C Raina MacIntyre, UNSW Sydney
Donald Trump’s plan to withdraw the USA from the World Well being Group (WHO) has been met with dismay within the public well being subject.
Some have referred to as one of many US president’s first government orders “a grave error” and “completely dangerous information”.
What does the WHO do?
The WHO is a United Nations company that goals to broaden common well being protection, coordinates responses to well being emergencies similar to pandemics, and has a broad give attention to wholesome lives. It doesn’t have the facility to implement well being coverage, however influences coverage worldwide, particularly in low-income international locations.
The WHO performs a vital coordinating position in surveillance, response and coverage for infectious and non-infectious illnesses. Actually, infectious illnesses have probably the most urgent want for international coordination. In contrast to non-communicable illnesses, infections can unfold quickly from one nation to a different, simply as COVID unfold to trigger a pandemic.
We’ve got a lot to thank the WHO for, together with the eradication of smallpox, a feat which couldn’t have been achieved with out international coordination and management. It has additionally performed a number one position answerable for polio and HIV.
Why does the US need to withdraw?
The explanations for withdrawing embody:
mishandling of the COVID-19 pandemic … and different international well being crises, its failure to undertake urgently wanted reforms, and its incapability to exhibit independence from the inappropriate political affect of WHO member states.
The manager order additionally cites the disproportionately greater funds the US makes to the WHO in comparison with China. In 2024-25, the US contributed 22% of the organisation’s necessary funding from member states in comparison with about 15% for China.
President Trump initiated withdrawal from the WHO over related considerations in 2020. However this was reversed by President Biden in 2021.
What occurs subsequent?
The withdrawal could take a 12 months to come back into impact, and may have approval by the US Congress.
How this can play out is unclear, nevertheless it appears doubtless the WHO will lose US funding.
The US withdrawal may additionally be the ultimate nail within the coffin for the WHO Pandemic Settlement, which faltered in 2024 when member states couldn’t agree on the ultimate draft.
Trump’s government order states all negotiations across the pandemic settlement will stop. Nevertheless, the order hints that the US will take a look at working with worldwide companions to sort out international well being.
The US Facilities for Illness and Management (CDC) already has such worldwide companions and will feasibly do that. It already convenes a worldwide community of coaching in outbreak response, which might present a mannequin. However to maneuver on this course wants finessing, as one other goal of the brand new US authorities is to scale back or stop worldwide assist.
The WHO additionally convenes a spread of professional committees and networks of reference laboratories. One amongst many community of laboratories is for influenza, comprising greater than 50 labs in 41 member states. This contains 5 “tremendous labs”, one in every of which is on the CDC. It’s unclear what would occur to such networks, lots of which have main US elements.
With the specter of chicken flu mutating to develop into a human pandemic these international networks are essential for surveillance of pandemic threats.
WHO professional committees additionally drive international well being coverage on a spread of points. It’s doable for the WHO to accredit labs in non-member international locations, or for specialists from non-member international locations to be on WHO professional committees. However how this can unfold, particularly for US government-funded labs or specialists who’re US authorities workers, is unclear.
One other potential impression of a US withdrawal is the chance for different highly effective member nations to develop into extra influential as soon as the US leaves. This will result in restrictions on US specialists sitting on WHO committees or working with the organisation in different methods.
Whereas the US withdrawal will see the WHO lose funding, member states contribute about 20% of the WHO price range. The organisation depends on donations from different organisations (together with personal corporations and philanthropic organisations), which make up the remaining 80%. So the US withdrawal could enhance the affect of those different organisations.
An opportunity for reform
The Trump administration shouldn’t be alone in its criticism of how the WHO dealt with COVID and different infectious illness outbreaks.
For instance, the WHO agreed with Chinese language authorities in early January 2020 there was no proof the “thriller pneumonia” in Wuhan was contagious, whereas in actuality it was doubtless already spreading for months. This was a pricey mistake.
There was criticism over WHO’s delay in declaring the pandemic, stating COVID was not airborne (regardless of proof in any other case). There was additionally criticism about its investigation into the origins of COVID, together with conflicts of curiosity within the investigating group.
The WHO was additionally criticised for its dealing with of the Ebola epidemic in West Africa a decade in the past. Finally, this led to a collection of reforms, however arguably not sufficient.
Extra modifications wanted
US public well being professional Ashish Jha argues for reform at WHO. Jha, who’s the dean of the Brown College Faculty of Public Well being and former White Home COVID response coordinator, argues the organisation has an unclear mission, too broad a remit, poor governance and infrequently prioritises political sensitivities of member states.
He proposes the WHO ought to slender its focus to fewer areas, with outbreak response key. This could permit diminished funding for use extra effectively.
Reasonably than the US withdrawing from the WHO, he argues the US could be higher to stay a member and leverage such reform.
With out reform, there’s a risk different international locations could observe the US, particularly if governments are pressured by their electorates to extend spending on home wants.
The WHO has requested the US to rethink withdrawing. However the organisation may have to have a look at additional reforms for any risk of future negotiations. That is the most effective path towards an answer.
C Raina MacIntyre, Professor of World Biosecurity, NHMRC L3 Analysis Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney
This text is republished from The Dialog beneath a Artistic Commons license. Learn the unique article.
