US withdrawal from WHO puts global health in jeopardy

Donald Trump signs an executive order to withdraw the United States from the WHO on 20 January 2025. Copyright 2025 The Associated Press. All Rights Reserved

President Donald Trump’s decision to withdraw the United States from the World Health Organization (WHO) will leave a gaping hole in the budget of the Geneva-based health agency. The US departure will also endanger global health, including that of the American people, say experts.

Freshly inaugurated in the White House, Donald Trump stares at the folder handed to him by an assistant. “What’s this one?” he asks. “Withdrawing from the World Health Organization, sir.” “Oh, that’s a big one,” the US president declares. Using a big black marker, Trump signs the executive order, but not before repeating his frequent complaint that China does not contribute enough to the UN agency ($203 million (CHF182 million) compared to $988 million from the US).

The US president has thus taken revenge on the organisation responsible for setting global health standards and monitoring health threats, which he has accused of inefficiency and being too ‘China-centric’. This marks the second time Trump has ordered the US be pulled out of the WHO. During his first term he criticised how the international organisation handled the Covid-19 pandemic and in July 2020 began the US withdrawal. President Joe Biden later reversed that decision.

The latest US pull-out will have significant consequences both for WHO programmes and for global health governance, increasing the risk of infectious disease resurgence and leaving the world more vulnerable to future pandemics.

“Everyone loses in this situation. WHO, of course, but also all the countries it serves, including the United States,” says Antoine Flahault, director of the Institute of Global Health at the University of Geneva.

A hole in the budget

The withdrawal of the United States, WHO’s largest financial contributor, will have a major impact on the organisation’s budget. For the 2024-2025 period, the US had committed to pay approximately $988 million, representing 14% of WHO’s total funding. Of this amount, $261 million are mandatory contributions – membership dues each country must pay based on wealth and populationExternal link. The remainder are voluntary contributions allocated to specific programmes.

WHO Director-General Tedros Adhanom Ghebreyesus expressed “regret” over the US decision, hoping the country would reconsider. A one-year notice period is required for the withdrawal to take effect, but the WHO is already preparing for budget cuts. WHO’s administration has proposed to cut its 2026-2028 budget to $4.9 billion, slashing $400 million from its planned spending. An internal emailExternal link also announced immediate cost-saving measures, including a hiring freeze and reductions in travel expenses.

The lack of US funds will be felt most acutely in programmes aimed at improving access to essential health services, responding to health emergencies, and eradicating polio, which account for about 70%External link of US contributions for 2024-2025.

Tedros Adhanom Ghebreyesus, Director-General of the WHO, said he regretted the US decision. The country has made major contributions to the development of global health policies in recent decades. Keystone / Salvatore Di Nolfi

But the consequences are not just financial. Due to its economic and diplomatic influence, the US has played a major role in shaping global health policies over the past decades. Washington has imposed its vision of global health and the models to be followed in areas such as vaccinations, public-private partnerships, access to medicines, and the fight against certain diseases. But this approach is now under threat.

“The US represents a significant portion of WHO’s total budget, but that budget is comparable to that of the Geneva University Hospitals,” Flahault points out. “So, I don’t think the issue is primarily financial.” According to the health specialist, it is the loss of the “US spirit” that could harm the organisation most.

A threat to the US and the world

Because of the withdrawal, global health experts warn of a resurgence of certain infectious diseases, including polio, HIV, and tuberculosis – diseases the US had been strongly committed to fighting.

The loss of collaboration with the US Centers for Disease Control and Prevention (CDC), which work closely with WHO, especially in epidemiological surveillance and the fight against infectious diseases, will be detrimental to the entire world, says Suerie Moon, co-director of the Global Health Centre at the Geneva Graduate Institute.

“Infectious diseases spread rapidly and know no borders. This lack of technical cooperation will put all countries at risk, including the United States. And I don’t think the US government has fully realised it,” she adds.

A prime example is the current avian flu outbreak in the US. The virus has already infected several dozen people, resulting in one fatality, and health experts fear a potential pandemic.

This risk is heightened by the Trump administration’s sceptical approach to science, which was on full display during the Covid-19 crisis. Trump downplayed the virus’s severity and even suggested injecting disinfectant into the body as a treatment.

By leaving the WHO, the United States will no longer have access to the data shared by the organisation, not least in the event of an alert, undermining the country’s health security. Keystone / Salvatore Di Nolfi

“If this approach is repeated, we could face an avian flu outbreak that continues to spread and potentially triggers a global pandemic, as the virus mutates rapidly,” explains Moon. “This risk, from within the United States, combined with a weakened WHO and a lack of information-sharing between the country and the organisation, directly threatens global health security.”

The sharing of scientific and health data between the US and the WHO will most likely end, as the Trump administration has ordered the country’s public health officials to immediately halt all collaboration with the Geneva-based organisation. Conversely, by leaving the WHO, the US will no longer have access to the data it shares, including on emergencies  – further weakening the country’s own health security.

And Washington’s withdrawal from the Paris climate agreement and planned cuts to US development aid will have consequences for climate-related diseases and the health systems of the world’s poorest countries.

The American pharmaceutical industry could also suffer. During the Covid-19 pandemic, the WHO-led COVAX initiative aimed at ensuring equitable access to Covid-19 vaccines favoured Western vaccines over those from Russia and China.

Pandemic agreement

Negotiations on the WHO pandemic treaty, launched three years ago to better prepare for and respond to future global health crises, will also be affected.

Washington officials pulled out of treaty talks in mid-February. Without such a major player at the table, there could be a “recalibration in the balance of power”, says Moon. However, she notes that US disengagement had already begun before Trump’s return to office.

Until now, European countries and the US had significantly watered down the future treaty’s provisions, opposing measures that would strengthen WHO’s authority and rejecting any proposal to waive patents on life-saving treatments.

A void to be filled

Washington’s empty seat within WHO may prompt other states to increase their involvement – if not financially then at least at the diplomatic level.

“In politics, there is no such thing as a vacuum. If a space opens up, another player will step in to fill it,” says Nicoletta Dentico, co-president of the Geneva Global Health HubExternal link, a network of NGOs. Financially, however, experts doubt the funding gap will be fully bridged, as WHO relies on a small number of states and foundations to cover most of its budget.

The European Union and major European donors, such as Germany, are confronted by economic difficulties and, in a tense security context, are prioritising defence over international cooperation. China, which favours bilateral investments, might decide to increase its contribution, but the question remains open. According to experts, only wealthy Arab nations have the financial capacity to compensate for the US shortfall.

For now, however, Trump’s decision has inspired other countries to follow suit. Argentina announced its withdrawal from WHO in early February, calling the organisation “harmful.” In Italy, a senator has urged the government to consider a similar move. And in Switzerland, a petition has been launched by the Federal Democratic Union, an ultra-conservative Christian party, which told Swiss newspaper Le TempsExternal link that it was considering proposing a motion to parliament or launching a popular initiative.

Edited by Virginie Mangin/sb