When President Trump issued an executive order withdrawing from the World Health Organization on his first day in office, he pledged to “identify credible and transparent United States and international partners to assume necessary activities previously undertaken by the WHO.”
Since that time, the president’s supporters have doubled down on the idea that we can find an alternative to the WHO via many outlets, including this opinion page.
But the truth is, we can’t and we won’t. The only thing that will happen as the U.S. pulls out of the WHO, stops all funding and instructs the Centers for Disease Control and Prevention not to even communicate with the agency is that we will become weaker and more isolated. In fact, as if to spite the president, the world just got on without the U.S. and is about to adopt an unprecedented pandemic treaty without us.
When we joined WHO in 1948, Congress was virtually giddy, asking the organization to “initiate studies looking toward the strengthening of research and related programs against [heart disease, cancer] and other diseases common to mankind.”
In the nearly eight decades since, the organization has overseen the eradication of smallpox and is on the verge of eradicating polio. It has generated vast data troves on diagnosing, treating and preventing chronic and infectious disease and led the world through eight global health emergencies, including HIV, SARS, Ebola, Marburg, mPox and COVID-19.
It has done all of this on a shoestring budget — its approved biennial $6.83 billion budget for 2024-2025 is roughly the same as the Food and Drug Administration’s for a single year. This makes WHO one of the most efficient uses of international financial support available.
This translates to the cost of running a single large U.S. university hospital. From the minuscule sums the U.S. gives to the WHO, we couldn’t get a better investment.
The president’s beef with WHO has little reality behind it. He claims we pay way more than our fair share of the organization’s budget. But our “assessed” mandatory dues are a little more than China’s. U.S. contributions are capped at 22 percent. China’s will reach about 20 percent for 2025-27, extremely close to ours.
Most of the funding disparity comes from voluntary U.S. contributions. But these are purely discretionary and help pay for what matters to us — health emergency response, polio eradication, HIV and tuberculosis. China, on the other hand, has contributed very little to the WHO on top of its fees.
Under the sensational heading: “Lab Leak: The True Origins of COVID-19,” the White House recently simply asserted what most scientists dispute. Yes, it is possible SARS-CoV-2 came from the Wuhan Institute of Virology, and China certainly should have allowed WHO teams to independently investigate, which it didn’t. But it is still more likely that COVID was a naturally occurring “spillover” from wild animals to humans at the Huanan Seafood Wholesale Market in Wuhan.
China also was not a good actor. It failed to alert the world to a mysterious SARS-like virus circulating in December 2019. When China finally confirmed the outbreak, it falsely claimed there was no efficient human-to-human transmission.
WHO Director-General Tedros Adhanom Ghebreyesus was relentless in pushing China to report more transparently and to permit independent scientists to investigate. And he has no power to force China, or any other country, including the U.S., to follow the binding requirements in the International Health Regulations.
Led by the Biden administration, the WHO adopted stricter amendments to the International Health Regulations in June 2024, but Trump also said those amendments would have no binding effect on the U.S.
And then there are the widely amplified claims that WHO has, or will be given, sweeping new powers under the International Health Regulations and Pandemic Treaty, including the authority to order “lockdowns” or mandatory vaccinations. Those claims are simply false. WHO has no such powers and won’t be given them.
The U.S. and all countries have unfettered power to determine their own national health policies — sovereignty that both the International Health Regulations and Pandemic Treaty empathically recognize. There is no bogeyman here.
But even more importantly than all of this is the fact that no alternative organization, public or private, has the constitutional authority, legitimacy, infrastructure and trust of governments worldwide to share information, collaborate with partners to save vulnerable populations, and pool resources during times of threat.
Ghebreyesus is one of the most recognizable and trusted public figures in the world. During COVID-19, WHO, under his leadership, organized and led with other public and private sector partners the Access to COVID-19 Tools Accelerator to facilitate the development and distribution of diagnostics, therapeutics and vaccines and to simultaneously strengthen health systems. Millions were saved.
The U.S. will now be on the outside looking in as the world continues to exchange scientific information to stem diseases and innovate for vaccines and treatments.
The U.S. is the epicenter of an avian influenza outbreak in dairy cattle, and yet we won’t have unimpeded access to circulating influenza viruses from WHO’s Global Influenza Surveillance and Response System, a collaboration of some 130 countries. Nor will we have full access to WHO’s Global Measles and Rubella Laboratory Network despite a major measles epidemic currently centered in Texas.
How does that advance American national interests?
To be sure, there is room for improvement, as there is for all large, complex international organizations. WHO could operate with more transparency and could be more welcoming to civil society. It could raise assessed dues or charge higher fees for projects it undertakes for its partners.
All this would help the agency move away from a budget model that relies too heavily on voluntary contributions, especially from a single large donor like the U.S. The sustainable financing initiative is already moving the WHO toward less dependence on earmarked/voluntary funds.
U.S. withdrawal from the WHO is a grievous mistake that will jeopardize the lives and livelihoods of Americans and everyone else. But even for those that support the withdrawal, they should not think that there is any real alternative to the WHO.
Frankly speaking, we cannot imagine a world without the World Health Organization.
Sam Halabi is the director of the Center for Transformational Health Law at Georgetown University’s O’Neill Institute for National and Global Health Law and a professor at Georgetown’s School of Health. He is also an affiliate researcher at the school’s Center for Global Health Science and Security. Lawrence O. Gostin is a Distinguished University Professor, the co-faculty director of the O’Neill Institute and the founding O’Neill Chair in Global Health Law. He is director of the WHO Collaborating Center on Global Health Law.
