The MeidasTouch Podcast
Meidas Health, Episode 4: Why Trump’s WHO Exit Puts Us All at Risk (Dr. Van Kerkhove)
Thu, 17 Apr 2025
America First or America Alone? The Trump Administration's decision to pull out of the World Health Organization might seem on brand—but is it? Dr. Maria Van Kerkhove, senior leader at WHO, joins Meidas Health host Dr. Vin Gupta to discuss the very real ways a full-scale withdrawal impacts every American, both visibly and behind the scenes. It’s a can’t-miss, honest discussion on why the WHO matters to all of us—and how it is reforming in response to the scrutiny it has received in the wake of COVID-19. Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: Who are the speakers and what is the podcast about?
Hello, everybody. Great to be with you. On episode four, we are lucky to be joined by a senior leader at the World Health Organization, Dr. Maria Van Kerkhove. And I'm glad she's here because there's a lot that we need to talk about. We actually did some media last week for broadcast TV. And the fact is, you can't talk about much in five minutes. And so Maria is going to join us.
And we're going to dive deeper into why the WHO matters to every single American across the country. It's an organization that does a lot for us, often behind the scenes, and often we don't really have enough time to talk about that. So that's why she's going to join us. Before she joins us, I just want to give you a sense of what we're trying to do here. This is episode four of a new podcast.
health-focused podcast on all things healthcare and public health. We know we have a wide audience, all of you. We know that we want to be respectful and time-efficient since all your lives are very, very busy. And we want to make sure that we're doing something new here, not just redundant.
which is why the caliber of guests and the entities that they represent is a signal for what this represents. We just had for episode two, Dr. Bob Califf, the recent former FDA commissioner. He's a good friend and mentor. And we talked about the role of misinformation in our current just healthcare landscape and the work that he did at FDA to try to combat that.
And really to keep up this momentum and to show you that your time is worth listening to this podcast. We're going to keep up the high caliber of guests and the entities that they represent here with Dr. Maria Van Kerkhove. Dr. Van Kerkhove, great to see you. Maria, I'm going to refer to you as Maria, if that's okay.
Please, no problem.
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Chapter 2: What is Dr. Maria Van Kerkhove's role at WHO and what does the organization do?
Well, Maria, thank you for joining us. And as a tee-up, I'd love to, if you could just give us the audience a little bit about your background at WHO and what your works looked like over the last, especially during the pandemic.
Well, thanks for having me, and I appreciate the time to have a chance to chat. I love podcasts, I have to say. I feel like it's the greatest opportunity to have a discussion and really not be forced to get them in these tiny little segments. But I'm Maria Van Kerkhove. I'm an infectious disease epidemiologist here at WHO. I sit in headquarters in Geneva, Switzerland.
We are an organization of thousands of individuals, 6,000, 7,000 individuals worldwide. We work in regions and in countries in more than 150 countries. And the job that we do here and the job that I'm responsible for is to promote, provide, protect health.
I sit in our health emergencies program and I lead our Department of Epidemic and Pandemic Threat Management, which is essentially where we develop prevention control programs, evidence-based guidance, tools, materials to support countries to detect, prevent, respond to pathogens with epidemic and pandemic potential. And we deal with some of the nasty ones.
So COVID, flu, RSV, which is particularly challenging for young kids and for older adults, but also orthopoxviruses and the MPOX public health emergency that we're dealing with. We deal with high threat pathogens like Marburg and Ebola. We deal with arboviruses like dengue and chikungunya and Zika and urapucha and, you know, many of these types of threats.
But not only the biological risks, we also look at laboratory biosafety, biosecurity. So looking at the unintentional potential. potential release of these types of pathogens into the human population. And we also deal with the deliberate release. So working with many other UN agencies on a security side of things in case there were to be a deliberate release.
And lastly, in my department, we deal with the landscape of medical countermeasures in terms of looking at access and benefits for diagnostics, therapeutics, and vaccines. Now, obviously, I work with tons and tons of people, you know, and across the health emergencies program in WHO.
But one of the things that I love the most and I hope we could potentially get into is that we are the secretariat of 194 member states and we work with incredible experts in every single country. So the best minds coming together to combat the world's biggest health challenges.
