The US has officially withdrawn from the World Health Organisation (WHO) – leaving the UN agency without one of its biggest donors, and without having paid its fees for 2024 and 2025, which has already caused huge job losses at the organisation, reports the BBC.
The US owes more than $280m to the global health agency, according to the WHO. And Trump administration officials acknowledge that they haven’t finished working out some issues, such as lost access to data from other countries that could give America an early warning of a new pandemic.
The withdrawal will hurt the global response to new outbreaks and hobble the ability of US scientists and pharmaceutical companies to develop vaccines and medicines against new threats, Lawrence Gostin, a Public Health law expert at Georgetown University, told MedPage Today.
“In my opinion, it’s the most ruinous presidential decision in my lifetime,” he said.
Nearly every country in the world is a member of the WHO. US officials helped lead the agency’s creation, and America has long been among the organisation’s biggest donors, providing hundreds of millions of dollars and hundreds of staffers with specialised public health expertise.
On average, the US pays $111m a year in member dues to the WHO and roughly $570m more in annual voluntary contributions, according to the Department of Health and Human Services.
But a year ago, President Donald Trump signed an executive order signalling the withdrawal of its 78-year commitment, having criticised the organisation for being too “China-centric” during the Covid pandemic, an inability to reform and political influence from member states.
WHO, like other public health organisations, made costly mistakes during the pandemic, including at one point advising people against wearing masks. It also asserted that Covid-19 wasn’t airborne, a stance it didn’t officially reverse until 2024.
Another Trump administration complaint: none of the WHO’s chief executives – there have been nine since the organisation was created in 1948 – has been Americans. Administration officials view that as unfair given how much the WHO relies on US financial contributions and on CDC personnel.
But the WHO has rejected these claims, with Director-General Tedros Adhanom Ghebreyesus saying the withdrawal was not just a loss for the US but also for the world.
On the issue of non-payment of its fees to the WHO, although the agency’s lawyers suggest the US is obliged to pay the arrears – estimated at $280m – Washington said it saw no reason to do so.
“The WHO tarnished and trashed everything that America has done for it,” according to a joint statement from US Health Secretary Robert F Kennedy Jr and Secretary of State Marco Rubio.
The pair said the organisation had “abandoned its core mission and acted repeatedly against the interests of the United States”, including failing to return the American flag based at its Geneva headquarters.
In response to a question about global efforts to combat polio or HIV, officials said the US would partner with “NGOs and faith-based groups” to continue that work, but could not give details of any partnerships yet established.
Blame-throwing for Covid deaths
During the Covid-19 pandemic, America had one of highest death rates, in part because of a patchy response to WHO advice on mask-wearing and social distancing, according to Drew Altman, a former US public health official.
In a 2020 article for The BMJ, he accused the federal administration in Washington, then led by Trump, of failing to offer national guidance, and allowing policy over Covid-19 to become politicised.
“The disappointing US response to Covid-19 was because of a failure of policy and leadership,” he said.
A research paper published in the US National Library of Medicine also examined the US response to Covid-19, and accused the Trump administration of a “slow and mismanaged federal response”.
Experts say the US exit from the WHO could cripple numerous global health initiatives, including the effort to eradicate polio, maternal and child health programmes, and research to identify new viral threats.
Ronald Nahass, MD, President of the Infectious Diseases Society of America, called the US withdrawal “short-sighted and misguided” and “scientifically reckless”.
The US has ceased official participation in WHO-sponsored committees, leadership bodies, governance structures, and technical working groups, which would seem to include the WHO group that assesses what flu strains are circulating and makes critical decisions about updating flu shots.
It also signals the US is no longer participating in global flu information-sharing that guides vaccine decisions.
Such disease intelligence has helped Americans be “at the front of the line” when new outbreaks occur and new vaccines and medicines are quickly needed to counteract them and save lives, Gostin told MedPage Today.
Trump administration officials say they already have public health relationships with many countries and are working to ensure direct sharing of that kind of information, rather than having the WHO serve as a middleman – but did not give specifics about how many such arrangements are in place.
Gostin, an expert on international public health treaties and collaborations, said it’s unlikely America will reach agreements with more than a couple of dozen countries.
Many emerging viruses are first spotted in China, but “is China going to sign a contract with the United States?” Gostin said. “Are countries in Africa going to do it? Are the countries Trump has slapped with a huge tariff going to send us their data? The claim is almost laughable.”
Gostin firmly believes Trump overstepped his authority in pulling out of the WHO. “America joined the organisation through an Act of Congress and it is supposed to take an Act of Congress to withdraw,” he argued.
WHO meeting
The WHO said the notification of the US withdrawal raises issues that will be considered by the WHO executive board at its regular meeting starting on 2 February and by the World Health Assembly at its annual meeting in May 2026.
In a statement, it said that “as we do with every Member State, WHO has always sought to engage with the United States in good faith, with full respect for its sovereignty”.
While no organisation or government got everything right, the agency said it stood by its response to the unprecedented global health crisis of the pandemic, that it had acted quickly, shared all information with the world, and advised Member States on the basis of the best available evidence.
“We supported sovereign governments to make decisions they believed were in the best interests of their people, but the decisions were theirs,” read the statement.
Timely alarm
In the first weeks and months of the pandemic, the WHO’s DG urged all countries repeatedly to take immediate action to protect their populations, warning that “the window of opportunity is closing”, “this is not a drill”, and describing Covid-19 as “public enemy number one”.
“The systems we developed and managed before, during and after the emergency phase of the pandemic, and which run 24/7, have contributed to keeping all countries safe, including the United States,” said the WHO’s statement.
“WHO appreciates the support and continued engagement of all its Member States, which continue to work within the framework of WHO to pursue solutions to the world’s biggest health threats, both communicable and non-communicable. Most notably, WHO Member States last year adopted the WHO Pandemic Agreement, which once ratified will become a landmark instrument of international law to keep the world safer from future pandemics.
“Member States are now negotiating an annex to the WHO Pandemic Agreement, the Pathogen Access and Benefit Sharing system, which if adopted will promote rapid detection and sharing of pathogens with pandemic potential, and equitable and timely access to vaccines, therapeutics and diagnostics.
“We hope that in the future, the United States will return to active participation in WHO.”
BBC article – US officially leaves World Health Organization (Open access)
MedPage Today article – U.S. Completes Its WHO Withdrawal (Open access)
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