The Case for and Against America’s Role in the WHO

On January 20, 2025, U.S. President Donald J. Trump signed an Executive Order “WITHDRAWING THE UNITED STATES FROM THE WORLD HEALTH ORGANIZATION (WHO),” which currently has 194 members. The reaction has been varied and swift by politicians, scientists, and advocacy groups, with reasonably predictable opinions. In truth, while there are valid arguments both for and against such an action, what is required is an objective weighing the situation, health needs and review of the institutional mandate, and possible areas of reform. Such an approach would lead to a reasoned judgment on conditioning U.S. continuing engagement and financing, all with the underlying goal to protect and save American lives and others.

The World Health Organization’s Past and Present

The Kaiser Family Foundation (KFF) is respected as an independent source for health policy research, polling, and news source. It described the WHO and the U.S. past relationship with key points as follows as follows:

• The U.S. government (U.S.) has been actively engaged with WHO throughout its history, providing financial and technical support as well as participating in its governance structure.
• Historically, the U.S. has historically been one of the largest funders of WHO. U.S. contributions have ranged between $163 million and $816 million annually over the last decade.
• Over the last several years WHO has overseen negotiation processes to update an existing agreement known as the International Health Regulations (IHR), and to establish a potential new “pandemic agreement”.
• In 2024, WHO launched its first ever “investment round,” seeking to mobilize an additional $7 billion from existing and new donors to support its operations through 2028. As of the end of 2024, the organization reported it received $3.8 billion in additional donor pledges, amounting to 53% of its fundraising goal.

President Trump cited the “mismanagement of the COVID-19 pandemic and other global health crises” and the “disproportionate payments compared to other countries’ dues.”

The graph below shows the top 10 contributors to WHO for the biennium 2022-23 were the United States of America, Germany, Bill & Belinda Gates Foundation, Gavi, European Commission, UK, Canada, Rotary International, Japan, and France.

U.S. and WHO Cooperation

Probably the most important U.S. Government counterpart to a core of WHO’s responsibility is the Centers for Disease Control and Prevention (CDC). It is well-considered worldwide by many domestic and international public health leaders as a critical partnership, and collaborator with WHO.

For example, the CDC and WHO have joined in the adoption of a One Health approach, which is the interface of human, animal, plant, and ecosystem health. This allows for much more powerful synergistic force multipliers well beyond conventional sectoral siloed approaches to achieve desired prevention, preparation, and response to infectious diseases. We need to achieve institutionalizing the critical One Health model to prevent life-threatening disaster(s) in future.

This is best possible through an international organization concerned with health. Such a broadened approach should be the aim and result of continued and active U.S. membership in reforming WHO to make it better serve its mission, both for the U.S. and for all countries.

Some Reasons Not to Stay

There are other instances, but most recent was WHO’s handling/mishandling throughout the COVID-19 pandemic. It is widely recognized that it began in Wuhan, China, but the cause, whether from an animal or laboratory leak, has not been resolved. One reason is that the People’s Republic of China (PRC), as a major WHO power, has not fully cooperated with the investigation, creating mistrust.

Further, the WHO has suffered from its governance structure with constrained independence to act, reliance on voluntary and inflexible funding which hampers reliability and sustainability of its operations, as well as self-imposed bureaucratic limitations that have slowed more effective action(s) to deal with basic global health security challenges.

Any assessment of WHO’s performance would be remiss if it did not address “political” issues, which should not be swept aside by those in favor of the U.S. staying. Already mentioned is how the PRC thwarted in-depth investigation of the origins of COVID-19. Another example concerns the October 2023 Israeli-Hamas war, during which WHO reports were concentrated on the Gaza numbers of dead and wounded but essentially silent on Hamas’s use of Gaza hospitals as locations for terrorists.

According to Richard Goldberg, a senior adviser at the Foundation for Defense of Democracies and former Trump National Security Council official, “Several international organizations operating in Gaza likely had direct knowledge of Hamas using hospitals as terror headquarters and only publicly protested Israel’s attempt to clear the terrorists. The Red Cross, UNRWA, and World Health Organization — they were all collaborators.” Whether accurate or not, such allegations create a basis for WHO antagonists to mistrust the organization.

Some Reasons to Stay

As mentioned, this organization has undergone some reforms, such as a strengthened International Health Regulations. Going further, according to Bloomberg Business Week and other publications, to cope with the next pandemic, there are measures that fall within WHO’s purview, which include better emerging pathogen control; better tracking of pathogens and variants; greater vaccine availability with more companies; quicker resolution of patent issues, and improved measures in logistics, coordination, and planning.

A stronger and more independent WHO, with its expert staff and access to scientific and other professional and business experts in relation to health problems, infectious diseases, pandemic prevention and control, is well positioned to do what is needed. But only if it is given the wherewithal to do so.

What Trump Can Do if He Chooses

President Trump is known as a tough and effective negotiator. These skills can be extremely valuable when applied to the right objective. If he so decides, he can change the course of global public (and clinical research) health history by pursuing ways to advance U.S. and international public health. He can use these talents to improve WHO (“Make it Great Again”).

In the short time after being elected before being in office, the President significantly helped bring about a ceasefire and hostage release in the Israeli negotiations with the Hamas terrorists. He can bring to bear his skill and have a lasting positive effect — he can do it!