Maria, that was a lot there. And it reminds me of some of the conversations you and I have had in the lead up to last week and just our ongoing dialogues behind the scenes. It strikes me, I served 12 years in the US Air Force, now in the reserves. And what I've realized is very few people, I mean, you can't get 100% of, say, all Americans to agree on anything.
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Chapter 3: Why is the World Health Organization important to every American?
For the U.S., we try to do with every single country across the globe, whether it's improving surveillance, whether it's improving capacities for clinical care, whether it's developing evidence-based guidance to turn data and knowledge into practical advice for leaders, for doctors, for parents. And that matters at the kitchen table because just think of COVID. Take COVID as the example.
How many people no longer sit at that kitchen table? That didn't have to happen. Certainly we were going to have a pandemic because of this pathogen and how it spread and the immunity profile of the globe, but it didn't have to have the impact that it did. It didn't have to kill 20 million plus people.
And the fact that we no longer have people at that kitchen table, maybe not at your immediate kitchen table, but certainly at that Thanksgiving table or that Christmas table, whatever holiday table that you have where you bring people together. Sunday dinners were big in my Italian upbringing family. They're not there anymore.
And what we do at WHO is we share information across every country as soon as we have it to have governments take decisions to keep their citizens safe. We advance research and development so that not only the vaccines for pathogens that we know about, we're preparing for coronaviruses. We're preparing for threats that may be somewhere far over there.
that could end up in your community in the near future, to be prepared, to anticipate. And we turn that science into action and into things that can protect you and your family. And you don't have to talk about it every day. You don't have to think about it every day. But people like me, people like you, people who work across institutions in every country do. And I think that's a privilege.
I think that's actually a blessing because we love what we do. I love what I do. I don't know about you, Vin, but... I feel so lucky to work in this field of work. I don't want a pandemic. I don't want the devastation that we dealt with before. But there's passion, there's dedication, and there's a willingness to be challenged constantly to do better. But WHO's work protects Americans.
Our work protects you home and abroad.
No, no true words have been spoken. And I will say, when we think about everything that you just said, and the opportunity to be able to tell that story, I think the analogy to how we talk about defense is correct. it's clear why that industry exists, why the military exists. And we recognize and acknowledge reform needs to happen, but nobody fundamentally questions the very existence of the U.S.
military. And I think we do need to tell a better story. To that end, It feels like because that story isn't getting through or why WHO exists or what it does for us isn't getting through to everyone. I mean, I think it's getting through to a good number of people.
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Chapter 4: How does WHO operate globally to prevent pandemics and epidemics?
preventing that spillover event or that breach in, you know, turning into infecting humans to turn into an outbreak, to turn into an epidemic, to turn into a pandemic. The earlier you can do that and collectively working together. You know, my experience with WHO has been in outbreak investigations, mainly in the Middle East for MERS, but in Asia as well, in Africa as well.
And we show up, we're invited by countries. We show up at the worst possible moment a country is dealing with an outbreak. to help them bring it under control. And that is just support. It's not placing blame. It's not saying something is wrong. It's just bringing people, you know, to use your best minds to say, okay, where are we in the outbreak? How do we bring it under control?
And how do we alert the world to get them ready to have their system agile to scale up and scale down if needed?
You know, just hearing you speak, Maria, it's so easy to understand now how, especially in our information environment, the way our politics are, not just in the United States, but globally,
How WHO operating in a very high stakes environment where to your exact point, I love your framing there, which is you are entering a country at a point in time in which it's the most complicated, it's the most difficult and most challenging.
Very few people want to be identified or any country wants to be identified with potentially the next pathogen of pandemic potential because so many things, economic consequences, reputational consequences. And then that's the environment that you guys are being dropped into and operating.
And it's obviously, obviously all you're going to get in many cases is arrows and criticisms and scrutiny and very little praise because, you know, no one wants to be receiving bad news or having to deal with that type of news. And there you are having to navigate all those complexities.
So one, I just want to say, we recognize that many, many people do recognize that the indelible role that the World Health Organization plays on things, conversations like this longer form, that I hope helped to really reframe this narrative is, you know, when you think about, so we know the purpose, the purposes as a convener.
I mean, this is one of many purposes, data information sharing on really sensitive topics, like a concerning new infection, recognizing that countries will not just post to social media. If they see something wrong, no one's going to just do that. And I think it's important to emphasize that to,
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Chapter 5: What risks do we face if the US exits or reduces support to WHO?
