Practically no country in the world has been free from having a population affected by the coronavirus. In the face of this global pandemic situation, the WHO (until now a world reference in health matters) has been considered the central body to which all countries turn their attention. Or at least they did, since, for a few days now, the questions about whether the action of this agency of the United Nations on health issues has been the most correct in this unusual scenario have become more and more noticeable.

One of the most critical questions is that of President Donald Trump, who on April 14 announced that his country will withdraw the funds it provides to this organisation. Trump blames the WHO for considering the information provided by China (the origin of the current coronavirus) to be valid at the beginning of the outbreak, and therefore recriminates that it did not act decisively and effectively. U.S. Secretary of State Mike Pompeo affirmed that China did not inform "properly" the organisation about the outbreak. Thus, the WHO has been punished by the United States (when the national management of the outbreak has been highly questioned) under the pretext of its mismanagement and concealment of the spread of the coronavirus.

But in the opinion of the full university professor of the Universitat, José María Martín Moreno, these recriminations and accusations go beyond words to the level of accusations and withdrawals of funds that only aggravate the crisis. The incriminated person or entity, in order to be excused, quickly finds someone else to blame or to share the responsibility for the failure. It often turns into a pointless exchange of mutual accusations. And in the meantime ... the problem, the crisis, keeps growing even more, because our already limited creative energy has been concentrated on attacking the other party and not on taking action to solve the problem,' recalls Martín Moreno, who also warns that the least developed and most vulnerable countries (which receive the most direct aid from the WHO) will suffer the most as a result of this measure.

The WHO has an intergovernmental nature and funding that prevents it from being truly independent of its member states. In addition, it is highly conditioned by foundations and donors who make voluntary contributions. Born in 1948 with the purpose "that all people achieve the highest level of health possible", throughout its history, the organisation has developed and maintained very important programmes of public health, maternity care, child nutrition, among others, but it is better known for its campaigns of eradication, prevention and control of epidemics, including the current coronavirus pandemic.

For the 2018-2019 period, the WHO had a budget of about US$ 5.6 billion, which was mainly funded by two different sources. On the one hand, the fixed contributions of its 194 member States established by the United Nations which represent 20% of its total budget, approximately $930 million. And on the other hand, the donations from entities and benefactors, which supposed 4.3 billion dollars.

The United States contributed $553 million to the last budget, almost 15% of the total. With the United States' suspension of these funds, the WHO loses its principal and most important donor.

Furthermore, the WHO does not really have total independence as it is the donors, both states and benefactors, who set the agenda for the WHO and not always on the basis of health criteria. It is the Member States who decide where the funds are spent, which generally coincides with the priorities or agenda of the donor. In the end, this reduces the autonomy of the organisation.

But although it is true, as José María Martín Moreno points out, the United Nations' agency 'has an intergovernmental nature that prevents it from being truly independent of its member states. Even in this context, it has played a key role on which the fight against the coronavirus is pivoting. We must remember that it has been at the front line of the global response to COVID-19: From monitoring events and providing regular situation reports to advising governments and the general population, including from hand hygiene to a physical distance to prevent infection', says the professor at the Faculty of Medicine.

The WHO was criticised for its actions in response to the latest epidemics of the Swine Flu (2009) and Ebola (2014 and 2016), when it was accused of exaggerating the situation and acting late, respectively. But as Martin Moreno recalls, there are many initiatives that go unnoticed by the large population. 'There is also technical work catalysing experts' knowledge and synergy, which goes largely unnoticed. This includes, for example, the clinical tests that under the name of "Solidarity" originate in the most agile way possible potential vaccines and treatments for the COVID-19, tests in which many countries collaborate, including ours.

Furthermore, in relation to global acquisition of requirements, the WHO leads the Pandemic Supply Chain Network (PSCN), a public-private network of collaboration to facilitate the procurement of essential products for COVID-19 for more than 120 countries. In the field of medical devices for clinical management (including invasive and non-invasive equipment), the WHO is continuously reviewing the technical specifications of medical instruments used in intensive care units (ICUs). And along with all of the above, it systematises the list of emergency use for in vitro diagnosis (IVD) and urges IVD manufacturers to perform the necessary testing to determine sensitivity and specificity. Finally, the organisation encourages manufacturers to contact the WHO if they have innovative products that could help in the fight against the coronavirus, in order to give them support and to try to share them with all the population that needs them.

However, 'the WHO is not free from this fallible nature,' explains José María Martín Moreno, 'and its mistakes cannot and must not be hidden. Probably in the near future all the people involved in the management of this terrible pandemic (including the WHO managers) will have to be self-critical and admit mistakes that have been made at several times, and there will be time to review all their performance in order to know how to do it better'.

In any case, the full university professor Martín Moreno states that 'at the moment, all leaders and responsible people should repeat a motto: "Let's focus on solutions." We must prevent the situation from deteriorating, with the result that additional difficulties arise. And let us remember that, if we were to eliminate the WHO, we would have to invent another equivalent body that would exercise the same functions, since we are living in a globalised world in which there is no doubt that there are threats to the whole world that must be tackled in a coordinated manner.

Fortunately, in order to counteract the current freezing of funds by the United States, initiatives have emerged that attempt to compensate for what has happened. Thus, in view of this new situation, China has announced an extraordinary donation of 30 million dollars to the WHO, in addition to the 20 million dollars that it has already given last March. Norway has also expressed its willingness to make a greater contribution to compensate for the deficit caused by the United States and the Bill & Melinda Gates Foundation has announced that it will increase its funding to the organisation. In addition, citizens' initiatives have emerged such as 'One World: Together at home', which, promoted by the WHO and the NGO Global Citizen, has brought together singers and actors such as Lady Gaga, the Rolling Stones and Elton John to raise money for medical staff.

In conclusion, after the moments of uncertainty about the prioritisation of accusations instead of actions, the initiatives mentioned are a source of inspiration, Martín Moreno says. 'We avoid to become individuals who enjoy finding a culprit more than finding a solution. It is in a great crisis or tragedy that people (leaders, professionals, family, friends, or fellow citizens) must help each other, when synergy and the deepest feelings can and should prevail,' says the Full University Professor of Public Health, who finishes with a defining phrase: 'getting the U.S. contribution out is like getting the water out to the firemen when you're putting out a fire.'

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This content has been prepared by the institutional communication area of the Office of the Principal of the Universitat de València with the collaboration of the Full University Professor of Preventive Medicine and Public Health of the Faculty of Medicine, José María Martín Moreno.