This week the US officially exited the World Health Organization, ending nearly 80 years of membership and financial support. The president has made it clear that the U.S. won’t resume payments or take part in WHO governance for the rest of his term.
Note: the Biden Administration pre-paid 2025 dues a couple of days before he left office – which is why the US official exit from WHO didn’t happen until this week.
At first this looks like a setback for global health. The US had been the largest contributor to WHO’s budget, and our exit triggered concern among some that the WHO’s ability to carry out its work effectively will be harmed because reduced funding (due to the US no longer paying dues). That raises concerns that disease surveillance, outbreak response, and vaccine coordination will weaken.
But, as I argued in my blog a year ago, there’s another way to look at it: losing U.S. influence during the next 3 years is, in fact, a good thing – as long as other countries step up and backfill the missing US dues.
Why? Because this US administration (e.g. Kennedy/Rubio) will no longer have influence on the WHO Executive Board and World Health Assembly – and will no longer be able to push politically driven and non-evidence-based WHO programming. That leaves the WHO free to focus on its core mission by protecting health with evidence and science without harmful interference by the US.
The US had been contributing 18% of WHO’s overall budget, initially creating a $760M funding gap in their 2-year budget. Thankfully, other countries and philanthropic organizations (e.g. Novo Nordisk Foundation) have stepped in to backfill the US former dues.
China has committed $500M and contributions from other countries total about $170M (e.g. Switzerland $40M, Sweden $13M, Angola $8M, Qatar $6M). That brings global pledges to roughly $670M… 88% of the U.S. funding loss (once the checks arrive).
That leaves a shortfall of about $90M right now, around 2% of WHO’s total 2-year budget. In practical terms, that’s a modest reduction, and one WHO should be able to absorb by prioritizing higher impact projects and lowering or dropping low value or politically imposed initiatives.
A 2% cut is unlikely to damage WHO’s core functions. What matters most is how WHO chooses to distribute scarce resources. WHO now has the flexibility to end any program that had been pushed by the US in the last year and bring back programs that were effective and evidence-based that the US was discouraging (e.g. vaccination campaigns in developing nations).
WHO’s most critical work will remain intact. Disease surveillance and outbreak detection networks will continue to operate; mechanisms for vaccine quality assurance and prequalification will remain in place; and long-term disease control programs (polio, measles, malaria) will still have global support. These are the functions that matter most for health outcomes in low-income countries.
So, while the WHO may end up with a slightly smaller budget, they will also be less subject to harmful and politically driven interference by people like Kennedy and Rubio over the next 3 years.
For example, Kennedy will no longer be able to use the US’ former position on the WHO Executive Board to kill vaccination campaigns in developing nations and vaccine distribution work for polio eradication etc.
Indeed, the WHO is arguably in better shape now than it was last week because the Trump Administration no longer has influence at the WHO.
It’s entirely possible (even likely) that 3 years from now the US will rejoin the WHO under leadership that is again committed to science, multilateral cooperation, and improving health outcomes in developing nations.
When that happens, U.S. engagement could again strengthen global health security.
Until then, WHO will work with a slightly smaller budget but with fewer political constraints and may emerge more focused & effective.
