Opinions about WHO heavily driven by ideology (party affiliation)
Summary
Registered voters in Montgomery County PA were asked to comment on a series of statements about the World Health Organization. The overriding conclusion is that Republicans are far more distrustful of WHO than Democrats, seeing WHO as part of the problem when it comes to health advice. Differing opinions were far from universal, with some Republicans having positive views of WHO and vice versa. But statements about COVID showed the greatest disparity, with Democrats were more supportive of WHO motives and advice. If one assumes Montgomery County is representative of the rest of the USA, then this political divide points to various policy changes and an up and down relationship between US and WHO.
Background and aims
Given recent national elections and numerous opinion polls, it is obvious that American society is highly polarized, often directly along party political lines. This study investigates whether that polarization applies to global health and specifically the World Health Organization.
To understand this polarization, registered voters were asked a series of questions online and in person to seek out their knowledge and opinions about the WHO.
A second survey was undertaken of physicians in the same location, who are in principle likely to know more about the WHO than your average voter.
Previous research undertaken in Montgomery County PA provided a list of voters and physicians. These lists were used for the survey below and the results are therefore confined to this part of the Philadelphia suburbs. There are more registered Democrats in this location (represented by two members of Congress) but there are Republican areas represented by one Republican Congressman, so it is easy to get a good mix. And with one predominantly Republican area it is also easy to get a mix of physicians within each area, although their political affiliation is unknown.
A third survey is being undertaken of UK registered voters to see if similar opinions exist in another English speaking nation with different media coverage, but that is for another time.
Methods
Surveys were designed to elicit knowledge and opinions about WHO. Several of the questions are antagonistic to each other with the aim of making respondents really consider their thoughts on WHO.
Surveys were given in several different ways during the months of March and April. In addition to the specific questions, respondents were able to comment on each question and also on the survey as a whole. The largest majority of responses (71%) came from online surveys, but telephone and in-person interviews were also undertaken. Telephone and in-person interviews allowed for greater back and forth with respondents, providing useful context for responses.
143 Democrats, 139 Republicans, as well as 79 physicians (unknown political affiliation) participated fully and it is those results that are presented in rounded percentages below. 256 people did online surveys and 105 either in person or telephone. There is no statistically significant disparity in results from the different survey methods so results can be safely combined.
Survey detail and results
Each respondent was presented with the following statement: “One of the acts President Trump made on his first few days in office was to sign an Executive Order to remove the US as a member nation of the World Health Organization. As part of my research on WHO, I would like to ask you about the WHO to get your responses.
What is your reaction to each of the following statements.
Do you….
1. Strongly Agree
2. Agree
3. Not sure
4. Disagree
5. Strongly Disagree
…with each of the following statements
1 WHO is predominantly an organization of doctors and other health professionals that try to help combat disease and improve health for everyone
2 WHO is an organization that promotes governmental control of healthcare delivery
3 WHO has an impressive track record of combatting diseases like tuberculosis and leprosy as well as assisting in the eradication of smallpox
4 WHO dismisses, admonishes, and attacks opinions it considers incorrect
5 WHO is overly influenced by a small number of powerful countries, such as China
6 WHO is unduly influenced by private and third-party interests, notably the pharmaceutical industry and billionaire donors
7 WHO did its best during COVID to provide advice based on the most reliable available information at the time
8 WHO lacks accountability and has a history of covering up or ignoring its mistakes, as it did during COVID
9 WHO should organize and run a pandemic treaty, to make another COVID less likely or less lethal
10 WHO is too corrupt and self-serving to have the power to run a pandemic treaty”
Explaining the statements and why interacting with WHO is important now and in the future
My expectation with the questions was that many people will have a polarized view of the WHO, either predominantly positive or negative, based on the media coverage they will have seen. Many people may also have no knowledge or little knowledge of the WHO and so any polarized views may be amplified. WHO to them may either be just good or bad.
Some of the statements, notably 9&10, are directly antagonistic to each other, so one cannot agree with both of them, but for the most part one could agree with all of the statements. Some statements may appear antagonistic but in fact may reflect the complex nature of the organization itself.
