Global Health in Transition: Understanding the U.S. Exit from the World Health Organization
On January 22, 2026, the United States officially completed its withdrawal from the World Health Organization (WHO), ending a 78-year relationship with the global health agency. This moment marked an unprecedented shift in U.S. engagement with international health coordination and sparked widespread debate among governments, experts, and communities worldwide.
The move has far-reaching implications for how nations prepare for and respond to global health threats — from pandemics to chronic disease outbreaks — and reshapes the role of multilateral institutions in promoting public health in the 21st century.
A Brief History: The United States and the WHO
The World Health Organization was established in 1948 as a specialized agency of the United Nations dedicated to coordinating global public health. Its mandate includes setting norms and standards, assessing health trends, assisting countries with their health systems, and responding to disease outbreaks. The United States was a key founding member and, for decades, one of the WHO’s most significant financial contributors.
U.S. funding to the WHO traditionally consisted of assessed contributions (mandatory dues based on a member’s wealth and population) and voluntary contributions earmarked for specific programs, including vaccine campaigns and emergency health responses. Historically, the U.S. provided hundreds of millions of dollars annually to support WHO operations and global health programs.
A unique aspect of this relationship was America’s influence over WHO priorities, often reflected in leadership participation, scientific collaboration, and embedded health professionals from agencies like the Centers for Disease Control and Prevention (CDC).
What Led to the Withdrawal?
Political and Policy Drivers
The decision to withdraw was formally initiated by President Donald Trump early in his second term. On January 20, 2025, he signed Executive Order 14155, which directed the U.S. government to exit the WHO and end its participation in the organization.
The Trump administration cited several key reasons for this move:
- Criticism of WHO’s handling of the COVID-19 pandemic, including claims the agency failed to act quickly or transparently.
- Perceptions of political bias and influence from member states deemed hostile to U.S. interests.
- Calls for urgent reform within the WHO that, according to U.S. officials, were not sufficiently met.
Officials argued that withdrawing from the WHO would give the U.S. greater control over its own health policy priorities and reduce its financial contributions to what they viewed as ineffective multilateral bureaucracy.
Legal and Legislative Context
Under U.S. law, participation in the WHO originates from a congressional act in 1948. Withdrawal requires one year’s notice — a process initiated by the presidential directive.
However, there has been legal debate about whether the President can unilaterally withdraw the U.S. without explicit approval from Congress. Critics argue that because the U.S. entered into the WHO framework through a legislative act, a similar legislative backing may be required to reverse that decision.
What Does the Withdrawal Mean?
Impact on Global Health Infrastructure
The U.S. exit carries significant implications for global disease surveillance, pandemic preparedness, and collaborative research:
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Loss of Membership Privileges
The U.S. no longer participates in formal WHO committees and governance bodies that shape global health policy and standards. -
Data Sharing and Surveillance Gaps
Previously, WHO coordinated international health data exchange — vital for tracking diseases like influenza or emerging viruses. U.S. scientists may now face restricted access to this centralized information, making it harder to respond quickly to new threats. -
Vaccine and Treatment Coordination
WHO plays a central role in convening experts to guide decisions on vaccine strain selection and distribution strategies. With the U.S. outside the organization, decision-making processes could fragment, potentially delaying responses during outbreaks.
Financial and Operational Consequences
The U.S. withdrawal also has financial repercussions:
- The U.S. ceased paying assessed dues and voluntary contributions for the 2024–2025 period, leaving a reported balance of more than $130 million owed to the WHO.
- For the WHO, the loss of U.S. funding — historically around 18% of its core budget — precipitated budget cuts and staff reductions.
These cuts have forced the WHO to reprioritize programs and reduce operational scope, especially in regions with fragile health systems.
Reactions and Perspectives
Criticism from Health Experts
Many public health professionals have been outspoken in their criticism:
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Scientific Concerns: Experts warn the withdrawal undermines global cooperation essential for managing infectious disease threats. They argue that pathogens do not respect national borders, making collaboration critical for health security.
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Reduced Preparedness: Analysts suggest that without access to WHO’s surveillance networks, the U.S. and other countries may be slower to detect and respond to outbreaks, increasing the risk of large-scale health emergencies.
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Global Health Equity: Leaving the WHO could diminish support for health programs in low- and middle-income countries, where WHO technical assistance and vaccine distribution efforts have been crucial.
Support and Alternative Approaches
Supporters of the decision emphasize:
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Sovereignty: They argue that U.S. health policy should be crafted independently, without reliance on international directives.
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Bilateral Partnerships: Officials have stated that the U.S. will pursue direct health agreements with other countries and organizations as alternative forums for cooperation.
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Some U.S. domestic agencies, such as CDC and National Institutes of Health (NIH), continue to engage internationally on technical matters even as formal WHO engagement ends.
Global Political Signals
The exit also sends broader geopolitical signals:
- Some governments see the move as a shift toward unilateralism and skepticism of multilateral institutions.
- Other countries and regions have reaffirmed their commitment to WHO and international health cooperation in response.
For example, California — a U.S. state — joined WHO’s Global Outbreak Alert & Response Network, highlighting sub-national efforts to maintain ties with global health systems.
How This Affects People Around the World
Public Health and Disease Control
For everyday people, the withdrawal could mean:
- Slower outbreak detection: Without centralized WHO data systems, governments may detect and respond to new viruses or disease trends more slowly.
- Vaccine strategy challenges: Guidance on vaccine updates — especially for seasonal illnesses like flu — may become less coordinated, potentially impacting effectiveness.
- Weakened support in vulnerable regions: WHO programs crucial to combating polio, Ebola, and other diseases could face funding shortfalls, affecting vulnerable populations.
Economic and Social Effects
Public health instability can ripple into broader social and economic areas:
- Healthcare systems may incur higher costs responding to outbreaks without global support.
- Travel and trade disruptions could increase if health surveillance systems are fragmented.
- Inequities between wealthy and poorer regions may widen without coordinated global initiatives.
Looking Ahead: Future Outlook
The U.S. withdrawal from the WHO sets a new trajectory for global health governance. Here’s what to watch in the years ahead:
1. New Health Partnerships and Alliances
The U.S. government has signaled plans to expand bilateral health agreements with individual countries and organizations to fill gaps left by WHO exit. The effectiveness of such arrangements will be a key indicator of how global health cooperation evolves.
2. Ongoing Debate over Rejoining
Though U.S. officials have ruled out rejoining in the near term, changing political leadership or global health emergencies could reopen discussions about joining or reengaging with the WHO.
3. WHO Adaptation and Reform
The WHO itself is adapting to the loss of a major member and financial contributor. This includes budget restructuring and prioritizing core programs. Other member states may increase their contributions or take on leadership roles to stabilize the organization.
Conclusion
The completion of the United States’ withdrawal from the World Health Organization marks a historic shift in international public health engagement. The decision reflects deep tensions over how global health governance should function and the balance between national sovereignty and international cooperation.
While proponents argue the move strengthens national control, critics warn it weakens global health systems and undermines collective efforts to prevent, detect, and respond to disease threats. The full effects will unfold over years, with implications for public health, diplomacy, and global stability.
What is clear is that the dynamics of international health collaboration are changing, and the world will be monitoring both the consequences and responses closely.