The U.S. Leaves the World Health Organization: A Threat to Global Health Security

Photo via Reuters

SARA MEDINA: On Jan. 20, in an executive order issued on his first day back in office, President Donald J. Trump officially withdrew the United States from the World Health Organization (WHO)—an action that has the potential to fundamentally alter the state of global health security and the ability of the world to handle the inevitable next global pandemic. 

Founded in 1948, the WHO is an agency of the United Nations (UN) designed to, according to its constitution, “act as the directing and coordinating authority on international health work.” The agency has been central to many of the greatest achievements in global health of the last century, including the declaration of healthcare as a human right in 1978, the eradication of smallpox in 1980 (the only disease to have ever been completely eradicated), and the establishment of the International Health Regulations (IHR). The WHO has also provided streamlined technical guidance during public health emergencies such as Ebola and COVID-19. 

Currently, the WHO’s priorities are the eradication of polio (which remains endemic in only two countries), improved equity in healthcare access, and response to acute health emergencies such as the current threat of mpox.

He first proposed the withdrawal towards the end of his first presidency in 2020, citing concerns such as “the organization’s mishandling of the COVID-19 pandemic” and “its inability to demonstrate independence from the inappropriate political influence of WHO member states.” Furthermore, the administration criticized the unfair financial burden on the U.S. posed by the WHO, particularly noting the small contribution of China compared to the U.S.

The U.S.’s withdrawal from the WHO makes it one of only two UN member states (the other being Liechtenstein) who are not WHO member states.

The same order also revokes the 2024 U.S. Global Health Security Strategy developed by the Biden administration, as well as an executive order signed by former President Biden in January 2021 which built new government leadership positions in the areas of biodefense and global health security. Additionally, the order pulls the U.S. out of negotiations for the WHO Pandemic Agreement, a proposed accord that would increase global cooperation in pandemic preparedness and resilience. 

The WHO is funded by member states as well as external donors. The United States is the largest contributor (14.5%), followed by the Bill & Melinda Gates Foundation (13.7%), GAVI Alliance (10.5%), and the European Union (7.8%). Historically, the U.S. has always been the largest contributor, except during the brief period in 2020 when Trump halted U.S. funding. In 2024, the U.S. contributed a total of nearly $1 billion to the WHO. Therefore, the U.S. leaving the WHO will have a significant impact on the function of the organization.

Beyond financial support, the U.S. has also played a key role in providing technical support to the WHO, including laboratory research and advisory panels in various areas such as cancer, nutrition, chronic disease, and health technology. U.S. scientists worked closely with the WHO during the Ebola response in 2014 as well as during the assessment of the COVID-19 response in China in February 2020. 

The U.S. is also home to the WHO office at the UN in New York as well as the regional office for the Pan-American Health Organization (PAHO), a subsidiary of the WHO, in Washington, D.C. From a human resources perspective, about 200 of WHO’s 8,000 employees are U.S. assets. 

U.S. withdrawal would clearly significantly hinder the organization’s ability to fund and coordinate global efforts like polio eradication and acute public health emergency response. At the same time, withdrawal is a threat to domestic security. For example, PAHO was responsible for the effort to monitor avian influenza in the Americas, recording 66 confirmed human cases in the U.S. in 2024 which was a sharp increase from previous years. 

The executive order instructs the administration to “identify credible and transparent United States and international partners to assume necessary activities previously undertaken by the WHO.” This means domestic agencies under Health and Human Services (HHS), such as the Centers for Disease Prevention & Control (CDC) and the National Institutes of Health (NIH), must take on more responsibility to fulfill gaps in infectious disease surveillance and public health efforts. However, the uncertain future direction of HHS under nominee Robert F. Kennedy, Jr. and the freezing of funds from the NIH makes this order difficult to implement.  

Trump’s decision reflects an increasingly realist approach to foreign policy, prioritizing national sovereignty over multilateral cooperation. His administration argues that the U.S. should not bear a disproportionate financial burden in international institutions, especially when other major powers like China contribute significantly less. Avoiding cooperation in global health is a critical issue that would severely impact the global response to a potential future pandemic. There is a consensus among most scientists and health professionals that another global pandemic is not a question of “if,” but “when.”. Thus, Trump’s decision has the potential to leave the U.S. and the rest of the world in a state of catastrophic danger if a global pandemic were to occur in the coming years. 

Sara Medina is a sophomore majoring in Global Health and minoring in Government, interested in the impact of world politics on population health. She is from Southborough, Massachusetts.