Indeed, I agree with the first six statements. WHO is predominantly an organization of well-intentioned health professionals who do their best to assist nations combat health problems, but it is also a highly politicized left-leaning group, whose leader comes from an authoritarian state and its leadership seems far more comfortable dealing with centralized powers as well as those that promote centralized solutions to health problems. WHO distrusts business and private health provision, but its leadership craves the funds that these businesses can provide. In that sense its leadership is hostile to business but transactional where funds and advice comport with its existing vision (hence aligning with, and funding from, drug companies to promote vaccine mandates).
As is well known, governments the world over made terrible mistakes during the COVID pandemic, giving bad advice that was known to be wrong at the time, and then lying about what they had done, in some instances to this day. WHO was responsible for a few of the errors and repeated many of the lies. It’s most egregious role was to kowtow to Beijing in almost every conceivable way – spreading Beijing propaganda, not pushing for the origin of COVID to be unearthed and criticizing those who did try to find out the truth. And like most of the world’s governments it shows little interest in revisiting its errors.
But having said all of the above, WHO is the only global health organization where antagonistic nations can talk to each other, which is important in a pandemic and frankly at all times. It has been a force for good, as well as ill, in the past and could be important in the future. If nations leave it, as US has announced it will, Italy and Argentina may well leave too, then the nations most critical of WHO, and those that are most likely to push for reform, will have no voice in a future WHO, making reform unlikely and a less useful WHO going forward.
Additionally, if, as I suspect, Democrats are supportive of WHO, then it is extremely likely that a future Democratic President will rejoin WHO.
Results
Interpreting the Results
As expected, Republicans had a far dimmer view of WHO than Democrats. Although this was far from a universal finding. At least 30% of Republicans (65% Democrats) agree that WHO health professionals aim to help nations improve health and at least a third of Democrats (70% of Republicans) agree that WHO is too close to nations like China, and nearly two thirds of Democrats (70% of Republicans) think WHO is too close to the pharma industry and billionaire supporters.
Republicans were more likely to agree that WHO criticizes opinions it considers incorrect (46% versus 30% Democrats), although this disparity is not as great as I expected.
Perhaps unsurprisingly, given the polarization around COVID, it is statements 7 and 8 about WHO response to COVID that show the greatest political divide. When asked if WHO did its best during COVID with the information available at the time 69% of Democrats either strongly agree or agree with that statement whereas only 24% of Republicans do. When asked if WHO has a history of lying or covering up mistakes only 15% of Democrats thought that likely, whereas 43% of Republicans did. There were a lot of both parties’ respondents who were unsure how to respond to that statement. I think this is a positive outcome demonstrating to me that most respondents are trying to answer honestly, because it’s an aggressive statement and one that requires more knowledge from the respondent.
While far more Republicans (68%) agreed that WHO is too corrupt to run a pandemic treaty, nearly a quarter of Democrats thought that too, and only a quarter of Democrats want it to run a treaty.
In the unsolicited comments made by respondents it is obvious that their opinions reflect the media sources they rely on. Democrats talking about “Conservative media lies” and Republicans decrying “coverups of the mainstream media”.
As one would expect, physicians generally answered “not sure” less often than those from the political parties, and they are more likely to side with Democrat opinion than Republican opinion. Nearly half of physicians thought WHO should run a pandemic treaty (markedly higher than either group of non-physicians).
Some physicians were quite strident in their comments to me about how the health profession, including from WHO, failed to give good advice and ignored evidence about COVID origin. Like other health authorities some physicians told me that WHO promoted poor policy advice like vaccine mandates. A few were also adamant that WHO and others had done their best and were angry at Republican “lies” about COVID and vaccines. Ironically, the physician comments to me were as polarized as the comments from non-physicians.
In short, while most physicians were broadly supportive of WHO, a significant number questioned the entire health profession response to COVID and after.
Conclusions and Moving Forward
As expected there is a notable difference in opinion about WHO based on party affiliation. With Republicans being far more, but not universally, hostile to WHO.
Over the next few months I intend to expand the survey both in terms of the number of questions and in terms of geographic locations.
My main concern moving forward is that the way voters, and presumably their parties, view the status quo. Based primarily on the comments, as well as the overall data, most Republicans appear to agree with President Trump that leaving WHO is the right thing to do because WHO and other health leaders are so dangerous that we can do without them and should go it alone, whereas Democrats don’t see the need for reform of WHO because it is Republicans who are to blame, and will simply rejoin WHO when their turn comes. There appears to be no appetite for reflection on WHO and whether it could be useful if reformed.