US exits WHO on the eve of Executive Board meeting

The United States' exit from the World Health Organization (WHO), under the presidency of Mr Donald Trump, became official on January 22, 2026. President Trump set the withdrawal process in motion with an executive order, as one of the first acts upon his return to power a year ago.

This is an enormous material blow to the WHO. The United States' contributions amounted to one-fifth of the annual budget of the United Nations' specialised body responsible for providing international health leadership. According to officials of the US Department of Health and Human Services, echoing Mr Trump, this step was taken because of the WHO’s supposed “mishandling” of the COVID-19 pandemic, overbearing influence of some other Member States, and lack of internal reforms.

The United States' contributions amounted to one-fifth of the annual budget of the United Nations' specialised body responsible for providing international health leadership.

These were the same reasons presented by Donald Trump during his first presidency when he initiated the process to withdraw the US from the WHO, after describing it as a “China-centric” international organisation which “really blew it” on the coronavirus. However, most people saw the move at the time as nothing but a wanton face-saving gesture. The evidence, including from US academics and public health experts, showed Donald Trump’s gross mismanagement of the COVID-19 response in the United States. When Joe Biden became president, he reversed that earlier withdrawal before its consummation. This time around, with the process initiated at the beginning of his four-year term and not the end, global health and indeed the world as a whole is burdened with this tragic farce, as a reality to confront.

The impact is already being felt. Even before the exit became sealed a few days ago, despite the WHO’s hope that it would reconsider its stance, the United States had refused to pay its mandatory membership dues (called assessed contributions in WHO lingo) for 2024 and 2025, despite this being binding. This whole drama of the absurd is part of a broader pattern of attacks on the multilateral system, spiced with the most outrageous lies and gunboat diplomacy . Within the first week of the year, the United States equally pulled out of 31 United Nations entities and 35 non-United Nations multilateral organisations.

However, as important as all these are, the withdrawal from the WHO is of utmost importance. The COVID-19 pandemic showed the existential centrality of international health to humankind. Pathogens and the diseases they cause do not know borders. International collaboration is necessary for safeguarding public health. The capacity of the WHO to carry out its core functions has been reduced with this sharp reduction in its accessed funds.

WHO’s budget for 2024-2025 was $6.8 billion. Last year, it initially projected $5.3 billion for the 2026-2027 biennium. This had to be cut further to $4.2 billion. But even at that, it is still $1.7 billion short of meeting this stripped down budget. The job losses have been drastic, affecting a quarter of WHO’s global staff. More than 1,200 staff at the WHO Secretariat in Geneva and across the world have been laid off. Departments have been merged and in some cases moved from the secretariat to other parts of the world. Programmes and projects of immense value to scores of millions of people, particularly in the global South, have been adversely affected.

The United States government presents a picture of self-sufficiency, claiming it will address the challenges of disease surveillance and pathogen sharing through bilateral agreements with countries it so chooses to enter into relations with. The country was also withdrawn from the negotiations that resulted in the historic signing of a pandemic treaty at the World Health Assembly last May. It is also absent at the ongoing negotiations over pathogen access and benefit sharing in the WHO. But, this false confidence could be treacherous. Pulling out the United States from the WHO puts the country and the health of its citizens in danger, especially in the event of another pandemic.

There are contending views and interests on the way forward for WHO and the rest of the world, in light of the current situation. A the last World Health Assembly, WHO Member States voted to increase their assessed contributions by 20% for the 2026-2027 biennium, with the aim of increasing this increase in the long run to 50 overall. The aim is to increase the WHO’s budgetary base whilst doing away with the former sort of situation where an hegemon gets away with playing “big daddy” including the possibility of taking his toys away tantrums.

Another side of the emerging considerations on what is to be done, which might be less benign is a diversification of donor base which might see increased influence of the already overly influential philantrocapitalist foundations and even private sector entities. While this leaning on multistakeholderism could help bring in some earmarked and even unearmarked money for WHO’s work, we have seen that how such global public-private partnerships enable the putting of profit first over people, when the chips are down.  

The insistence of the Bill & Melinda Gates Foundation (the equivalent of what the United States is in the current “league of nations” within the league of philantrocapitalist foundations), on global genuflecting at the altar of intellectual property rights contributed to what some described then as “vaccine apartheid” and others as “vaccine imperialism”. Either way, probably millions of more lives could have been saved at that hour if people had been put unambiguously before profit. The decolonisation of global health as much as the struggle for the full realisation of the right to health itself requires we ensure that industry, in whatever guise is not granted such powers as would be reinforced with leveraging more on them.

The 158th session of the WHO Executive Board will take place next week, from 2 to 7 February. WHO Member States will have deeper discussions on the implications of the United States' exit and various possibilities of how to cope with it. Public Services International will be at the meeting, as the global voice of health and care workers. We will also be there with a clear message: put people and the planet over profit. And that requires that WHO Member States unambiguously put health over wealth. Governments and not business, must be at the heart of funding and delivering quality healthcare for all, within our different countries and across the globe in its entirety.