So I have been this stream of Tweets from people about what a bad move it is to leave the WHO, gives China a win, and US needs international institutions and all these Tweets are high on ideals and clichés but lack realism about what has happened either in the institutions 1/n

or the landscape that created those institutions. I am personally very torn about the decision to leave the WHO. Think about the institutions more broadly: they were constructed in a post WWII world with specific focus on what to achieve and how to achieve it. Since 2/n

the turn of the century, China has actively been seeking to remake these institutions in their own image and repurpose their technical focus. For all the talk about the WTO restraining China, the WTO (partially for reasons outside its institutional mandate and partially for 3/n

for reasons it does have some control over) has done very little on China. China actively sought to appoint domestic security personnel to run Interpol and it turned out just as badly as expected. China got Tedros appointed to the WHO and no one would call him a top flight 4/n

leader except the CCP. The first issue this raises is that countries like the US have gone out of their way to include other countries in this institutional system but this merely opens the door for countries like Beijing to pervert the entire intention of the system. 5/n

This is why countries like Saudi Arabia and China end up on the UN Human Rights Council. Authoritarian countries can group together to elect or place themselves in positions to actively influence these institutions. The reason this matters is that despite all the well 6/n

Intentioned talk about US influence, these institutions are terminally corrupted. The UNHRC given its election system will never be anything but a place for the worst violators to congratulate themselves based upon the election system. This was true long before Trump and 7/n

It will be true LONG after Trump. No matter who you elect, this is now the state of the UNHRC and the WHO. That's just the fact. This raises the question of what is the benefit of the US being apart of these institutions. This is where it get problematic. If the US is the 8/n

Largest funder and no viable way to drive major policy direction and in fact the institutions are promoting policies that are not just against US interests but US values, we need to ask ourselves very clearly what is the purpose of funding these institutions that do the 9/n

Complete opposite of what the US wants and the more fundamental values we want. Put another way: why is the US funding the UN Human Rights Council to have it used to white wash the worst abusers? Specifically on the WHO, before Trump began criticizing the WHO it was 10/n

Clear to everyone who the WHO worked for: it was not global health it was the CCP. We can honestly debate what comes next or what better alternatives might exist to this policy but we need to make clear that the WHO is not changing and the US is funding CCP priorities. 11/n

One thing I have maintained for some time, and you can check the writings, the global institutions structure we recognize was designed in a post WWII environment and much of it was designed to contain an expansionist communist power. It is now being pushed to include 12/n

An expansionist communist power who has corrupted these institutions from their missions but most people still look to these institutions for leadership in their policy domains. That is a completely failed paradigm. The US leaving the WHO requires the US to take leadership 13/n

Redirecting those funds to building the next broad global public health focused institution. Whether that works in the short term from a US institution or other potential solutions. It is very fair to note the profound problems with these institutions, it is now incumbent 14/n

Upon the US to go out and create something better. The existing global institutions are rotting and unreformable. We need to recognize the new environment and new demands and create something more suited for the challenges we face.