1. Cipriano, Pamela F. PhD, RN, NEA-BC, FAAN


Hope for the future of global health.


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For many months, COVID-19 has ravaged the world and invaded our thoughts. We've been obsessed with following the hot spots at home and abroad. Imagine, though, that you live in Pakistan, and are still striving to eliminate polio, or in Egypt, which has the highest prevalence of hepatitis C worldwide. These are but a few of the other hot spots that go unnoticed in the United States but are the targets of daily interventions by the World Health Organization (WHO) and its many partners addressing public health crises around the world.

Figure. Pamela F. Ci... - Click to enlarge in new windowFigure. Pamela F. Cipriano

Members of the United Nations formed the WHO on April 7, 1948, a date we honor and celebrate each year as World Health Day. The 2020 theme for this day recognized the critical roles of nurses and midwives in creating a healthier world. Today, 194 member states across six regions share the commitment to "achieve better health for everyone, everywhere," which describes the vast efforts of the WHO in establishing global standards and advancing prevention and treatment measures for a wide range of conditions. Top global health experts, many from the United States, participate in the WHO's work to engage governments and health professionals to fight infectious diseases, halt antimicrobial resistance, reduce preventable deaths from noncommunicable diseases, reduce violence and prevent traumatic injuries, promote safe environments with clean water and sanitation, and remain ever vigilant to prevent disease outbreaks and epidemics.


Claiming dissatisfaction with the WHO's handling of the pandemic, on July 6, the United States notified the United Nations that it will withdraw from the WHO effective July 6, 2021, providing the one-year required notice. The announcement drew swift and grave rebuke from the public health, scientific, and diplomatic communities in the United States and around the world. There was bipartisan condemnation citing the serious danger of withdrawing in the midst of a pandemic, eroding U.S. influence in global health, and the risk of diminishing our role in research-including in the development and distribution of any potential COVID-19 vaccines.


Many health care organizations, including the American Nurses Association and American Academy of Nursing, called for the United States to reverse its decision. The International Council of Nurses expressed its dismay and emphasized that no single country can fight a pandemic on its own, highlighting the devastating effects on those who would suffer disproportionately without WHO support. The United States is the largest contributor to the WHO, and commitment to global health is an important humanitarian symbol of solidarity, especially in preventing the spread of infectious diseases that are not bound by geography or politics.


It is abundantly clear from this pandemic that we are all connected and need the strength of nations working together to thwart any threat to global health and well-being. We ignore our connectedness at our own peril. The H1N1 virus that caused the Spanish flu pandemic of 1918 took 18 months to spread around the world; today, given our mobile society, that spread can occur in days or weeks. It is naive to think we can fight public health emergencies alone. The foundation for fighting diseases has been scientific partnerships.


The United States claims it will pursue its own efforts to fight health emergencies, yet experts quickly point out they will still need to be pursued in collaboration with the WHO. No other group has established the relationships needed to negotiate political minefields and achieve compromises to mount global campaigns to improve health. Is the WHO perfect? No. Should the United States withdraw? No. We can enact reforms and help strengthen the WHO through constructive engagement rather than by abandoning an organization that uplifts the health of the world.


Should nurses be concerned? Yes. Our voices count when we contact our representatives to ensure that our country values health over politics. And our votes count when we elect officials who will keep the United States leading international efforts to preserve health, reduce disease burden, address emerging infectious diseases, and support poorer nations to make a difference in the lives of millions.