Russia has attacked hundreds of Ukrainian health care facilities since it invaded unprovoked in February, yet it remains a World Health Organization executive-board member with full voting rights. Indeed, even as WHO documents assault after assault on Ukrainian hospitals and clinics, its reports notably avoid naming the country responsible. As the world gathers next week for WHO’s annual assembly, the Biden administration must reverse the agency’s fecklessness to hold Moscow accountable.
In March, a Russian airstrike destroyed a maternity hospital in Ukraine’s heavily bombed Mariupol, wounding at least 17 people and killing a pregnant woman and her unborn child. Two or three survivors reportedly fled for safety to a nearby theater only to become victims of another Russian airstrike that killed as many as 600 a week later. By the end of the first month of fighting, Russia had reportedly hit 72 hospitals and clinics, resulting in 71 deaths and 37 injuries.
The United States and many other countries have declared such attacks crimes against humanity, noting the civilian nature of the targets was clear. WHO’s director-general said May 7 the agency had “verified 200 attacks on health care in Ukraine” since the invasion began. Ukraine’s President Volodymyr Zelensky put the number even higher, saying Russia had “destroyed or damaged nearly 400 health-care institutions” by May 5. And those numbers will continue to rise.
Moscow’s crimes have ample precedent. In Syria, for example, the Russian and Syrian air forces have bombed hundreds of medical facilities since Russian President Vladimir Putin intervened on behalf of dictator Bashar al-Assad in 2015, leaving scores of medical workers dead. Three years ago this month, Russian pilots bombed four Syrian hospitals in just 12 hours, all of which had shared their locations so pilots would know to avoid them.
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WHO member states did nothing in the face of these crimes against humanity. Rather, they elected Russia to serve a three-year term on WHO’s executive board in 2020. They elected Syria to the board a year later.
The agency’s head remains in the sand: A recent WHO report on the “Emergency in Ukraine” didn’t include one mention of Russia in its 13 pages.
As Russian attacks on Ukrainian health care facilities continue apace, the World Health Assembly will convene its 75th annual meeting May 22 to 28 in Geneva. Team Biden has vowed to isolate Russia within international organizations — and prove it can reform WHO by engaging more deeply rather than walking out.
To make good on those commitments, symbolic measures aren’t enough. Last week, WHO’s Regional Committee for Europe adopted a resolution condemning Russia and calling on WHO’s regional director to consider suspending meetings in Russia and relocating a Russian regional office.
But WHO members should go further next week: remove Russia from the executive board and suspend Moscow’s voting rights. Russia could still participate in health-related information-sharing mechanisms, but it should have no ability to influence WHO policy or budgets.
The Biden administration organized a similar campaign last month to suspend Russia’s United Nations Human Rights Council membership. The United States worked with Ukraine and other allies to whip votes in the UN General Assembly, which has the power to suspend council members. The WHO Constitution lays out the path for achieving a similar outcome at the World Health Assembly.
Article 7 says the assembly may suspend a country’s voting privileges in “exceptional circumstances.” Surely the devastation of hundreds of health-care facilities meets that definition. While the WHO Constitution is silent on the removal of an executive-board member, Ukraine has argued the assembly has the authority to press for such a vote. To pass, decisions on “important questions” such as these require a two-thirds majority of members present and voting (not including abstentions) — a threshold the General Assembly easily met in the vote to suspend Russia from the Human Rights Council. If the same countries cast their ballots against Moscow again, it cannot win.
Team Biden made a big bet on its ability to reform WHO via persuasion when it reversed its predecessor’s decision to withdraw US financial support and political participation. WHO aided China’s coverup of the COVID-19 pandemic and has since failed to independently investigate the virus’ origins. At Beijing’s behest, the World Health Assembly continues to exclude Taiwan, even as an observer. Meanwhile, it maintains a standing agenda item focused on castigating Israel — making the assembly seem more like the anti-Semitic Human Rights Council than a body devoted to global health.
The question facing the Biden administration is whether a strategy of engagement can deliver reform. Like Syria’s continued service on WHO’s executive board, it is nothing short of an abomination for Russia to wield influence in the agency while destroying health-care facilities in Ukraine.
If the United States cannot remove Russia from the executive board and suspend its voting rights at the World Health Assembly, there is little hope Washington can achieve the many other reforms necessary to make WHO credible again. If Russia emerges unscathed from this year’s assembly, Congress should step in and make further US contributions dependent on cleaning house at WHO.
Richard Goldberg, a former National Security Council official, is a senior adviser at the Foundation for Defense of Democracies, where John Hardie is research manager and a senior research analyst.