Introduction
In January 2025, U.S. President Donald Trump signed an executive order withdrawing the United States from the World Health Organization (WHO). The decision, which became effective later in 2025, marks a major shift in global health governance. Trump justified the move by citing unfair financial burdens on the U.S. and political influence within the WHO.
This article explores the background of the withdrawal, its implications for international health cooperation, and how global partners are responding to the absence of the U.S. from the WHO.
Background: The U.S. and WHO
The United States has been a cornerstone of the WHO since its founding in 1948. As one of the organization’s largest financial contributors, the U.S. historically supplied roughly 15–20% of WHO’s total budget through both assessed and voluntary contributions. These funds supported programs ranging from polio eradication to pandemic preparedness and maternal health.
The Trump administration’s tensions with WHO date back to the COVID-19 pandemic, when the U.S. suspended funding temporarily in 2020. Although the Biden administration restored funding in 2021, Trump’s reelection in 2024 revived longstanding criticisms of WHO’s governance, leading to the January 2025 executive order.
Reasons Cited for Withdrawal
In signing the executive order, President Trump cited three main reasons:
- Financial Burden: He argued that the U.S. disproportionately funded WHO compared to other member states without commensurate influence over decision-making.
- Political Influence: The administration accused WHO of succumbing to geopolitical pressures that undermined its neutrality and effectiveness.
- Sovereignty Concerns: Trump contended that WHO’s recommendations sometimes conflicted with U.S. policies and should not dictate national health strategies.
Supporters of the withdrawal frame it as a push for reform and accountability, while critics warn it undermines global solidarity.
Immediate Effects on WHO Programs
WHO’s budget is built on contributions from member states, and losing a top donor has significant repercussions:
- Funding Gaps: Programs for immunization, infectious disease surveillance, and emergency response face shortfalls.
- Operational Uncertainty: Long-term initiatives, including antimicrobial resistance efforts, may stall without U.S. backing.
- Reallocation of Resources: WHO must seek increased contributions from other countries, private donors, or international organizations.
Although WHO has diversified its funding sources in recent years, the U.S. withdrawal still creates a major financial hole.
Implications for Global Health Coordination
- Pandemic Preparedness: WHO leads early warning systems for emerging diseases. Without U.S. support, these systems may lose crucial data or technical expertise.
- Research Collaboration: The U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) have been key partners in global research. Coordination may weaken without formal WHO ties.
- Standard Setting: WHO’s guidelines on vaccines, diagnostics, and treatment protocols may have less influence in U.S. policy, creating fragmented approaches.
These disruptions could slow responses to outbreaks and weaken collective action against transnational health threats.
International Response
Many countries and global health experts expressed concern over the withdrawal. European Union leaders emphasized the need for continued multilateral cooperation, while some low- and middle-income countries feared losing access to U.S.-backed technical assistance traditionally channeled through WHO.
However, some nations also saw the move as an opportunity to reform WHO and diversify leadership. China, the EU, and philanthropic organizations such as the Bill & Melinda Gates Foundation have stepped up contributions to partially offset the shortfall.
The WHO’s Perspective
WHO officials publicly expressed regret at the U.S. decision but reiterated their commitment to impartiality and reform. Director-General Tedros Adhanom Ghebreyesus emphasized that WHO remains a forum for all nations and invited the U.S. to continue informal collaboration even after formal withdrawal.
In practice, U.S. scientists may still participate in WHO working groups as independent experts, but institutional ties will be weaker.
Domestic Debate Within the U.S.
The executive order triggered intense debate among lawmakers, public health professionals, and civil society:
- Supporters argue the withdrawal will force WHO to address inefficiencies and politicization.
- Opponents warn it diminishes U.S. leadership in global health and jeopardizes national security by reducing access to early warnings on outbreaks.
Several states and NGOs have called on Congress to legislate continued engagement with WHO programs at the subnational or nongovernmental level.
Potential Legal and Practical Hurdles
Although the executive order initiated withdrawal, U.S. participation in international organizations is subject to domestic legal processes. Some analysts question whether the administration can fully disengage without congressional approval, particularly where treaty obligations or appropriated funds are involved. These legal ambiguities could lead to partial or delayed implementation.
Long-Term Consequences
If the withdrawal persists:
- WHO’s Financial Structure: The organization may become more dependent on earmarked voluntary contributions from a smaller set of donors.
- Geopolitical Shifts: Other powers may fill the leadership vacuum, potentially reshaping WHO’s agenda.
- Global Health Equity: Programs in low-income countries may suffer if funding is not replaced.
Conversely, if the withdrawal sparks genuine governance reforms, it could ultimately strengthen WHO’s credibility. The outcome depends on whether the gap left by the U.S. is bridged effectively.
Opportunities for Reform and Innovation
While disruptive, the withdrawal could catalyze:
- New Financing Models: Expanding public-private partnerships or introducing innovative funding mechanisms.
- Decentralization: Strengthening regional offices to reduce overreliance on headquarters.
- Transparency Measures: Clearer processes for decision-making and conflict-of-interest disclosures.
These reforms could enhance WHO’s resilience and legitimacy in the long run.
A Global Health Crossroads
The U.S. withdrawal from WHO in 2025 is more than a budgetary issue; it is a test of the world’s commitment to multilateralism in health. Infectious diseases, climate-related health risks, and chronic conditions do not respect national borders. Coordination through a central body like WHO remains essential to respond effectively.
The next few years will reveal whether WHO can adapt to reduced U.S. involvement or whether global health governance will splinter into competing blocs.
Conclusion
President Trump’s decision to withdraw the United States from the World Health Organization represents one of the most significant shifts in global health policy in decades. While the move was justified by the administration on grounds of financial fairness and political neutrality, its impact on funding, coordination, and leadership is profound.
As other nations and stakeholders rally to fill the void, the world faces a choice: allow weakened collaboration or seize the moment to reform and strengthen global health institutions. For millions who rely on WHO’s programs, the stakes could not be higher.
