The United States has officially withdrawn from the World Health Organization the US Department of Health and Human Services announced on Thursday, completing a long-standing objective of President Donald Trump.
Trump had attempted to exit WHO during his first term and, on the first day of his second term, issued an executive order initiating the formal withdrawal.
By law, the US was required to provide WHO with a one-year notice and settle all outstanding fees before leaving.
Currently, the US still owes WHO approximately $260 million. Legal experts, however, suggest it is unlikely the debt will be paid, with the organization having limited means to enforce collection.
“As a matter of law, it is very clear that the United States cannot officially withdraw from WHO unless it pays its outstanding financial obligations,” said Dr. Lawrence Gostin, a Georgetown University expert on global health law and public health. “But WHO has no power to force the US to pay what it owes.”
Although WHO could theoretically pass a resolution preventing the US from leaving until its dues are cleared, Gostin noted the organization would probably avoid doing so to prevent further tension, given that Trump is expected to finalize the withdrawal regardless.
HHS confirmed that all US government funding to WHO has ended, and all personnel and contractors assigned to the organization have been recalled.
The US has also ceased participation in WHO committees, governance bodies, leadership structures, and technical working groups.
Still, the door remains open for limited collaboration. When asked whether the US would join an upcoming WHO-led meeting to determine next year’s flu vaccine composition, officials said discussions are ongoing.
During a call with reporters, a senior administration official stated the US has “not been getting much return for our value, on our money, on the personnel that we’ve given.”
“A promise made and a promise kept,” the official added, claiming WHO “has acted contrary to the US interest in protecting the American public.”
Despite being the largest financial contributor, the official pointed out that there has never been an American director-general at WHO.
HHS also criticized WHO’s handling of the Covid-19 pandemic, alleging delays in declaring a global public health emergency that cost critical time.
“During that period, WHO leadership echoed and praised China’s response despite evidence of early underreporting, suppression of information and delays in confirming human-to-human transmission,” the agency stated.
The department further condemned WHO for downplaying airborne transmission and the potential for asymptomatic spread.
“This action means our country’s health policies can no longer be constrained by unaccountable foreign bureaucrats,” the HHS official said.
Nonetheless, the administration insisted the US would remain a global health leader. While details of the new strategy are pending, officials indicated the country would continue to collaborate internationally on disease surveillance and data sharing through bilateral agreements and partnerships with NGOs and religious organizations.
The effort is expected to be led by the US Centers for Disease Control and Prevention’s Global Health Center.
“We’ve assessed all of the gaps and the potential gaps. We’ve done analysis. We have plans in place. We will continue to work through countries and the ministries of health as we have for decades, and we’ll continue to develop those relationships and utilize those relationships in a way that’s mutually beneficial,” another senior administration official said.
Experts, however, warn that managing global health through bilateral agreements could create a fragmented system that cannot replace WHO’s coordinated efforts.
“It doesn’t allow the same level of partnership and surveillance as working with WHO,” said a former CDC official, who requested anonymity. “There’s not enough funding to replace it all.” The official added that the CDC has staff in roughly 60 countries, but “that’s not every country, which is why an overarching structure like the WHO is important.”
Critics also cautioned that withdrawing from WHO could leave the US and the world vulnerable to future biological threats.
“The U.S. withdrawal from the World Health Organization is a shortsighted and misguided abandonment of our global health commitments. Global cooperation and communication are critical to keep our own citizens protected because germs do not respect borders,” said Dr. Ronald Nahass, president of the Infectious Disease Society of America.
“Withdrawing from the World Health Organization is scientifically reckless. It fails to acknowledge the fundamental natural history of infectious diseases. Global cooperation is not a luxury; it is a biological necessity,” Nahass added.
Others voiced similar concerns.
“Today is a day where the world’s public health took a sad and consequential hit. We will experience more deadly worldwide outbreaks. They will occur because the experts in the US public health community won’t be at the table to lead the global response. These outbreaks will spread to the US and do us great harm,” said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“This is the most ruinous presidential decision in my lifetime,” Gostin said. “Not being a member of WHO is deeply harmful to our national self-interests and security. We will not have rapid and full access to the epidemiological data, virus samples, and genomic sequencing data to create vaccines and treatments. And we will not be able to work internationally to curb serious health threats before they arrive on our shores. When the next pandemic hits (and it will) the United States will not be prepared and our response will be slow and weak. That harms all Americans.”
Last spring, WHO Director-General Dr. Tedros Adhanom Ghebreyesus described the US withdrawal as a “lose-lose” situation.
“The US loses, and the rest of the world, we know for sure, loses,” he said.
