President Trump’s decision to withdraw the United States from the World Health Organization could have severe consequences for countries around the world that count on the agency to achieve important health objectives, including routine immunizations, epidemory and nutrition control programs.
But it could also have unfortunate and involuntary repercussions for Americans.
WHO’s disengagement would deprive the United States of crucial information on emerging epidemics such as MPOX and the dangers of resurgence such as malaria and measles, said public health experts. This can also give more power to nations such as Russia and China to establish a global health program, and it could harm the interests of American pharmaceutical and health technology companies.
WHO’s work affects very myriades American lives. The agency compiles the international classification of diseases, the diagnostic codes system used by doctors and insurance companies. It attributes generic names to recognizable drugs worldwide. Its vast flu monitoring network helps select the seasonal flu vaccine each year.
The agency also closely follows antibiotic resistance and other drugs, maintains American travelers during the threats to health and studies a wide range of questions such as adolescent mental health, consumption of substances and aging , which can then enlighten policies in the United States.
“There is a reason why there was a Who,” said Loyce Pace, who was assistant secretary for health and social services under former president Joseph R. Biden Jr. “It is because we We have seen value, even as a superpower, in the awakening of the World War to meet as a global community on global problems. »»
“America, no matter how great we are, cannot do this work alone,” she said.
Although it will take a year for the withdrawal to take effect – and it is not quite clear that this can happen without the approval of the Congress – Mr. Trump’s announcement has already caused reduction measures Drastic costs at WHO
In a memo to the employees, the director general, Dr. Tedros Adhanom Ghebreyesus, announced a job frost and a limited renegotiation of major contracts, adding that more measures would follow. He also said that all meetings without prior approval should be fully virtual from now on and “missions to provide technical support to countries should be limited to the most essential”.
Late Sunday evening, the employees of the Centers for Disease Control and Prevention of the United States were invited to win immediately, to stop engaging with WHO in any way. Employees were then invited not to participate in meetings or even send an email to conversations that included WHO staff.
WHO is often criticized as a wood bureaucracy, too conservative in its approach and too slow to action. Mr. Trump quoted The “mismanagement of the covid-19 pandemic” of the organization as one of the main reasons for which the United States is withdrawing.
Many public health experts have called for decades reform of the agency, noting that it is too shy to call the faux pas of its members, has a rigid vision of what constitutes medical proofs and Too many areas of focus. Critics degenerate during the pandemicWhen the one who was late to recognize that the The coronavirus was in the air And that the The virus could spread in the absence of symptoms.
However, no other organization can match the scope or influence of WHO in the world, said Dr. Thomas Frieden, who has been working with WHO for decades, including as a former CDC.
“Are there many things in which they could be better?” Of course, “he said. But, he added, “are they essential? Yes.”
For all its scope, WHO has a relatively modest budget, totaling around $ 6.8 billion for 2024 and 2025. For comparison, the Department of Health of the tiny state of the Rhode Island spent just over $ 6 billion in 2024 only.
The United States is the largest donor in WHO, representing almost 15% of its planned budget.
In the executive decree, Trump complained that the WHO “continues to require unjustly expensive payments of the United States, very out of proportion to payments evaluated by other countries”, adding that China contributes near 90% less.
These two claims are inaccurate.
Mandatory costs are calculated according to the population and income of each country, using a formula approved by the Member States. For the two-year budget of 2024-25, this amount was $ 264 million for the United States and $ 181 million for China, a difference of approximately 31%.
The assertion of Mr. Trump according to which China pays much less can have been based on voluntary contributions, which are generally motivated by specific interests such as the eradication of polio: the United States has so far provided $ 442 million in voluntary contributions for 2024-25, while China gave $ 442 million for only $ 2024-25. Despite this, the total contribution of China is approximately 74% less than that of the United States, not 90%.
Trump’s decision was “not based on sound and fact,” said Helen Clark, a former Prime Minister of New Zealand and former administrator of the United Nations Development Program.
