair share to the WHO. Now, payments are based on a complex formula, including a country's wealth and their voluntary contributions, but all in all, China does not pay nearly as much as the U.S. typically pays.
Now, the second issue, he says, is China has too much influence over WHO. Here, experts say, especially early in COVID, WHO did praise China on its response to the outbreak and adopt China's assessment of how the pandemic began. But recently, WHO officials have publicly criticized China for not sharing data, including about the earliest COVID cases.
SHAPIRO: What do people say who want the U.S. to stay in the WHO?
EMANUEL: So they say that as the U.S. steps back, it's making room for China to expand its influence within the organization. Here is Lawrence Gostin of Georgetown University.
LAWRENCE GOSTIN: It would simply remove our influence and leadership in global health at a very dangerous time in our history. We won't be at the table. China will.
EMANUEL: Experts say China will not make up for all the money lost as the U.S. pulls out, but they could step in in other ways. Like, as Trump recalls U.S. officials from WHO, China may send more of their own personnel. Also, China could have more muscle and say in how the organization works - for example, keeping Taiwan out of the WHO or influencing which diseases to focus on. But all of this remains to be seen, since it will take a year to become formalized.
SHAPIRO: Big picture, is there a meaningful difference between how China and the U.S. approach public health?
EMANUEL: Well, this week, China came out and said that they are committed to supporting the WHO. But beyond that, China invests in global health very differently than the U.S., yes. So the U.S. often works through these big international organizations and NGOs and does a lot of, like, local skill building with a focus on human rights and transparency.
Yanzhong Huang is with the Council on Foreign Relations in New York. He says, for China, the bulk of their work is done directly with individual countries, and they typically build hospitals, provide medicines and vaccines. And they don't just gain goodwill.
YANZHONG HUANG: They use health-related development assistance as an important means to expand China's market share of their products - the pharmaceutical products, for example.
EMANUEL: Also, they get data. Nadege Rolland, of the National Bureau of Asian Research, says China goes into Latin America, Africa, Asia, and doesn't simply say, we can build a hospital for you.
NADEGE ROLLAND: But we can also offer the digital architecture that will help you collect those medical files that will then be hosted in a cloud that is located in China.
EMANUEL: She says all of that data is really useful, like when developing new medicines or understanding health trends. The thing you have to remember here is that, yes, superpowers are interested in global health, but it is often part of a broader political and economic agenda.
SHAPIRO: That's NPR global health correspondent Gabrielle Emanuel. Thanks a lot.
EMANUEL: Thank you. Transcript provided by NPR, Copyright NPR.
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