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We live in strange times. US President Donald Trump has decided to put a hold on World Health Organization (WHO) funding—due to alleged inadequate information and bias towards China—in a time when the work of the organization is more needed than ever. The corona virus (covid-19) pandemic quickly evolved to a highly politicized health crisis invoking reactions from a wide range of actors, internationally as well as nationally, potentially challenging the legitimacy of the organization. Yet, despite repeated attempts to delegitimize the WHO, data from the research program “Legitimacy in Global Governance” (Dellmuth et al. 2019; also see show that the WHO scores higher in legitimacy perceptions among both citizens and elites in surveyed countries compared to a number of other prominent international organizations. How can that be?

To give a brief background, it is not the first time the authority of the WHO has been questioned. Over the years the WHO has been exposed to several legitimacy crises and survived them—the most recent one the poorly handled Ebola epidemic in 2014. The legitimacy of the WHO has been discussed not only in relation to influenza outbreaks, but also in relation to cumbersome bureaucracy and relationships to the pharmaceutical industry. A multitude of articles and reports have analyzed the shortcomings of the organization and how to overcome these. At the same time, the WHO gets solid support by its proponents showing a solid belief that the organization is the authority in the field of global health in general and infectious diseases in particular.

In order to understand this seeming contradiction David Easton’s work on political support may be helpful. He makes a distinction between specific and diffuse support (Easton 1975; also see Gronau and Schmidtke 2016; Gregoratti and Uhlin 2018). The former is based on satisfaction with the output and performance of an international organization, such as “perceived decisions, policies, actions, utterances or the general style” of the authority (Easton 1975: 437), and the latter of the overall authority, such as “what an object is or represents” (Easton 1975: 444). Diffuse support typically expresses itself through a belief in the legitimacy of political objects as the right and proper authority. It is more durable than specific support and normally independent of output and performance (Easton 1975: 451). In other words, specific support relates to the perceived appropriateness of specific decisions or policies, while diffuse support relates to the authority of the whole organization.

This implies that heavy criticism may be directed towards political institutions without challenging their overall legitimacy, as long as this criticism is aimed at particular decisions or policies and not the organization’s authority itself (Hurrelmann 2017: 66). These insights are helpful in understanding why the WHO can be perceived as an organization with serious legitimacy challenges and as an organization with high legitimacy. In other words, the legitimacy crises that have occurred have primarily been “limited”, as they have not affected the very idea with the WHO, namely the mission to promote and safeguard the health and wellbeing of the citizens of its member states (WHO 1948), but only specific decisions, policies, actions, or statements.

That said, in practise, specific critique can build up to more overarching critique affecting the legitimacy of the whole organization (Easton 1975). It is quite clear that the WHO and its staff have been aware of the importance to counter critique that potentially could lead to delegitimation of the organization. Several reforms and legitimation campaigns have been introduced in recent years with varied success. However, the failure to reform the current funding system which is largely based on voluntary contributions clearly has made the WHO vulnerable to critique—not the least when major donors such as the USA withhold funding.

To conclude, the WHO seems to be a case in point of how contradictory processes of (de)legitimation in global governance coexist. The organization is vulnerable to critique, as evidenced by the US cuts in funding, but this does not necessarily mean that the overall legitimacy of the organization is undermined. And in the case of Donald Trump’s decision to withhold funds, the reason ultimately appears to have more to do with US domestic politics than the actual performance of the WHO, which people likely recognize as they consider the legitimacy of the organization.

Kristina Jönsson

Dellmuth, Lisa, Aart Scholte, Jan, Tallberg Jonas, and Verhaegen, Soetkin (2019) The Elite-Citizen Gap in International Organization Legitimacy. Paper prepared for presentation at the APSA Annual Meeting, Washington DC, 28 August – 1 September.

Easton, David (1975) A Re-Assessment of the Concept of Political Support. The British Journal of Political Science, Vol. 5, No. 4, pp. 435-457.

Gregoratti, Catia and Uhlin, Anders (2018) ‘Civil Society Protest and the (De)Legitimation of Global Governance Institutions’, in Jonas Tallberg, Karin, Bäckstrand and Jan Art Scholte, eds. Legitimacy in Global Governance: Sources, Processes and Consequences, 135-150, Oxford: Oxford University Press.

Gronau, Jennifer and Schmidtke, Henning (2016) The quest for legitimacy in world politics – international institutions’ legitimation strategies. Review of International Studies, 42(3): 535-57.

Hurrelmann, Achim (2017) Empirical legitimation analysis in International Relations: how to learn from the insights – and avoid the mistakes – of research in EU studies. Contemporary Politics, 23:1, 63-80.

Zürn, Michael (2018) A Theory of Global Governance. Authority, Legitimation & Contestation. Oxford: Oxford University Press.

WHO (1948) Constitution of the World Health Organization,