This article explores the intricate separation between the United States and the World Health Organization, a move initiated by the Trump administration. It details the unique legal standing of the U.S. within the WHO, the financial disagreements surrounding the withdrawal, and the far-reaching implications for global health cooperation and disease surveillance.
Unraveling the Ties: America's Departure from Global Health Leadership
A Contested Parting: The U.S. and WHO's Tumultuous Relationship
Exactly one year prior to this week, then-President Trump set in motion a profound split from the World Health Organization. Following his inauguration, he issued an executive order expressing his intention to sever ties with the global health body. This directive cited the organization's purported mishandling of the COVID-19 pandemic, originating from Wuhan, China, and its alleged failures in addressing other global health crises. The order also criticized the WHO's inability to implement necessary reforms and maintain independence from political influences of member states.
Repeated Attempts: Trump's Second Bid for Disengagement
This marked the second instance of President Trump attempting to withdraw the United States from the WHO. His initial endeavor began in 2020, during the height of the COVID-19 pandemic, but this decision was subsequently reversed by President Biden on his first day in office. Now, in this renewed effort, the separation appears to be on the verge of finalization, as a one-year notice period, a condition of the U.S. agreement with the WHO, has been served.
A Knotty Uncoupling: The Financial Hurdle to Withdrawal
However, like many complex separations, this one is fraught with complications. WHO officials highlight two prerequisites for withdrawal: the one-year notice, which would set the official withdrawal date as January 22nd, and the payment of all outstanding dues. The latter presents a significant challenge, as the U.S. currently owes a substantial sum of $278 million for the 2024-2025 period and has no intention of settling this debt. The State Department has explicitly stated that no payments will be made prior to withdrawal, citing the heavy costs already borne by the U.S. taxpayer and economy due to the WHO's alleged failures during the pandemic.
Legal Perspectives: A Contentious Financial Standoff
Lawrence Gostin, a prominent professor of global health law at Georgetown University, likens the situation to a contentious divorce, where one party refuses to pay while demanding separation. He argues that leaving without fulfilling financial obligations is unlawful. Nevertheless, Gostin believes there are no immediate legal impediments to the president's decision, given the absence of ongoing litigation or congressional opposition. The State Department further asserts that the WHO's opinions do not constrain U.S. actions and are merely sources of "meaningless headlines." Brett Schaefer, a senior fellow at the American Enterprise Institute, supports the U.S.'s sovereign right to withdraw, dismissing the WHO's stance as "juvenile."
WHO's Stance: A Call for Reconsideration and Cooperation
The WHO's principal legal officer, Steven Solomon, explains that the organization's constitution does not include a withdrawal clause, a deliberate decision by its founders to ensure a universal approach to global health. However, the U.S. secured a unique exception in 1948, allowing it to withdraw. The WHO maintains that it is ultimately up to its 193 member states to determine the effectiveness of the U.S. withdrawal, especially concerning the unpaid dues. Director-General Tedros Adhanom Ghebreyesus has urged the U.S. to reconsider its decision, emphasizing that cooperation, not money, is paramount for global health security, warning of a "lose-lose" scenario if the U.S. isolates itself.
Consequences of Disengagement: Threats to Global Health Preparedness
Gostin expresses concern that a complete severance of ties could lead to the WHO restricting U.S. access to critical resources, such as viral specimens and disease outbreak data. This could significantly hinder the U.S.'s ability to develop essential vaccines, including seasonal flu shots and those for future pandemic strains, and impede its participation in vital surveillance networks for diseases like measles. Such a lockout, he warns, would leave both the U.S. and the wider world vulnerable to infectious disease spread. Dr. Gavin Yamey of Duke University describes this potential outcome as a "tragedy," highlighting its extreme and unprecedented nature.
Alternative Engagements and the Prospect of Continued Interaction
Conversely, Schaefer of the American Enterprise Institute suggests that the U.S. remains engaged in global health through other United Nations agencies, such as UNICEF and UNAIDS. He also believes that even without formal membership, the U.S. and WHO could maintain cordial contact, particularly in areas of mutual interest like the Epidemic Intelligence from Open Sources (EIOS) platform, which is crucial for identifying potential pandemics. He hopes the WHO would not "pettily" block U.S. participation, as building a similar global surveillance system outside the WHO would be immensely challenging. However, the State Department has indicated that beyond activities related to the withdrawal itself, the U.S. will not participate in regular WHO-led or managed events.
