Illustration by Paola Bilancieri.
On January 20, 2025, President Donald J. Trump, by executive order, indicated his intention to remove the US from World Health Organization (WHO), the United Nations agency responsible for global public health. This decision will have wide-ranging and negative consequences for people’s health worldwide.
Since it joined the organization in 1948, the United States has been its greatest funder, making it WHO’s most influential member. However, despite its global importance, the agency has a budget of roughly one-quarter of the US Centers for Disease Control and Prevention (CDC), which shows its limitations in addressing critical health challenges at a global level.
WHO is funded by contributions from its nearly 200 member states, with each contribution determined by the United Nations based on a country’s wealth. For the period 2024-2025, for example, that number has been set at $264 million for the US and $181 million for China. WHO also receives voluntary contributions from member states, philanthropic foundations and private donors. While for the same period the US is projected to provide $442 million (making it the largest contributor,) China is set to provide just $2.5 million.
Headquartered in Geneva, Switzerland, WHO has six regional offices and 150 country offices worldwide. Through them, the agency promotes the control of epidemic and endemic diseases, sets international health standards, collects information on global health issues, serves as a forum for health-related scientific and policy discussions, and assesses worldwide health challenges.
As part of its mandate, WHO heads a vast network of public health agencies and laboratories where scientists track new disease outbreaks and collect data to develop vaccines and therapies to address them. There are 21 WHO collaborating centers at the US Centers for Disease Control and Prevention (CDC) and three at the National Institutes of Health (NIH). Those centers are focused on US health priorities, such as polio eradication, cancer prevention and global health security.
WHO has been at the frontline response to national disasters such as the earthquakes in Afghanistan, Nepal, Syria and Turkey, and devastating floods in Libya, Pakistan and South Sudan. It has done so by deploying emergency medical teams, sending medical aid and helping countries cope with the mid- and long-term effects of these events.
US cuts in funding will affect childhood immunizations, polio eradication, and response to emergencies and to influenza and other pandemic threats. Through its Global Influenza Surveillance and Response System, the WHO processes data from countries around the world to track and assess circulating viruses. Cutting its ties to WHO could hinder US access to critical tools for developing biological ways to control influenza.
In 2019, WHO established a Special Initiative for Mental Health which has helped bring badly needed community mental health services to 50 million more people. At least 320,000 girls, boys, women and men were receiving mental, neurological, and substance abuse services for the first time in their lives. A new WHO Commission on Social Connection has been created, aimed at combating loneliness and social isolation as pressing health threats. The Commission intends to elevate social connection as a public health priority in countries of all income levels.
Experts predict that the US withdrawal from WHO will allow China to gain control of the organization. “There is one country that’s desperate for the United States to leave the WHO, and that’s China,” cautioned Sen. Chris Murphy, a Connecticut Democrat at a past hearing of the US Senate Committee on Foreign Relations.
Because the US entered WHO membership through a joint 1948 resolution passed by both houses of Congress –that President Harry Truman explicitly referenced as his legal basis for joining WHO—observers believe that the US withdrawal from the organization violates US law because it doesn’t have the express approval of Congress.
As an independent international public health consultant, I have conducted health-related missions in over 50 countries worldwide for several agencies, including WHO. I have seen the lives-saving work that local branches of WHO does to improve the health of the most vulnerable in developing countries, work that will be severely curtailed from lack of funds.
During the 2020 conflict of the US with WHO, when the US’s withdrawal from the organization was later rescinded by President Biden) a group of leading international health experts wrote in the Lancet, “Health and security in the USA and globally require robust collaboration with WHO –a cornerstone of US funding and policy since 1948. The USA cannot cut ties with WHO without incurring major disruption and damage, making Americans far less safe.” This statement remains as true now as when it was written.
