America’s Health & Human Services department has proposed spending $2bn a year to re-create systems the country previously accessed through the WHO at a fraction of the cost, reports The Washington Post.
After pulling out of the World Health Organisation, the Trump administration has now suggesting replicating the global disease surveillance and outbreak functions the United States once helped build and accessed, according to three administration officials briefed on the proposal.
The US-run alternative would re-create systems likes laboratories, data-sharing networks and rapid-response systems the country abandoned when it announced its withdrawal from the WHO last year and dismantled the US Agency for International Development, said the officials, who spoke on condition of anonymity.
While President Donald Trump accused the WHO of demanding “unfairly onerous payments”, the alternative his administration is considering carries a price tag about three times what America contributed annually to the UN health agency, they said.
The plan is for the United States to build on bilateral agreements with countries and expand the presence of its health agencies to dozens of additional nations.
The HHS has been leading the efforts and requested the funding from the Office of Management and Budget as part of a broader push to construct a US-led rival to the WHO.
Before withdrawing from the agency, America provided roughly $680m a year in assessed dues and voluntary contributions to the WHO, often exceeding the combined contributions of other member states, according to the HHS.
Citing figures in the proposal, officials said the US contributions represented about 15% to 18% of the WHO’s total annual funding of about $3.7bn.
HHS spokesman Andrew Nixon did not answer detailed questions about the proposed WHO replacement but said the agency “is working with the White House in a deliberative, interagency process on the path forward for global health and foreign assistance that first and foremost protects Americans”.
Public health experts said the effort would be costly and unlikely to match the WHO’s reach.
“Spending two to three times the cost to create what we already had access to makes absolutely no sense in terms of fiscal stewardship,” said Tom Inglesby, director of the Centre for Health Security at the Johns Hopkins Bloomberg School of Public Health, who served as a senior Covid-19 adviser during the Biden administration.
“We’re not going to get the same quality or breadth of information we would have by being in the WHO, or have anywhere the influence we had.”
Rather than attempting to rebuild with “something not constructable”, Inglesby said, the administration should specify what reforms it seeks and re-engage with the agency.
In a statement last month when the withdrawal became official, HHS said America would “continue its global health leadership” through direct engagement with countries, the private sector, and non-governmental organisations, prioritising emergency response, biosecurity co-ordination and health innovation.
Atul Gawande, a Harvard Medical School Professor who served as USAID’s assistant administrator for global health from 2022 to 2025, said the proposal follows deep cuts that have already had consequences.
“It’s after the decimation of foreign aid for health, including the dismantling of USAID, and has already cost upward of three-quarters of a million lives,” Gawande said, citing data from a 2025 Lancet study and modelling from Boston University estimating the toll of dismantling USAID.
“This is not reversing the damage. It is spending more than we spent on WHO to create an institution that’s unlikely to survive and will certainly accomplish only a fraction of what we did by working together with the entire world.”
The WHO, he added, provides “global access we do not have”, including to countries like China and Russia that do not routinely share health data directly with the United States.
The WHO did not immediately return a request for comment on the new US proposal. The agency said last month that the US withdrawal was “a decision that makes both the United States and the world less safe”.
The departure stunned global health experts and international authorities because America had been the most influential member of the nearly 200-member organisation and played a key role in its establishment in 1948. It had also historically been the agency’s largest financial contributor.
Experts and medical societies have said withdrawing from the preeminent global health alliance is scientifically reckless because global co-operation is key to controlling and preventing infectious diseases. Exiting the WHO makes the US less prepared to respond to health emergencies such as the coronavirus pandemic or the West African Ebola crisis from 2014 to 2016, which killed more than 11 000 people in the largest outbreak of the deadly disease since the virus was discovered in 1976.
Outbreaks of viral haemorrhagic fevers, including Ebola, Marburg virus, Lassa fever and yellow fever, have quadrupled since the mid-1990s, according to figures cited in the proposal for a US alternative to the WHO.
Another pandemic on the scale of Covid-19 could incur economic costs of an estimated $375bn a month, according to figures in the proposal.
Whether the federal government can build a worldwide disease-monitoring system comparable to the WHO, and how long it would take, remains uncertain.
Public health and infectious-disease experts have long said stopping diseases at their source is cheaper than emergency responses in the United States.
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