Public health programmes around the world could be cut due to the US leaving the WHO
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In one of his first executive orders as president, Donald Trump has begun the process of withdrawing the US from the World Health Organization (WHO). One year’s notice is required to retreat from the international public health body, at which time the US will stop contributing funds. The impact could be huge. In recent years the US has contributed nearly a fifth of the WHO’s $6.8 billion budget.
In a statement released with the order, the Trump administration said the move was due in part to “the organization’s mishandling of the COVID-19 pandemic”. However, the WHO is essentially a coordinating body for public health around the world. It makes recommendations, but it cannot tell governments what to do and it doesn’t have legal powers to enforce anything.
This isn’t the first time Trump has attempted to remove the US from the WHO – much the same happened in 2020, but that decision was reversed by former US president Joe Biden before it came into effect. This time a reversal is less likely, although in theory the US Congress could block the move, and other countries are hoping Trump will change his mind.
The statement made alongside the order also falsely claimed the WHO demands unfair payments from the US. Contrary to these claims, the vast majority of the US contribution is voluntary. It is not required as part of membership. The US contribution – and indeed the entire WHO budget – is also a pretty tiny sum compared with the US’s $5 trillion health budget or the estimated $16 trillion cost to the US of the covid-19 pandemic.
To further put things into perspective, the Gates Foundation contributes nearly as much the US government voluntarily does – it is the third largest donor after the US and Germany.
Losing a fifth of its budget will clearly have a big impact on the WHO’s activities. These include coordinating vaccine campaigns – which in the past included the successful drive to eradicate smallpox – efforts to control infectious diseases such as tuberculosis and HIV/AIDS and surveillance for potential new pandemics.
These programmes are particularly important for low-income countries that lack resources, but they matter for everyone on the planet, because, as we saw during the most recent pandemic, infectious diseases can now spread around the globe in a matter of weeks. Vaccinating children in Accra, Ghana can ultimately protect kids in Orlando, Florida.
“Diseases don’t have any borders,” says Krutika Kuppalli, an infectious disease physician at the University of Texas Southwestern Medical Center who worked for the WHO during the covid-19 pandemic. “This will end up negatively impacting the US.”
She also points out the US contribution goes beyond money. Many of the experts and collaborating centres the WHO relies on are based in the US. For instance, two of the labs that monitor flu infections and help decide which variants should go into the flu vaccine are in the US.
A US withdrawal also raises questions about what would happen if, say, a bird flu virus started spreading among people in the US. Would the US promptly inform the WHO if it is no longer a member? Indeed, would it even still have the capacity to detect such a flu promptly and respond effectively? The withdrawal from the WHO could be just the start of broader cuts to various US health initiatives, says Kuppalli.
It would be ironic if the US ends up failing to promptly inform the world of a potential H5N1 pandemic, given that Trump claims the WHO helped China cover up the start of the covid-19 – claims that lack any factual basis, Kuppalli says. “That’s completely incorrect. I was there, I saw firsthand.”
There are, of course, some issues with the WHO itself. Some of these are to do with the inefficient nature of an international organisation that works by consent and has to consult with its members. That is not to say there isn’t room for improvement, Kuppalli says, but the best way to achieve this is for the US to stay a member and push for reform from within.
For its part, the WHO has said it regrets the US decision. “For over seven decades, WHO and the USA have saved countless lives and protected Americans and all people from health threats. Together, we ended smallpox, and together we have brought polio to the brink of eradication,” the WHO said in a statement in response to Trump’s announcement.
“We hope the United States will reconsider and we look forward to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe.”
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