Monday, the Trump administration interrupted the distribution HIV drugs purchased with American aid. Suddenly final treatment will jeopardize the health of people living with HIV and will result in more infections and could result in resistance to available medicines, have warned health experts.
WHO programs monitor resistance to drugs around the world in antibiotics and HIV, malaria and other diseases.
“These are not invincible drugs, and have this ability to know when resistance occurs and why we have to change the strategies can be very important,” said Dr. Meg Doherty, who directs WHO that programs HIV and HIV and HIV Sexually transmitted infections.
“These are things that people in the United States should be aware of and should be concerned about coming to the future,” she said.
If the United States loses access to the WHO information and data sharing, online reports and informal communications can fill part of the vacuum, but it can be stifled, filtered or spoiled by disinformation. And WHO and other countries are not forced to share information, such as genetic sequences, with the United States, not to mention its advice, if the country is not a member.
“If we are not there, we don’t have one voice at all,” said Dr. Frieden.
WHO began in 1948 as the United Nations Branch focused on global health. Over the decades, he led to the eradication of the smallpox, almost defeated and helped control the use of tobacco and trans fats.
Countries that do not have the equivalent of a CDC or a food administration and drugs rely on WHO for public health guidelines, infant vaccinations and drug approval, between many other health efforts.
“The Ministries of Health will generally only move if there is an WHO guideline,” said Dr. Chris Beyrer, director of the Duke Global Health Institute and OMS advisor
This dynamic has implications for American companies, allowing the pharmaceutical and technological companies of health to operate in countries which closely respect the recommendations of the WHO, said Anil Soni, Director General of the WHO Foundation, a Independent entity that facilitates partnerships and the financing of the organization.
“The United States will not be at the table to establish quality evidence and standards that allow competitive positioning of American companies and lead directly to American affairs,” said Soni.
Mr. Trump and others have criticized the one who For Do not hold responsible China At the start of the pandemic, and for having taken too long to declare the cocovid pandemic a public health emergency.
But the WHO cannot reprimand its member countries, noted Ms. Clark, who was co -president of the independent panel for the preparation and the pandemic response, which conducted a survey on the Who is the answer to the cocovid-19 pandemic.
“Who does not have the power to force countries to do anything,” said Clark. “He has only the power of persuasion. China was not transparent, and it bothered the response of who. »»
Trump also said that China had too much influence on WHO, but “in fact, the real problem is that the small Pacific islands with 100,000 people have too much power,” said Dr. Frieden.
“Who works by consensus, and any country can therefore throw a monkey key and stop procedures,” he said.
It is not clear if Mr. Trump can unilaterally break links with WHO unlike most international agreements, which may arise from executive action or require a ratification of the Senate, belonging to WHO A been devoted by a joint resolution of the congress and may have to be dissolved in the same path.
“There is a very good argument to argue that the president cannot do it himself-that is to say without the participation of the congress,” said David Wirth, former head of the State Department and Expert in foreign relations law at the Boston College.
If the congress approves, the United States must always give a one-year notice and fulfill its financial obligations for the year.
Some experts fear that Mr. Trump’s action invites nations such as Hungary and Argentina, whose leaders are ideologically similar, to follow suit. Already, the Italian Deputy Prime Professor proposed a law to leave the WHO
American withdrawal can also allow the authoritarian member states of the organization, such as Russia and China. Public health decisions in Russia and China are “much more politically controlled, and it is a danger to everyone,” said Dr. Beyrer. “None of us wants to live in a world where Russia has a wider voice in global health governance.”
In his decree, Trump said the United States would cease negotiations on changes to international health regulations, the legally binding rules for countries to report emerging epidemics to WHO, but the last amendments have been Adopted by the World Health Assembly last year and are expected to come into force in September.
Ironically, it was the first Trump administration that proposed the amendments due to frustration in the face of the lack of transparency of certain countries during COVID-19, said Ms. Pace, who supervised negotiations during the Biden administration.
Ms. Pace also directed negotiations for a pandemic treaty which would allow countries to work together during an international crisis. The treaty had been blocked And can now collapse.