Analysis: Trump Follows Through on WHO Exit, Ending U.S. Revenue Lifeline

Introduction

The United States has formally severed its ties with the World Health Organization (WHO), marking a definitive shift in global health policy. Following through on an executive order signed by former President Donald Trump, the withdrawal concludes a long-standing financial lifeline that has historically supported international health initiatives. This move reignites intense debate regarding the future of global health financing and the United States’ role in international multilateral organizations.

As the world continues to grapple with the aftermath of the COVID-19 pandemic and emerging viral threats, the departure of the WHO’s largest donor raises critical questions about the sustainability of essential health programs. This article provides a detailed analysis of the withdrawal, the financial ramifications, the operational impact on the WHO, and the broader implications for international health security.

Key Points

Background

The relationship between the United States and the World Health Organization has been complex, characterized by decades of leadership followed by recent friction. Historically, the U.S. has been a cornerstone of the WHO’s financial structure and a key driver of its policy agenda. However, the onset of the COVID-19 pandemic in 2020 served as a catalyst for deteriorating relations.

Historical Context and Previous Attempts

Former President Donald Trump has long criticized the WHO, citing an alleged “China-centric” bias in its handling of the COVID-19 outbreak. In July 2020, amidst a global surge in infections, Trump announced the U.S. intention to withdraw. However, WHO regulations mandate a one-year notice period for withdrawal. Consequently, the decision did not take effect before President Joe Biden assumed office in January 2021. President Biden promptly reversed the decision, restoring U.S. funding and engagement with the organization.

The 2025 Executive Order

The current withdrawal is the result of a renewed executive order signed by President Trump upon returning to office. Unlike the 2020 attempt, this order has been fully executed, meeting the procedural requirements set by the WHO constitution. This formal exit marks a permanent shift in U.S. foreign policy, signaling a move away from multilateral health cooperation toward a more isolationist stance regarding global health governance.

Analysis

The termination of U.S. membership represents a seismic shift in the global health landscape. The analysis of this development reveals significant financial, operational, and geopolitical consequences that extend far beyond the balance sheets of the WHO.

The Financial Void

The United States has traditionally been the largest donor to the WHO. Over the past decade, annual contributions have fluctuated between $160 million and $815 million. For the 2024–2025 budget cycle, the U.S. was projected to contribute approximately $988 million. This figure accounts for roughly 14% of the WHO’s total budget, which stands at $6.9 billion.

The sudden cessation of this revenue stream creates a massive fiscal deficit. While the WHO has attempted to draw down existing funds to cover authorized expenditures, the organization faces immediate liquidity issues. Sources confirm that Washington has withheld assessed contributions for 2024 and 2025, triggering widespread operational cutbacks within the agency.

Impact on Global Health Programs

Health professionals warn that the loss of U.S. funding threatens the core mandate of the WHO. The financial cuts are not merely administrative; they directly affect frontline health interventions. According to WHO documentation, U.S. revenue supports approximately 95% of the organization’s tuberculosis (TB) work in Europe and over 60% of TB programs in Africa, the Western Pacific, and at WHO headquarters in Geneva.

Furthermore, the funding shortfall jeopardizes efforts to eliminate polio and undermines maternal and child health projects. The ability to identify and contain emerging viral threats—critical to preventing future pandemics—is also compromised. The withdrawal effectively dismantles a vital component of the global health safety net.

Geopolitical Shifts and African Health Systems

The repercussions of the U.S. exit are expected to be most acute in developing countries, particularly in Africa. Several African governments are already re-evaluating health and education programs following broader cuts to U.S. Agency for International Development (USAID) funding. For instance, Ghana anticipated receiving over $150 million in USAID support last year, a sum that is now at risk.

The WHO withdrawal compounds these financial pressures. It diminishes the hope of securing alternative funding for health interventions, placing additional strain on fragile health systems. As the U.S. recedes, the vacuum may invite other geopolitical actors to fill the void, potentially altering the strategic priorities of global health initiatives.

Practical Advice

For stakeholders, policymakers, and health organizations navigating the fallout of the U.S. withdrawal from the WHO, the following strategic actions are recommended to mitigate risks and ensure continuity of care.

For Global Health Organizations

• Diversify Funding Sources: Organizations heavily reliant on WHO sub-grants funded by the U.S. must aggressively pursue alternative donors, including private foundations, European governments, and multilateral banks.
• Optimize Operational Efficiency: Immediate audits of current programs are necessary to identify non-essential expenditures. Streamlining operations can help stretch remaining capital during this period of fiscal uncertainty.
• Strengthen Regional Partnerships: bolstering collaboration with regional health bodies, such as the Africa Centres for Disease Control and Prevention (Africa CDC), can provide alternative frameworks for health coordination and resource sharing.

For Policymakers in Developing Nations

• Conduct Vulnerability Assessments: Governments should immediately assess which health programs are most exposed to U.S. funding cuts to prioritize domestic resource allocation.
• Leverage Domestic Financing: There is a need to explore innovative domestic financing mechanisms, such as health taxes or reallocation of national budgets, to offset the loss of external aid.
• Engage in Diplomatic Dialogue: While the U.S. has withdrawn, diplomatic channels should remain open to advocate for the continuation of specific bilateral health aid that may operate outside the WHO framework.

FAQ

Conclusion

The formal withdrawal of the United States from the World Health Organization represents a historic turning point in international relations and public health. By ending its financial lifeline, the U.S. has not only altered its own foreign policy but has also triggered a cascade of operational challenges for the WHO and health systems worldwide. The immediate future will likely be defined by financial austerity for the WHO and increased pressure on developing nations to sustain health programs without American support.

While the U.S. administration views this move as a necessary step toward accountability and fiscal responsibility, the global health community faces the stark reality of reduced capacity to fight disease and prevent pandemics. The long-term consequences of this separation will unfold over the coming years, testing the resilience of the global health architecture and the ability of the remaining member states to fill the void left by a superpower.