While most of the Trump health-related policies will primarily impact on Americans, and especially the poorest and most discriminated against, the biggest international impact will come from Trump’s decision to begin the process of withdrawing from the World Health Organization.
Trump made a similar push to leave WHO relatively late in his first term but did not complete the withdrawal, because Joe Biden won the election and halted the process as soon as he took office in January 2021.
The process of exiting the organization takes about a year, leaving WHO a small window to find a new top donor. The U.S. contributed a combined $1.3 billion to the organization in 2022 and 2023, making it the biggest donor, with 22% of mandatory contributions.
The risk is that global initiatives spearheaded by WHO to eradicate diseases such as HIV, polio and Ebola and improve public health will be harmed without US support, even as outbreaks of avian flu remain a risk to the USA as well as poorer countries.
Lawrence Gostin, a professor of global health at Georgetown University in Washington and director of the WHO Collaborating Center on National and Global Health Law told Reuters: “This is the darkest day for global health I’ve ever experienced. Trump could be sowing the seeds for the next pandemic.”
Announcing his decision, Trump argued that the WHO had “mishandled” the COVID-19 pandemic and other international health crises.
Trump said the WHO had failed to act independently from the “inappropriate political influence of WHO member states,” and required “unfairly onerous payments” from the U.S. that were disproportionate to the sums provided by other, larger countries, such as China.
“World Health ripped us off, everybody rips off the United States. It’s not going to happen anymore,” Trump said at the signing of an executive order on the withdrawal, shortly after his inauguration to a second term.
Ironically China, which is currently the second largest donor with just over 15% of mandatory contributions, would become the mainstay and its influence in the WHO would be increased by a US withdrawal.
The WHO responded to the planned US withdrawal by noting
“The United States was a founding member of WHO in 1948 and has participated in shaping and governing WHO’s work ever since…. For over seven decades, WHO and the USA have saved countless lives and protected Americans and all people from health threats. Together, we ended smallpox, and together we have brought polio to the brink of eradication. American institutions have contributed to and benefited from membership in WHO.
“… We hope the United States will reconsider and we look forward to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe.”
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