The United States Withdrawal From the World Health Organization: Implications and Challenges

Document Type : Editorial

Authors

1 Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

2 Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK

4 Centre of Excellence for Global Health, Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran

5 Vassar College, Poughkeepsie, NY, USA

6 Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland

7 School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA

8 Institute for Health, Rutgers University, New Brunswick, NJ, USA

9 Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran

10 O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA

11 Keio University, Tokyo, Japan

12 Graduate Institute for International and Development Studies, Geneva, Switzerland

13 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada

14 Health Services Management Centre, University of Birmingham, Birmingham, UK

15 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

16 Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA

17 Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada

18 Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

19 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

Abstract

President Trump’s 2025 decision to remove the United States (US) from the World Health Organization (WHO), echoing his initial 2020 move, raises existential questions about the future of global health governance. This editorial explores the immediate and long-term potential impacts of the withdrawal, noting that it poses a significant threat to the WHO financing. This, in turn, will have adverse consequences for future pandemic preparedness, health inequities, and cross-border collaboration. We also explore the potential role of private philanthropies in bridging the funding gap, against the risk of shifting health priorities away from local needs. For the US, withdrawal means diminished influence on global health policies and weaker alignment with new international regulations. Moving forward, structural reforms within the WHO, equitable contributions from global powers, and renewed US involvement are essential to maintain strong health systems worldwide. Ultimately, a collaborative approach is necessary to uphold collective preparedness against emerging health crises. 

Keywords


  1. World Health Organization (WHO). Basic Documents. 49th ed. Geneva: WHO; 2020.
  2. World Health Organization (WHO). The Access to COVID-19 Tools (ACT) Accelerator. WHO; 2020. Available from: https://www.who.int/initiatives/act-accelerator.
  3. Cohen Z, Hansler J, Atwood K, Salama V, Murray S. Trump Administration Begins Formal Withdrawal from World Health Organization. CNN; 2020. Available from: https://edition.cnn.com/2020/07/07/politics/us-withdrawing-world-health-organization/index.html.
  4. Buse K, Pagel C, Kamarulzaman A, McKee M. President Trump wants an alternative to the World Health Organization: how should we respond? BMJ. 2025;388:r188. doi:1136/bmj.r188
  5. Buse K, Gostin L, Kamarulzaman A, McKee M. The US withdrawal from the WHO: a global health crisis in the making. BMJ. 2025;388:r116. doi:1136/bmj.r116
  6. Kickbusch I. US exit from WHO: it is about much more than WHO. Lancet. 2025;405(10477):444-446. doi:1016/s0140-6736(25)00163-1
  7. World Health Organization (WHO). Financial Flow: By Contributor- United States of America; Updated Until 12-2023. WHO; 2025. Available from: https://open.who.int/2022-23/contributors/contributor?name=United%20States%20of%20America.
  8. Shuham M. CDC Staff Prohibited from Co-Authoring Papers with World Health Organization Personnel. HuffPost; 2025. Available from: https://www.huffingtonpost.co.uk/entry/cdc-who-publicatiolgin-memo_n_67c1eb34e4b0bf54864084cf.
  9. Lerman D, Krawzak PM. Trump’s World Health Organization Funding Cutoff: It’s Complicated. Roll Call; 2020. Available from: https://rollcall.com/2020/04/15/trumps-world-health-organization-funding-cutoff-its-complicated/.
  10. Chorev N. The World Health Organization between the United States and China. Glob Soc Policy. 2020;20(3):378-382. doi:1177/1468018120966660
  11. Castro KG. The World Health Organization and the U.S.: A Brief History of Collaboration. Infectious Diseases Society of America (IDSA); 2020. Available from: https://www.idsociety.org/science-speaks-blog/2020/the-world-health-organization-and-the-u.s.-a-brief-history-of-collaboration#/+/0/publishedDate_na_dt/desc/.
  12. World Health Organization (WHO). Audited Financial Statements for the Year Ended 31 December 2022. Seventy-Sixth World Health Assembly. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_17-en.pdf.
  13. Dear Donald Trump: a letter from Nature on how to make science thrive. Nature. 2025;637(8046):517. doi:1038/d41586-025-00050-1
  14. Bradley E, Taylor LA. Turning the tide: the application of grand strategy to global health. In: Nichols CM, Borgwardt E, Preston A, eds. Rethinking American Grand Strategy. Oxford University Press; 2021.
  15. El-Sadr WM, Holmes CB, Mugyenyi P, et al. Scale-up of HIV treatment through PEPFAR: a historic public health achievement. J Acquir Immune Defic Syndr. 2012;60(Suppl 3):S96-S104. doi:1097/QAI.0b013e31825eb27b
  16. World Health Organization (WHO). Financial Flow: By Contributor- China; Updated Until 12-2023. WHO; 2025. Available from: https://open.who.int/2022-23/contributors/contributor?name=China.
  17. World Bank. GDP (Current US$). World Bank Group; 2023. Available from: https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?most_recent_value_desc=true.
  18. Dieleman JL, Apeagyei AE, Hay SI, Mokdad AH, Murray CJL. The USA's role in global development assistance for health, 2000-30. Lancet. 2024;404(10469):2258-2260. doi:1016/s0140-6736(24)02266-9
  19. World Health Organization (WHO). Contributors by Fund Types. WHO; 2025. Available from: https://open.who.int/2022-23/contributors/top25?name=United%20States%20of%20America.
  20. Breen E, Kumar R. Private Foundations and Their Global Health Grant-Making Patterns: A Rapid Analysis of the Rockefeller Foundation, Wellcome Trust, and Bill and Melinda Gates Foundation. Germany: Global Policy Forum Europe; 2023.
  21. Blunt GD. The Gates Foundation, global health and domination: a republican critique of transnational philanthropy. Int Aff. 2022;98(6):2039-2056. doi:1093/ia/iiac022
  22. Stuckler D, Basu S, McKee M. Global health philanthropy and institutional relationships: how should conflicts of interest be addressed? PLoS Med. 2011;8(4):e1001020. doi:1371/journal.pmed.1001020
  23. Butler CD. Philanthrocapitalism: promoting global health but failing planetary health. Challenges. 2019;10(1):24. doi:3390/challe10010024
  24. Speed E, Mannion R. The rise of post-truth populism in pluralist liberal democracies: challenges for health policy. Int J Health Policy Manag. 2017;6(5):249-251. doi:15171/ijhpm.2017.19
  25. Carnegie A, Clark R, Zucker N. Global Governance under Populism: The Challenge of Information Suppression. University of California Institute on Global Conflict and Cooperation (IGCC); 2024. Available from: https://www.peio.me/wp-content/uploads/2021/papers/PEIOo21_paper_76.pdf.
  26. World Health Organization (WHO). Country & Technical Guidance - Coronavirus Disease (COVID-19). WHO; 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance.
  27. World Health Organization (WHO). World Health Statistics 2024: Monitoring Health for the SDGs, Sustainable Development Goals. WHO; 2024. Available from: https://iris.who.int/bitstream/handle/10665/376869/9789240094703-eng.pdf?sequence=1.
  28. Bush E, Bendix A, Chow D. Science Under Siege: Trump Cuts Threaten to Undermine Decades of Research. NBC News; 2025. Available from: https://www.nbcnews.com/science/science-news/trumps-nih-budget-cuts-threaten-research-stirring-panic-rcna191744.
  29. Wadman M. ