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Washington, Jul 7: President Donald Trump on Tuesday formally started the withdrawal of the United States from the World Health Organization, making good on threats to deprive the UN body of its top funding source over its response to the coronavirus.

Public health advocates and Trump's political opponents voiced outrage at the departure from the Geneva-based body, which leads the global fight on maladies from polio to measles to mental health -- as well as Covid-19, at a time when cases have again been rising around the world.

After threatening to suspend the $400 million (Dh1.47 billion) in annual US contributions and then announcing a withdrawal, the Trump administration has formally sent a notice to UN Secretary-General Antonio Guterres, a State Department spokesperson said.

The withdrawal is effective in one year -- July 6, 2021 -- and Joe Biden, Trump's presumptive Democratic opponent, is virtually certain to stop it and stay in the WHO if he wins the November election.

A spokesman for Guterres and the global health body itself confirmed that the United States, a key founding WHO member, gave its notice.

In a speech earlier in the day, WHO chief Tedros Adhanom Ghebreyesus said of Covid-19, "National unity and global solidarity are more important than ever to defeat a common enemy."

In line with conditions set when the WHO was set up in 1948, the United States can leave within one year but must meet its remaining assessed financial obligations, the UN spokesman said.

'Total control'

In late May, Trump said that China exerted "total control" over the WHO and accused the UN body led by Tedros, an Ethiopian doctor and diplomat, of failing to implement reforms.

Blaming China for the coronavirus, Trump, a frequent critic of the UN, said the United States would redirect funding "to other worldwide and deserving, urgent, global public health needs."

Democratic lawmakers have accused Trump of seeking to deflect criticism from his handling of the pandemic in the United States, which has suffered by far the highest death toll of any nation despite the president's stated hope that the virus will disappear.

"To call Trump's response to Covid chaotic and incoherent doesn't do it justice," said Senator Robert Menendez, the top Democrat on the Foreign Relations Committee.

"This won't protect American lives or interests -- it leaves Americans sick and America alone," he wrote on Twitter.

Representative Ami Bera, himself a physician, said that the United States and World Health Organization had worked "hand in hand" to eradicate smallpox and nearly defeat polio.

"Our cases are increasing," Bera said of Covid-19. "If the WHO is to blame: why has the US been left behind while many countries from South Korea to New Zealand to Vietnam to Germany return to normal?"

Even some of Trump's Republican allies had voiced hope that he was exerting pressure rather than making a final decision to abandon the World Health Organization.

The investigative news outlet ProPublica reported last month that most of Trump's aides were blindsided by the WHO withdrawal announcement, which he made during an appearance about China. 

The Trump administration has said that the WHO ignored early signs of human-to-human transmission in China, including warnings from Taiwan -- which, due to Beijing's pressure, is not part of the UN body.

While many public health advocates share some criticism of the WHO, they question what other options the world body had other than to work with China, where Covid-19 was first detected late last year in the city of Wuhan.

The anti-poverty campaign ONE said the United States should work to reform, not abandon, the WHO.

"Withdrawing from the World Health Organization amidst an unprecedented global pandemic is an astounding action that puts the safety of all Americans the world at risk," it said.

India continues to remain ranked 43rd on an annual World Competitiveness Index compiled by Institute for Management Development (IMD) with some traditional weaknesses like poor infrastructure and insufficient education investment keeping its ranking low, the international business school said on Tuesday.

Singapore has retained its top position on the 63-nation list.

Denmark has moved up to the second position (from 8th last year), Switzerland has gained one place to rank 3rd, the Netherlands has retained its 4th place and Hong Kong has slipped to the fifth place (from 2nd in 2019).

The US has moved down to 10th place (from 3rd last year), while China has also slipped from 14th to 20th place. Among the BRICS nations, India is ranked second after China, followed by Russia (50th), Brazil (56th) and South Africa (59th).

India was ranked 41st on the IMD World Competitiveness Ranking, being produced by the business school based in Switzerland and Singapore every year since 1989, but had slipped to 45th in 2017 before improving to 44th in 2018 and then to 43rd in 2019.

While its overall position has remained unchanged in the 2020 list, it has recorded improvements in areas like long-term employment growth, current account balance, high-tech exports, foreign currency reserves, public expenditure on education, political stability and overall productivity, the IMD said.

However, it has moved down in areas like exchange rate stability, real GDP growth, competition legislation and taxes.

Arturo Bris, Head of Competitiveness Center at IMD Business School, said India continues to struggle on the list and the recent country rating downgrade by Moody’s reflects the uncertainties regarding the economy’s future.

"In our ranking this year, we again emphasize the traditional weaknesses of India -- poor infrastructure, an important deficit in education investment, and a health system that does not reach everybody. For India to follow the path of China, it must stress its intangible infrastructure," Bris said.

"In a less global world, with China, USA, and Europe looking inwards, currencies like the rupee (and the Brazilian real for instance) are going to suffer and display high volatilities.

"Moody’s has threatened the country with a downgrade to junk and that would put India in a terrible position to attract foreign capital. So the urgency for the government should be to fix the short-term problems—and this requires to improve the credibility of the government itself," Bris added.

With the exception of Singapore, the Philippines, Taiwan and the Korean Republic, most Asian economies dropped in rankings this year, the IMD said.

The reason for the Asian economies’ less stellar performance as a region, this year is partly the result of the trade frictions between China and the US, particularly because these economies are highly dependent on trade with China.

About Singapore, which moved to the top rank last year, the IMD said its position is largely driven by the relative ease of setting up business, availability of skilled labour and its cutting-edge technological infrastructure.

The IMD said the impact of COVID-19 on the competitiveness ranking has partially been captured by executives’ opinions about the effectiveness of the different health systems.

In the ASEAN countries included in the survey, only Singapore and Thailand have a positive performance in the effectiveness of the health infrastructure.

Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.