US President Trump initiated the U.S. withdrawal from the WHO, accusing it of mishandling the COVID-19 pandemic and favoring China.

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Executive Order on U.S. Withdrawal from WHO

• Termination of Membership: The order formally initiates the process for the United States to withdraw from the World Health Organization (WHO) within 12 months, in accordance with the rules governing WHO membership.
• Ceasing Financial Contributions: All U.S. financial contributions to WHO, including assessed and voluntary funding, will stop immediately.
• Reallocation of Resources: Funds previously allocated to WHO will be redirected to other international and domestic health initiatives that align with U.S. priorities.
• Exit from Pandemic Treaty Negotiations: The US will cease its participation in negotiations for the WHO’s pandemic treaty.
  • The executive order explicitly states that any actions under this treaty will not bind the US.
• Call for Reform: The order emphasizes the need for reforms within WHO to improve transparency, accountability, and equitable burden-sharing among member nations.

Reasons for U.S. Withdrawal from WHO

• Alleged Mishandling of COVID-19: The U.S. accused WHO of delayed response and inadequate measures in the early stages of the pandemic.
  • WHO declared COVID-19 a Public Health Emergency of International Concern (PHEIC) on January 30, 2020, but faced criticism for relying on incomplete information from China.
• Perceived Bias Towards China: Trump administration alleged that WHO favored China, undermining its impartiality.
  • WHO praised China’s transparency, despite concerns about suppressed early reports of human-to-human transmission.
  • China’s assessed contribution to WHO was 15% (~$87.6M), significantly less than the U.S., raising questions about WHO’s political motivations​.
• Failure to Adopt Reforms: U.S. criticized WHO for resisting structural reforms to improve governance and accountability.

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• • WHO faced scrutiny for insufficient funding diversification, with only ~20% of its budget coming from assessed contributions and overdependence on voluntary funding (~80%).
• Financial Burden on the U.S.: The Trump administration viewed U.S. contributions as disproportionately high compared to other nations.
  • The U.S. accounted for 22.5% of assessed contributions ($138M) and 13% of voluntary contributions ($356M in 2023), while China’s voluntary contribution was just 0.14% ($3.9M), amplifying U.S. concerns about inequitable burden-sharing​.
• Insufficient Accountability: The U.S. accused WHO of lacking transparency and accountability in its decision-making processes.
  • Criticism over WHO’s delayed investigation into the origins of COVID-19 in China fueled mistrust.
  • Calls for independent audits and reforms in WHO’s response protocols have grown post-pandemic.
• Political Motivations and Domestic Agenda: Withdrawal aligned with Trump’s “America First” policy, appealing to domestic audiences critical of international organizations.
  • The move mirrored prior U.S. withdrawals from multilateral agreements like the Paris Climate Accord and the Trans-Pacific Partnership.

WHO’s Role in Global Health

• Disease Prevention and Control: Leads global efforts to eradicate infectious diseases like polio and smallpox.
  • Provides technical support for disease prevention and management of non-communicable diseases (NCDs).
  • WHO’s Global Malaria Programme reduced malaria mortality by 60% between 2000 and 2015.
• Pandemic Preparedness and Response:Coordinates global responses to health emergencies and pandemics.
  • Provides guidelines, training, and resources for outbreak containment.
  • WHO declared COVID-19 a Public Health Emergency of International Concern in January 2020, mobilizing resources globally.
• Health Equity and Access: Promotes equitable access to vaccines, medicines, and healthcare services, especially in low-income countries.
  • Manages global initiatives like COVAX for vaccine distribution.
  • WHO’s Expanded Programme on Immunization (EPI) improved vaccination coverage worldwide.
• Health Policy and Guidelines: Develops international health guidelines and standards.
  • Provides evidence-based recommendations for healthcare interventions.
  • WHO’s Framework Convention on Tobacco Control (FCTC) has influenced global anti-tobacco policies.
• Building Health Systems: Supports countries in strengthening healthcare infrastructure and workforce capacity.
  • Assists in establishing universal health coverage (UHC).
  • WHO collaborates with governments to implement primary healthcare systems in underserved regions.
• Data Collection and Research: Monitors global health trends and compiles data on diseases, mortality, and healthcare access.
  • Funds and supports global health research.
  • WHO’s World Health Statistics provides crucial health data for policymaking.
• Advocacy for Global Health Priorities: Advocates for funding and political commitment towards health initiatives.
  • Raises awareness about emerging global health threats.
  • WHO’s campaigns on antimicrobial resistance (AMR) have mobilized international action.

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Challenges Faced by WHO in Funding

• Overdependence on Voluntary Contributions: Around 80% of WHO’s funding comes from voluntary contributions, often earmarked for specific projects.
  • Reduces flexibility for WHO to allocate resources to urgent or emerging health crises.
• Stagnation of Assessed Contributions: Assessed contributions, which are mandatory and provide stable funding, have remained unchanged for decades.
  • These now cover less than 20% of WHO’s budget, limiting its core operational capacity.
• Disproportionate Burden on Major Donors: A few countries (e.g., U.S. contributes 22.5%) and organizations (e.g., Bill & Melinda Gates Foundation) burdens the majority of funding.
  • Withdrawal or reduced contributions by major donors, like the U.S., create significant financial shortfalls.
• Dependence on Philanthropic Organizations: Heavy reliance on private entities for funding raises concerns about influence and priority-setting.
  • Private donors may focus on specific agendas, potentially sidelining comprehensive global health needs.
• Unpredictability of Voluntary Contributions: Voluntary funding varies annually and is influenced by geopolitical and economic conditions.
  • In 2024, WHO secured only 53% of its required $7.1 billion budget for 2025-28 programs.
• Limited Contributions from Emerging Economies: Emerging economies contribute minimally to WHO’s budget despite their growing global influence.
  • This creates an overreliance on developed nations and limits the financial diversity needed for stability.
  • China’s voluntary contribution in 2023 was only $3.9M (0.14% of voluntary funds), despite being the world’s second-largest economy.

