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Trump says the U.S. will pull out of the World Health Organization. China will happily fill the void.

Trump complains that China has “total control” over the WHO, but his action will probably increase China’s influence.

- April 14, 2020

On May 29, in a press conference where he didn’t take any questions, President Trump announced that he was terminating the US relationship with the World Health Organization (WHO), claiming that China has “total control” over the WHO “despite paying only $40 million a year.” Trump claimed that the U.S. had requested reforms from the WHO, but that it had failed to act. Now, Trump says that he will redirect U.S. funds for the WHO to other deserving organizations.

International organizations like the WHO are not a sideshow to power politics — they are a crucial arena of struggle. The United States has already experienced costs from backing away from the United Nations, where China and other powers have happily stepped into the void. Now it may be pulling out of the preeminent institution of global health governance, again creating an opening for China. Here are the implications.

The United States shaped world politics by shaping how countries cooperate

Global health coordination is one form of an international public good — something that benefits all countries, when it works well, and from which no country can be excluded.

Does the World Health Organization have the freedom to do what it needs to do about covid-19?

After the collapse of the Soviet Union in 1991, the United States, along with its allies, was the only truly global source of not just public goods, but also club and private ones such as credible security guarantees. As we argue in our new book, “Exit from Hegemony,” this “international patronage monopoly” was a crucial factor in U.S. leadership.

For example, the United States, along with its allies and the multilateral institutions they dominated, controlled most of the supply of development assistance and set the rules for world trade. With combined GDPs totaling more than 70 percent of the global economy, the United States and its allies could exercise enormous market and regulatory power to influence international and domestic policies in other countries.

The provision of these international goods isn’t just something that leading powers do, it’s one of the main ways that they make and enforce the norms, rules and arrangements that guide the international order.

Trump has pulled back from U.S. global leadership

The patronage monopoly the United States enjoyed was unlikely to last forever. But the Trump presidency — skeptical of multilateral alliances and hostile to international organizations like the United Nations — has accelerated its decline.

The coronavirus pandemic is no exception. Rather than coordinate and underwrite international responses to a global health emergency as the disease covid-19 spread, the United States has instead competed for goods, at times undercutting its own allies. Reports of the United States seizing medical shipments to other countries exemplify this move toward zero-sum power politics.

Will China fill the international void?

In contrast, China has attempted to demonstrate its own international leadership. As Kurt M. Campbell and Rush Doshi write, Chinese leader Xi Jinping “understands that providing global goods can burnish a rising power’s leadership credentials.” Beijing is overwriting early covid-19 failures — marked by heavy-handed attempts to conceal the scope of the crisis from both its people and the international community — with a narrative that emphasizes China’s apparent success in containing the virus and the new role as provider of medical supplies to countries such as Italy, Serbia and Spain.

Is China ready for this major global health challenge?

The U.S. attacks on the WHO also further open the door to increased Chinese influence in the global health arena. In recent years, China has increasingly viewed international institutions as a key space to shape the international order. In 2017, Beijing successfully supported the election of current WHO Director General Tedros Adhanom Ghebreyesus over a U.S.-backed rival.

In institutions like the U.N. Human Rights Council, Beijing has taken on a new role in fashioning human rights norms. By promoting preferential bilateral partnerships through its Belt and Road Initiative and building its own institutions, such as the Shanghai Cooperation Organization and the Asian Infrastructure Investment Bank, Beijing has also made it more difficult for regional institutions like the European Union to act collectively.

While Western commentators often portray these moves as sinister, China is just using available tools to advance its own interests. And these techniques are not new. What we’re seeing now is only shocking to many U.S. observers, who have grown accustomed to a world where the United States makes the rules.

China already leads 4 of the 15 U.N. specialized agencies — and is aiming for a 5th

The U.S. can still lead — but only if it wants to

Just because there is more room for China to influence world politics doesn’t mean the sky is falling for the United States.

When Washington and Beijing compete, China isn’t guaranteed to prevail in even a majority of influence contests. Indeed, for Beijing, covid-19 presents both opportunities and risks. Beijing’s early failures remain a serious challenge to its global standing and the appeal of Chinese-style authoritarianism, while reports that masks and test kits were of poor quality undermined the public relations benefit of China’s overseas medical assistance.

In principle, the United States still has cards to play. It still enjoys a dominant position in the established infrastructure of international order and global governance. When its continued presence makes the institution indispensable for global cooperation, as with the Universal Postal Union, the U.S. can use leverage to demand more favorable terms from Beijing.

But making use of those advantages — and protecting the U.S. power base — means remaining in the game, not outside. Trump has consistently criticized multilateral institutions and has emphasized government-to-government deals that are short-term, zero-sum and transactional.

Trump’s announcement that he is cutting U.S. ties with the WHO is therefore just the latest in a series of moves that may leave Washington even more isolated from key instruments of power as other countries, including China, continue to take over existing institutions or construct alternatives in their place.

Editor’s note: This post was updated on May 29 to reflect Trump’s announcement that the U.S. was cutting ties with the World Health Organization.

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Alexander Cooley (@CooleyOnEurasia) is the Tow Professor of Political Science at Barnard College and the director of Columbia University’s Harriman Institute.

Daniel Nexon (@dhnexon) is an associate professor in the Department of Government and School of Foreign Service at Georgetown University. They are the authors of “Exit from Hegemony: The Unraveling of the American Global Order” (Oxford University Press, 2020) and co-editors, along with Morten Andersen, of “Undermining American Hegemony: The Logic of Goods Substitution” (Cambridge University Press, forthcoming).

Funding for their research was provided by the Norwegian Research Council under the project “Undermining Hegemony” (project no. 240647).