At the end of January 2026, Donald Trump’s administration officially confirmed the United States’ withdrawal from the World Health Organisation. The decision took effect one year after the president signed an executive order on the day of his second term inauguration. Trump first announced his intention to leave the organisation in 2020 at the beginning of the COVID-19 pandemic.
The severing of ties with the WHO will have long-term consequences for the public health system both in the US and beyond. Jordan Miller, a professor of public health at Arizona State University, explains what this move means in the short and long term.
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Why is the US leaving the WHO?
The White House stated that the United States pays disproportionately large contributions to the organisation’s budget. China is cited as an example, with a population three times larger than that of the United States, but a financial contribution that is 90% smaller, according to the administration’s estimates. Accusations were also made against the WHO regarding its inadequate response to the COVID-19 pandemic and lack of transparency.
The WHO rejected these claims. The organisation emphasised that its recommendations during the pandemic were based on available scientific data and included wearing masks and physical distancing.
Financially, the United States remained the largest donor to the WHO. In 2023, US contributions were almost three times higher than funding from the European Commission and about half as much as contributions from Germany, the second largest donor. Health experts note that investing in crisis prevention and rapid response costs significantly less than dealing with the consequences of epidemics after they have spread on a large scale.
The withdrawal procedure turned out to be more complicated than it initially appeared. Most countries do not have a formal mechanism for terminating membership, but the United States provided for this possibility in its own accession to the organisation. The conditions are one year’s notice and full payment of contributions. Despite giving notice, Washington still owes about $260 million for 2024–2025. The legal aspects of this process remain a matter of debate.
What does the US withdrawal from the WHO mean in the short term?
In the short term, the US withdrawal reduces the potential for international cooperation in the field of health. Among the WHO’s priorities are containing infectious diseases, combating antimicrobial resistance, responding to natural disasters, ensuring access to medicines and preventing chronic diseases. Many challenges require coordination between countries, as pathogens do not recognise national borders.
Due to the loss of a significant portion of its funding, the organisation has announced that it will cut approximately 2,300 employees, or a quarter of its staff, by the summer of 2026. The number of departments is planned to be reduced from ten to four.
American experts have participated in joint WHO programmes for years. Examples include responses to Ebola outbreaks, the spread of mpox, and Marburg virus outbreaks in Rwanda and Ethiopia. The mortality rate for Ebola and Marburg averages 50%, so containing these infections before they spread globally was crucial.
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What will be the long-term consequences of the US withdrawal from the agreement?
In the long term, the United States will lose its participation in the Global Influenza Surveillance and Response System, which has been in operation since 1952. It is within this system that recommendations are made regarding the composition of annual influenza vaccines. Data is collected worldwide, analysed by international experts, and then twice a year the WHO determines which strains should be included in the vaccine.
American manufacturers will be able to refer to the published findings, but the US will not participate in the analysis of data and will not provide information to the same extent. This creates a risk of discrepancies between international recommendations and the position of US health authorities.
According to estimates by the US Centres for Disease Control and Prevention, millions of people fall ill with influenza every year, hundreds of thousands are hospitalised, and tens of thousands die. Weakening the mechanisms for preparing for seasonal outbreaks could affect these figures.
The withdrawal also affects the international authority of the United States in the field of public health. For decades, the country has shaped its role as one of the key developers and implementers of global programmes. Reduced participation in multilateral initiatives limits the ability to influence international strategies and coordinate responses to new crises.
Analysts suggest that China may strengthen its role in the WHO. Beijing has pledged an additional $500 million in support to the organisation over the next five years.
Membership in the WHO provided the US with rapid access to detailed data on new threats. Although most of the information eventually becomes public, member countries receive it earlier and with expanded explanations of collection methods. Delays in accessing such data could complicate responses to future outbreaks of infection.
Can the US return under the leadership of a new president?
The United States may return to the organisation if the new president decides to do so. The WHO has stated that it regrets the United States’ withdrawal and hopes that this decision will be reconsidered.
Alternative initiatives have already emerged at the state level. California has joined a global outbreak alert and response network that is open to a wider range of participants. The state has also co-founded the West Coast Health Alliance, which includes 14 states. Governor Gavin Newsom has initiated a programme to strengthen public health infrastructure with the participation of former federal officials.
The federal government’s decision changes the architecture of international cooperation in the field of health. The consequences of this step will determine the ability of the United States and its partners to respond to new challenges in a world where epidemiological risks remain a constant factor in global security.
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