The decision of the United States to withdraw from the World Health Organization (WHO) for the second time in less than five years has sent shockwaves across the global health community. Signed into action by US President Donald Trump, this executive order has been met with a wide range of reactions from politicians, public health experts, scientists, and world leaders. While Trump justifies the move by claiming mismanagement, political influence, and unfair financial burdens placed on the US, the consequences for global health, particularly in pandemic preparedness, are likely to be profound. As the WHO’s largest donor, the loss of US contributions will create financial instability, endanger decades of collaborative health programs, and risk the advancement of vital global health initiatives.
The Executive Order: What’s Behind the Withdrawal?
In his signature on the executive order, President Trump expressed discontent with the WHO, criticizing the organization’s response to the COVID-19 pandemic and alleging political influence from member states, particularly China. He framed this move as an effort to relieve the United States of an unequal financial burden while also addressing mismanagement within the WHO. Trump’s rhetoric also emphasized the idea that the US was being taken advantage of by the international community, particularly in regard to its role as the WHO’s largest donor.
Historically, the US has contributed around 18% of the WHO’s annual budget, funding critical health programs ranging from polio eradication to infectious disease surveillance. However, the decision to withdraw was not made abruptly. Trump’s administration had previously threatened to withdraw from the WHO in 2020, but this executive order marks a definitive action that, while still requiring a year-long notice period, threatens the US’s longstanding role in shaping global health responses.
The Immediate Consequences for the WHO
The WHO’s response to the US withdrawal has been one of regret and concern. The US has been a major contributor to the organization’s efforts in eradicating deadly diseases such as smallpox, as well as advancing maternal and child health. A critical component of the WHO’s ability to respond to health crises worldwide has been its collaboration with the United States, which has contributed substantial financial and technical resources.
The loss of such significant funding is expected to have an immediate impact on the organization’s ability to tackle pressing health concerns. Programs aimed at combating diseases like polio, tuberculosis, HIV/AIDS, and malaria—areas where the US has made considerable contributions—now face uncertainty. The WHO has long depended on US funding to address these diseases globally, and without this financial support, efforts to fight epidemics and improve health outcomes may be significantly weakened.
Lawrence Gostin, a prominent public health expert, warned that a US withdrawal would leave the world less healthy and less safe. He expressed concerns that vital research on vaccine development, epidemic response, and disease prevention could be severely undermined, thus affecting global public health initiatives. The potential repercussions include reduced international cooperation in combating pandemics and a decrease in funding for initiatives to strengthen health systems in low-income countries.
The Global Health Landscape: A Call for Reform or Disengagement?
While President Trump has portrayed the US withdrawal from the WHO as an opportunity to push for reforms, many global health experts are alarmed by the broader implications of disengagement. The United States has played an essential role in promoting global health security. From leading efforts in immunization programs in the 1980s to its contributions to strengthening global disease surveillance and preparedness, the US has been instrumental in shaping the trajectory of public health worldwide.
However, tensions regarding the WHO’s governance structure, transparency, and alleged political influence from powerful nations such as China have led to growing dissatisfaction, particularly among conservative circles in the US. Critics argue that the WHO’s bureaucracy has slowed down its ability to effectively address global health crises, pointing to its initial response to the COVID-19 pandemic as an example of inefficiency.
Despite these concerns, experts caution that withdrawing from the WHO is not the solution. The organization’s work, particularly in pandemic preparedness, vaccine distribution, and research, has been vital to controlling diseases on a global scale. Critics of the WHO argue for reform and better oversight, but a complete severance of ties could risk undermining decades of progress.
Financial Impact: Who Will Fill the Gap?
The US has been the largest donor to the WHO, contributing billions of dollars annually to support its programs. In 2019 alone, the US contributed more than $400 million to the WHO, supporting various initiatives such as polio eradication, maternal and child health, and the response to infectious diseases like tuberculosis and malaria. The withdrawal of the US would create a significant financial void, and while some countries and organizations, like Germany and the Bill and Melinda Gates Foundation, have expressed their willingness to increase their contributions, it remains uncertain whether they can fully replace the US funding.
Germany, which temporarily became the WHO’s largest donor during the previous withdrawal attempt in 2020, has expressed hope that the US will reconsider its decision but has yet to make commitments regarding whether it will fill the funding gap. Likewise, the Bill and Melinda Gates Foundation has reaffirmed its support for the WHO but may not be able to absorb the financial burden left by the US withdrawal.
Without sufficient funding from alternative donors, the WHO may face difficulties in maintaining its global health programs, particularly in low- and middle-income countries where health systems are fragile and vulnerable to the effects of disease outbreaks. The absence of US funding could lead to cuts in critical health services and delays in responding to emerging health threats, such as the next pandemic.
Reforms Within the WHO: Can It Adapt?
Many critics of the WHO argue that the organization needs reform to address governance issues, transparency concerns, and perceived political interference. The US withdrawal, however, may not be the answer to these issues. Instead, experts suggest that reforms can be achieved through constructive engagement and collaboration, not through disengagement. The WHO has made significant strides in responding to health crises, such as the Ebola outbreak in West Africa and the COVID-19 pandemic. Still, its effectiveness can be improved through stronger accountability measures and better coordination among member states.
A reformed WHO could enhance its ability to respond to future health emergencies, improve its decision-making processes, and increase its responsiveness to emerging global health threats. However, a complete withdrawal of the US could severely hinder the organization’s ability to implement such reforms, as US expertise and funding have been key to many of the WHO’s successes.
The Road Ahead: What Will Happen Next?
The US withdrawal process will take a full year to complete, during which time the US must honor its financial commitments to the WHO. This timeline provides an opportunity for other nations to step up and fill the void left by the US. However, the challenges posed by this decision are not limited to finances alone.
If the US proceeds with its withdrawal, global health priorities may need to be reevaluated. The WHO’s programs may become less effective, and the lack of US support could undermine international health cooperation, making it more difficult to prevent future pandemics. Given the growing interconnectedness of the world and the ease with which diseases can spread across borders, the US’s decision could have lasting consequences for global public health security.
In the meantime, countries and organizations must find ways to ensure that the WHO can continue its work, even in the face of diminished resources. Alternative funding sources, including private foundations, other governments, and philanthropic organizations, will need to collaborate to maintain the WHO’s critical health programs. However, without US funding, the challenge of responding to global health crises will only become more difficult.
The Impact of the US Withdrawal from WHO
The US withdrawal from the WHO marks a pivotal moment in global health history. While some view this move as a necessary step to address criticisms and seek reforms, others fear it will undermine the international health response system. The WHO’s ability to address global health challenges—whether through vaccine development, pandemic preparedness, or disease eradication—could be significantly hampered by the loss of US funding and expertise. As the global health community grapples with the implications of this decision, it remains to be seen whether the WHO can adapt and whether other nations can step up to fill the void left by the US. In any case, the US withdrawal represents a significant shift in the landscape of global health cooperation, one that may have profound consequences for the future of public health.