There's international law. The international health regulations is law that countries have signed up to to agree to share this information, yes.
And without it, we wouldn't have, however imperfect, we wouldn't have the mechanisms in place that you've worked to establish. Can you talk about, I know you're working on some new efforts here in light of COVID, lessons learned.
Wondering if you can talk to us about how you're thinking about optimizing that, recognizing some of the criticisms, some of the scrutiny that WHO has received in the last few years.
Yeah, I mean, criticism is not a bad thing. I mean, criticism for me, unfair criticism, I have a problem with, but criticism that pushes us and drives us to do more. I mean, that's why we're here. We think every day, what can we be doing better? What can we be doing more? And I have to say, you know, at WHO... For me in particular, I don't have to work here. I want to work here.
Like, I want to be part of it. I've drunk the Kool-Aid. I believe wholeheartedly in what we're trying to do and wanting to make it better. And so many of my colleagues want to do the same, including our director general, including Mike Ryan. But there is criticisms of us. I mean, one of the things learning, and we're criticized of this, of, like, not acting fast enough.
I mean, one of the lessons you learn every single time is to act fast. And I have to say, you know, this is one of the criticisms I find the most strange. Could we have done more? Absolutely. Could we have done better? Absolutely. There's no other answer to that question. But in terms of acting fast, what we were able to do is from that first
instance of this cluster of pneumonia of unknown etiology, we activated what we call our emergency response framework. We do this for every outbreak, whether it's a big signal or it's a small signal. We knew right away something was wrong. A cluster of 27, no health workers involved.
We didn't know the cause in a country that has very strong lab surveillance, meaning it's not flu, it's not MERS, it's not SARS, it's not adenovirus, it's not Legionella, it's not, not, not, right? What is it? I immediately thought coronavirus because that's my background, but that's just, you know, what we, but immediately red flags. We set up an incident management team.
We informed our member states through our closed system. And then we informed publicly. We issued a package of guidance, technical guidance within two weeks. The 9th of January to the 12th of January issued guidance. The sequence was shared around the 9th, 10th, 11th, depending on the day, depending on the, you know, the source of that. But the first PCR test,
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Chapter 6: Why is international cooperation essential for global health security?
And the next one doesn't have to be as bad as COVID.
Well, thank you for saying all that. And it just reminds me that I spend a lot of my time as I'm a pulmonologist and often think about the intersection of climate and health, as I know the WHO does. And it's something that you have to be very careful.
This is no surprise to you, how you talk about, because certain words will trigger and you'll immediately turn off four or five and 10 of people that might be wanting to listen to you. And And there's a short-termism that afflicts how we think about policymaking right now where it's easy. The easy button is to say let's – we didn't like something about some entity or some response.
We're just going to say let's shut it down or let's tear it down. The hard thing and what a WHO or climate health advocates for that group of entities and individuals, that is a body of work that by definition is medium to long term for a reason, for prevention, to prevent the scenes in Rio and New Delhi and others from playing out again. And it is...
We operate, unfortunately, in a political and policymaking timeline that rewards short-termism often. And so it's with that, Tia, I'm curious... So we've seen some of the criticism, direct criticism of the WHO when it comes to handling of the root causes of the COVID-19 pandemic.
And I think it's important that we talk about that because you've done an amazing job, I think, of level setting why the WHO exists. and how it improves all of our lives because it is the shield for every single family in the United States from something bad from happening. Without it, again, there is no other off-ramp or alternative.
I'm curious though, when people want to say, if they hear the words WHO, I would imagine some people are triggered to think something negative. Not everybody, obviously. And maybe that is vis-a-vis the etiology of COVID-19. So if you were talking to somebody that firmly believe that you didn't do enough to be transparent about the origins of COVID-19. What's the response?
And how was WHO responding to that specific question?
Yeah. We still don't know the origins of COVID-19 five plus years on. For us, it's not just a scientific endeavor. It's a moral and an ethical imperative that we find out because it's not just enough to know if it was zoonotic or lab. We need to know the details surrounding all of that because without knowing that detail, we're not going to be able to prevent it the next time.
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Chapter 7: How does WHO handle outbreak investigations and support countries?
