In summer in 2020, 15 recognized leaders in US public health gathered to author an article in The Lancet—one of the most prominent medical journals in the world—condemning Donald Trump's intention to withdraw the US from the World Health Organization, a decision President Biden later reversed before it took effect.
Nearly five years later, one of the opening salvos of Trump's second term was the start the withdrawal process again the US from the WHO. The move is already causing both controversy and the threat of legal challenges.
According to a 1948 joint resolution passed by both houses of Congress, any such withdrawal would require the US to give the WHO a year's notice, but Trump's intentions appear to be to withdraw immediately and do so without seeking approval of congress.
“The executive order is announcing an immediate withdrawal from the WHO, and he's not asking for congressional approval, and he's not giving the required one-year notice,” said Lawrence Gostin, a health law professor. of the public at the Georgetown University Law Center in Washington, DC, and is one of the co-authors of the 2020 Lancet article. “In my view, it's reckless and it's illegal, and it needs to be challenged in court.”
Trump has a long history of criticizing the WHO, previously accusing the organization of being “corrupt,” usurping America, and “grossly mismanaging and covering up” the spread of Covid-19. The US used to be one of the WHO's biggest funders, with some estimates suggesting it provides a fifth of the organization's entire budget. Between 2022 and 2023, the US gave WHO the nearly $1.3 billion.
However, Gostin and others are particularly concerned about the effects of a US withdrawal on the country's ability to manage the ongoing threat of infectious diseases. Although the WHO has a wide range of purposes, from advice on essential medicines to public policy recommendations on everything from tobacco and drug use to road safety, it is probably most effective when it comes to monitoring on potentially problematic new diseases, such as bird flu, and coordinating the international response.
“Leaving the WHO makes the world lonelier, weaker, and more fragile,” Gostin said. “You can't close a border against a pathogen. We need WHO on the ground to put out the fire before they reach the United States. And we also need WHO's vast network to provide us with information about those mutations and viruses we need to develop life-saving vaccines and medical treatments.”
According to Sten Vermund, chief medical officer of the Global Virus Network and another co-author of The Lancet article, what happens next depends on the reactions of other countries and non-governmental organizations such as Bill and Melinda Gates. Foundation, the World Bank, and Gavi, the Vaccine Alliance, all of which provide WHO with significant funding. After Trump cuts US contributions to WHO to $680 million in 2020–21, Germany respond by quadrupling its contribution to more than $1 billion. The Danish government agreed too to double its contributions, placing a strong emphasis on improving sexual and reproductive health and tackling the rise of non-communicable diseases.
