On January 20, 2025, the United States took a significant and controversial step by issuing an executive order to formally withdraw from the World Health Organization (WHO). This decision reflects a major shift in global health policy and is rooted in a complex tapestry of concerns about the performance and management of WHO during critical health crises, notably the COVID-19 pandemic. Allegations of political influences and financial inequalities among member states were also at the forefront of this decision-making process.
Historically, the relationship between the United States and WHO has been intricate, with the U.S. playing a foundational role in its establishment and ongoing funding initiatives. The U.S. has been a pivotal financial contributor, providing nearly 20% of the total WHO budget. Despite this financial commitment, tensions have sometimes flared due to differing priorities and governance issues within the organization. The executive order withdrawing from the WHO should be viewed as an expression of a particular vision for international relations held by the current U.S. administration, rather than an endpoint in a long-standing relationship that has ebbed and flowed over the decades.
This commentary delves into the underlying historical dynamics that led to the U.S. decision to withdraw from the WHO, and critically evaluates the justifications presented in the executive order. A dual focus on domestic and international consequences reveals a potential erosion of U.S. leadership in global health, alongside significant questions concerning the future of international health cooperation.
Since its inception in 1948, the United States has been central to the development and operations of WHO. The nation’s contributions have supported various crucial health initiatives worldwide, including polio eradication and HIV/AIDS programs. Nevertheless, episodes like the Ebola outbreak and the COVID-19 pandemic highlighted criticisms regarding WHO’s response, raising questions about its operational effectiveness and readiness in handling global health crises. This evolution has occasionally led the U.S. to reconsider its engagement with WHO, reminiscent of patterns witnessed in past decades.
For instance, during President Richard Nixon’s administration in the 1970s, the U.S. withdrew its funding, expressing dissatisfaction with WHO’s approach to global health. Following this, initiatives like structural adjustment programs became more prominent, showcasing a shift in global health priorities toward economically-driven models. This backdrop illuminates the broader narrative of U.S. engagement with WHO—a narrative now once again under scrutiny with the 2025 order.
The U.S. had previously voiced dissatisfaction with WHO’s handling of the COVID-19 pandemic, cataloguing issues related to delays and apparent biases in addressing the crisis effectively. Accusations of undue political influence, particularly from China, arose during critiques of the WHO’s strategies and responses. Moreover, claims of financial inequities among member states exacerbated frustrations, with the U.S. arguing that it bears an unfair burden relative to other nations. These factors coalesce within the framework of a broader demand for reform, emphasizing transparency, accountability, and the necessity for modernized operational procedures within the organization.
As the U.S. prepares to withdraw, experts and critics are raising alarms about the potential ramifications. The significant financial implications tied to U.S. withdrawal from WHO could lead to substantial shortfalls in funding for critical health programs worldwide, affecting initiatives targeted at infectious disease control and maternal and child health.
The implications of this withdrawal underscore a potential leadership vacuum within the global health sphere. The absence of U.S. influence could open avenues for other nations, notably China, to assert dominance within WHO, possibly shifting the global health agenda towards their strategic interests. This shift raises the prospect of fragmented global health responses, detrimental to coordinated action during future public health emergencies.
Critics argue disengagement from WHO undermines not only global health security but also national security for the U.S. The complexities associated with withdrawal could divert resources from urgently needed health initiatives, ultimately shifting focus away from pressing health challenges. Furthermore, the U.S.’s reputation as an active global health leader is jeopardized, with potential long-term consequences for its international relationships and credibility.
One key concern is how U.S. withdrawal may exacerbate existing health disparities, particularly in low- and middle-income countries that have relied heavily on American funding and support. Trends emerging from Africa, Asia, and Latin America suggest that as alliances grow in response to U.S. pullback, new regional health coalitions may arise, asserting their influence over health policy and governance. The strengthening of institutions like the Africa CDC, with a focus on self-reliance, represents an important evolution in global health governance and response capabilities.
The call for reform, articulated in the executive order, also underscores the need for diverse representation within WHO. Advocates stress that a de-escalation of U.S. prominence could lead to innovations in governance, emphasizing equitable access and responses attuned to regional health needs. This pivot in leadership dynamics serves as a reminder of the potential validity of a more collaborative, decentralized approach to global health governance.
Should the United States follow through on its withdrawal, the consequences for WHO and global health may reverberate loudly. The potential transition presents opportunities and challenges alike, reflecting the evolving landscape of global health politics. The U.S. may also have to contend with the unforeseen ramifications of its decision, including shifts in international partnerships and alliances that could redefine how global health priorities are set and addressed moving forward.
Ultimately, while U.S. engagement in global health has historically propelled substantial advancements, the notion of stepping back raises a pivotal question about the future trajectory of health leadership. As new regional alliances reinforce their capacity, the global health landscape might be better positioned to address its challenges, relying more on locally informed strategies and less on dominant frameworks dictated by historically powerful nations. The decision illustrates not just a pivotal moment for the WHO, but a reflection of broader global tensions and changing paradigms of international cooperation. In a world marked by interdependence in health matters, the implications of the U.S. withdrawal resonate beyond the parameters of global health, shaping the contours of future international relations.
image source from：globalizationandhealth