And I think I hear some people use that when they want to and others just say, we just believed everything that they said. But as an organization, as scientists, you know, you already think there's human to human transmission. You already know that it's probably bigger than what's actually being reported. And so we act. We acted already as if that were happening.
I think on the origin side of things, this is extremely frustrating for me. I fully, fully believe that much more information is actually out there that has not been shared with us about how this pandemic began. And we had several missions. I was part of a mission that went to China in February 2020.
One of the earliest groups that were in there of actually looking at and in fact, in many parts of the country in China, the cases were coming down. It was it was pretty incredible. Learning was the first time we got information out of the country to say what was happening. It was the first time we knew people could be infectious before they tested positive. I mean, it's it's developed symptoms.
Excuse me. It's incredible. Right. And the origins is unknown. And right now, we don't know when, where, and how this pandemic began. The totality of available evidence, and the key word here is available, is zoonotic in origin, right? We're looking at the market, the amplification at the market, but we don't have the upstream study. So where did the first cases occur?
I don't fully believe they occurred at that market. I believe that these animals were important in terms of potential spillover, but we don't have evidence that it actually happened at the market. It could have happened as part of the trade route. It could have happened at some of the source farms. We have no information on the labs.
Maria, zoonotic, just for the audience. Zoonotic.
Yeah, so that's transmission between animals and humans. And when I say zoonotic, the hypothesis is that an animal was infected, some kind of an intermediate host, maybe a raccoon dog or a civet cat or something like that. And people came in contact with those animals. And usually what happens when you have a spillover event, you have what we call almost like a stuttering.
Some people might get infected. They may not develop severe disease and therefore they don't seek health care. So they might get missed. And the pathogen may not be, it may not have developed enough characteristics to transmit between people easily. And so you have a petering out. But other times when the virus is able to transmit efficiently, that's when you start to have an outbreak.
And usually you'll pick up people in a health care system because they develop severe disease. But at that point, there's normally more cases. Now, the other hypothesis is that there was a breach in biosafety, biosecurity leaked from a lab. This is the lab leak hypothesis, not an intentional release, but that either the Wuhan Institute of Virology or the
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Chapter 8: What challenges does WHO face in today's political and information environment?
If they're not being transparent, it is then going to potentially birth what's happening right now, which is politics over health. Do you feel like, I mean, to state the obvious, but let's have this conversation, it feels like the WHO is being unfairly blamed for realities beyond its control, but wondering how you would respond to that.
Listen, I mean, I am glad people know what WHO does. I'm glad we have an opportunity to answer these questions. We are in lacrosse hairs, but we are in the long game. You know, you mentioned in one of your earlier questions here, you know, these outbreaks, these epidemics, the work that we do, whether it's climate change or pandemic preparedness, outlives any election cycle.
These transcend election cycles. And politicians need to show their people that they are responsible for, that they've got them through this.
And so there's this collective amnesia right now about what's happening with COVID, which is very detrimental, again, to what we need to do for it, especially in a constricting fiscal space of most of the money from health, certainly from COVID crisis shrinking. going to Gaza, going to Ukraine, and now many of the government budgets going from health to defense.
That area of work is constricting even further. I think we don't mind criticism. Like, we are not sitting here saying, oh, you know, please don't talk bad about us. We want to do better, but we do need, as a member state organization, our member states give us the power they want us to have.
So they sit every year at the executive board in January or January and the World Health Assembly every May here in Geneva. And they come together to outline what they want us to do in support of all member states. We have a global program of work. All of that is online. You can see what it is that our member states are asking us to do. But we have the power that they want us to have.
And I think that's the crux of like how, and you can hear, I mean, there's been recordings of us leaked, you know, which is a terrible thing to happen. But, you know, it's happened to me several times. And the threats on myself and my colleagues and my children, you know, we're here to do a job. We want to do that to the best of our ability. And just like you.
Just like you who want to see us do better, we want to do better as well. But we are restricted on what we can do, and that's limited by what our member states want us to be able to do and give us the power to do.
Really, really well stated, Maria. I mean, before we wrap, I want to be respectful of your time. I want to acknowledge the fact that our audience members are busy. And I've loved this conversation. Frankly, I've learned a lot in this conversation that, again, it's not amenable to a three- to five-minute media segment or something even shorter or a headline. So you've made us all smarter, Maria.
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