On January 20, 2017, one of President Donald Trump's first actions as Commander-in-Chief was the signing of an executive order announcing the United States' withdrawal from the World Health Organization (WHO), the specialized agency of the United Nations responsible for international public health. This decision came with no surprise as tensions had already surfaced during Trump's tenure, particularly concerning the WHO's handling of the global COVID-19 pandemic.
During his presidency, Trump heavily criticized the WHO, accusing it of being overly influenced by its member states, particularly China. He expressed dissatisfaction with what he termed the organization’s mismanagement of the global health crisis. This skepticism not only fueled international debates but severely impacted perceptions about the WHO's credibility and effectiveness.
After experiencing the effects of COVID-19 firsthand, the President's administration decided to withdraw, claiming it was necessary to sever ties with what they viewed as an ineffective organization. "The United States noticed its withdrawal from the World Health Organization (WHO) ... due to the organization’s mishandling of the COVID-19 pandemic and its failure to adopt urgently needed reforms," stated the executive order issued at the time.
The effort to withdraw shed light on the financial contributions the U.S. made to the WHO, which amounted to about $1.284 billion for the 2022-2023 fiscal years. Critics of the withdrawal claim this move would undermine the WHO, as the U.S. was its most prominent funding source. According to the WHO, without U.S. support, the organization faced serious financial hurdles and accountability issues.
Stephanie Psaki, the former U.S. coordinator for global health security at the National Security Council, expressed urgent concerns about the ramifications of easing U.S. influence on global health governance. On January 28, she opined, "WHO withdrawal will sever ties with ... cut our resources ... diminish our access to ..." highlighting how such decoupling can impact future health emergencies and overall disease management.
Notably, the executive order showcased discontent with the organization being viewed as pushing what some termed dangerous global health policies, particularly trends toward promoting reproductive rights, including abortion services internationally. Critics allege this has become part of the broader narratives against the WHO, leading to calls for defunding.
While the executive order aimed to restrict financial resources allocated to the WHO, it simultaneously put U.S. public health at risk. Infectious diseases, as scholars and health officials reiterate, do not respect borders. Diseases like COVID-19, tuberculosis, and avian influenza require coordinated international responses to be effectively managed. Katelyn Jetelina, adjunct professor at the Yale School of Public Health, warned about the increasing challenges for domestic health security stemming from international withdrawal. She articulated, "Even if the U.S. is well-equipped to handle its own health challenges, our safety depends on the rest of the world being equipped, too."
Trump's withdrawal decision also came at a delicate time with rising health threats, such as the largest recorded tuberculosis outbreak and human cases of avian flu occurring on U.S. soil. With data exchanges between the U.S. Centers for Disease Control and Prevention (CDC) and the WHO severed, responses to disease threats became even more complicated and less coordinated, endangering U.S. citizens.
Following the withdrawal, WHO spokesperson Tarik Jasarevic expressed regret over the United States’ decision. He stated, "The World Health Organization regrets the announcement ... we hope the United States will reconsider and we look forward to engaging ..." This sentiment reflects broader international concerns on how the U.S. position can influence global health diplomacy.
The Biden administration reversed Trump’s decision and re-engaged with the WHO soon after taking office. This re-engagement highlights the strategic importance of global health policy where national interests, economic benefits, and international collaboration converge to form complex layers of diplomacy. Support for the WHO is often described as “soft diplomacy,” yielding long-term benefits for U.S. national security and economic interests.
Elisha Dunn-Georgiou, President and CEO of the Global Health Council, pointed out several reforms initiated by the WHO before the withdrawal aimed at improving operational efficiencies and financial management. She mentioned, “Reforming WHO is a process ... made several changes to improve financial management and operational performance.” This optimistic outlook resounded with the necessity of engaging rather than withdrawing, especially during times of global health crises.
The U.S. withdrawal from the WHO and subsequent funding cuts prompted urgent calls from former officials and health experts to reconsider future engagement. Atul Gawande, former USAID global health administrator, urged, "Make no mistake—these lifesaving activities are being halted right now. ... Consequences aren’t in some distant future. They are immediate." Amidst such heated discourse, combating global health issues relies heavily on collective efforts where partnerships can critically avert crises.
With shifting international dynamics and health threats looming closer each year, the narrative surrounding the WHO remains intricately tied to national interests, strategic diplomacy, and the urgent need for cooperation. Only through collaborative frameworks can comprehensive responses to health emergencies become effective and sustainable, ensuring the well-being of all nations.
With the geopolitical and health landscapes perpetually changing, the importance of the United States as a key actor in the WHO cannot be overstated. Sustainability of global health efforts is contingent on how nations choose to engage and invest, particularly when the stakes for public health reach monumental highs.