Impact of US withdrawal from WHO

Impact on WHO

• Funding Shortfall: The U.S. contributed 22.5% of assessed contributions ($138M) and 13% of voluntary contributions ($356M in 2023), amounting to ~20% of WHO’s budget.
  • The loss of funding threatens global health initiatives like HIV/AIDS programs, vaccine distribution, and disease eradication.
• Program Disruption: Major health programs, including those for tuberculosis, polio, and malaria, face potential delays or halts.
  • WHO’s ability to address emergencies, such as pandemics, is severely constrained.
• Weakened Leadership: U.S. expertise, including contributions from agencies like the CDC, is critical for technical guidance and health policy frameworks.
  • Potential increase in reliance on other nations, such as China, for leadership and funding.

Impact on Global Health

• Pandemic Preparedness and Response: Reduced resources and expertise weaken WHO’s ability to coordinate global responses to health emergencies.
  • Delayed responses to new pandemics or outbreaks could lead to higher mortality and economic losses globally.
• Erosion of Multilateralism: U.S. withdrawal undermines collective global action and fosters geopolitical divisions in health governance.
  • Increased dependence on voluntary contributions from private organizations and smaller nations creates instability.
• Equity Challenges: WHO’s initiatives for equitable access to vaccines and medicines, especially in low-income countries, are at risk.
  • Programs like COVAX may suffer reduced funding, hindering vaccine distribution in developing nations.

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Impact on India

• Disruption of Health Programs: WHO-supported initiatives in India, including immunization campaigns, antimicrobial resistance programs, and vector-borne disease control, may face funding gaps.
• Reduced Technical Support: WHO’s guidance in managing public health challenges, such as non-communicable diseases and pandemics, could weaken.
• Increased Regional Leadership: India may need to step up as a regional health leader to fill the void left by the U.S., increasing its funding and policy contributions to WHO.
• Global Vaccine Supply: As a major vaccine producer, India could face challenges in coordinating global vaccine programs due to WHO’s resource constraints.

India’s Role in Strengthening WHO and Global Health

• Leadership in Global Health Governance: India can leverage its position in the Global South to advocate for reforms in WHO, ensuring equitable representation and decision-making.
  • Utilize platforms like G20, BRICS, and NAM to push for more inclusive global health policies.
• Increased Financial Contributions: India can enhance its assessed and voluntary contributions to WHO to fill funding gaps.
  • Gradually increase its financial support, showcasing commitment to global health security.
• Regional Health Leadership: India can lead regional collaborations in South Asia to strengthen health systems and tackle transboundary health issues.
  • Initiatives under SAARC or BIMSTEC for coordinated responses to pandemics and disease control.
• Vaccine Diplomacy: As a major vaccine producer, India can strengthen WHO-supported programs like COVAX by supplying affordable vaccines to low-income countries.
  • Expand initiatives like Vaccine Maitri, providing vaccines to nations in need.
• Capacity Building in Developing Nations: Share expertise and resources to strengthen health systems in low- and middle-income countries.
  • Offer training programs for healthcare professionals through partnerships with WHO.

Way Forward for Addressing WHO’s Funding Impacts and Challenges

• Increase Assessed Contributions: Member states should agree to raise mandatory assessed contributions to reduce dependence on voluntary funding.
  • Revising the contribution formula to reflect current global economic realities can ensure more stable funding.
• Diversify Funding Sources: WHO should explore partnerships with regional organizations, private sector entities, and non-traditional donors.
  • Example: Engage emerging economies like India and Brazil to increase their contributions.
• Establish Emergency Reserve Funds: Create dedicated emergency funds to address global health crises without diverting resources from existing programs.
  • Similar to the Contingency Fund for Emergencies (CFE), expand reserves with multi-stakeholder contributions.
• Promote Accountability and Transparency: Strengthen reporting mechanisms for donors to ensure funds are used efficiently.
  • Publish detailed annual financial reports and impact assessments for all contributions.
• Engage Philanthropic and Private Sector Partners: Balance partnerships with private organizations to address specific health challenges while maintaining WHO’s independence.
  • Expand collaborations with global health initiatives like Gavi and the Global Fund.
• Regional Self-Reliance: Encourage regional collaboration to fund localized health programs.
  • African Union or ASEAN-led initiatives for regional health crises.
  • Reduces WHO’s financial burden while building regional health capacities.
• Advocate for Multilateral Health Funding: Mobilize international advocacy for increased global investments in health security.
  • Encourage nations to view health funding as critical to global security and economic stability.
  • Secures long-term financial commitments from member states and private sectors.

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Conclusion

The U.S. withdrawal from WHO poses significant challenges to global health governance, funding, and equity. Addressing these impacts requires increased financial contributions, greater regional collaboration, and reforms to strengthen WHO’s transparency and resilience, ensuring its ability to safeguard global health security.

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