Trump's controversial decision: what does leaving the WHO mean for global health?

IN A DECISION that has sent shockwaves across the globe, President Donald Trump has announced that the United States has withdrawn from the World Health Organization (WHO).

This marks a historic and controversial moment in global health diplomacy. It’s not the first time Trump has aimed to sever ties with the WHO. However, with a second term ahead, the administration now has the time to complete the 12-month withdrawal process.

This decision could have widespread consequences for global health systems, scientific collaboration, and the fight against pandemics.

But what does this move mean for global health? Are we facing a crisis of cooperation at a time when the world needs it most?

The role of the WHO in global health

The World Health Organization, established in 1948, has been a crucial player in global health for decades.

With 194 member states, the WHO coordinates international efforts to combat infectious diseases, improve maternal and child health, and strengthen healthcare systems worldwide.

The organisation has been instrumental in eradicating smallpox, fighting polio, and responding to health emergencies, including the Covid-19 pandemic.

The United States has historically been a cornerstone of the WHO, providing funding, expertise, and leadership.

The US has been the largest single contributor to the WHO budget, funding critical programs to combat AIDS, tuberculosis, and malaria amongst other diseases. The collaboration between the US and the WHO has been a partnership that has saved millions of lives globally.

Why is the US leaving the WHO?

Trump has pointed to the WHO’s alleged mismanagement of the Covid-19 pandemic and perceived undue political influence, particularly from countries like China, as key reasons for the withdrawal.

Trump has also criticised what he sees as the “unfairly onerous payments” the US makes compared to other member nations.

“The World Health Organisation ripped us off, everybody rips off the United States. It’s not going to happen anymore,” Trump said during the announcement.

The decision to withdraw follows a 12-month notice period, during which it will sever financial contributions and partnerships with the WHO. This move comes even though the US has played a central role in establishing and supporting the WHO for over 75 years.

This decision echoes Trump’s “America First” policy, which emphasises reducing international commitments in favour of domestic interests.

However, critics argue that leaving the WHO does not make America healthier or safer. Instead, it isolates the US from the global health community at a time when international cooperation is critical.

The ripple effects of withdrawal

The US withdrawal from the WHO could weaken the organisation’s ability to respond to global health crises and disrupt decades of progress in fighting infectious diseases.

Here’s how the impacts could unfold:

Loss of funding

The US contributed nearly 22% of the WHO’s budget in 2020, amounting to over $400 million annually. This funding supported vital programs, including vaccine research, disease surveillance, and maternal health initiatives.

Without US contributions, the WHO may struggle to maintain these programs, particularly in lower-income countries that rely heavily on its support.

The US has significantly contributed to South Africa's fight against HIV/AIDS, with PEPFAR being the largest global health initiative.

Between 2004 and 2021, the US government invested over $7.5 billion in South Africa through PEPFAR, making the exact total amount difficult to determine. US contributions are typically channelled through bilateral programs, multilateral organisations, and specific health initiatives.

A step backwards for disease control

The global fight against infectious diseases like AIDS, malaria, tuberculosis and Mpox could face significant setbacks.

Over decades, the WHO has coordinated global responses, shared scientific knowledge, and provided resources to combat these diseases. Losing US funding and expertise could weaken the world's defences against future pandemics and outbreaks.

Scientists warn that this decision could roll back decades of progress in public health. For instance, the US Agency for International Development (USAID) allocates billions of dollars annually to programs that include HIV care, tuberculosis prevention, and reproductive health.

Scientific collaboration at risk

The WHO serves as a vital platform for exchanging scientific knowledge and best practices. With the US stepping away, informal collaboration channels between American scientists and their global counterparts may need to take precedence.

American universities, hospitals, and research institutions often partner with the WHO through Collaborating Centers.

These partnerships have been crucial in advancing medical research and implementing evidence-based policies. However, the withdrawal could disrupt these channels, limiting the global exchange of expertise.

Health equity under threat

Many low and middle-income countries rely on WHO support to address pressing health challenges.

For instance, the WHO provides funding for contraception, maternal health programs, and vaccinations in regions with limited resources. Reducing US contributions could jeopardise these essential services, disproportionately affecting vulnerable populations.

Responding to the exit, WHO spokesperson Tarik Jasarevic said: “We hope that the United States will reconsider, and we really hope that there will be constructive dialogue for the benefit of everyone, for Americans but also for people around the world.”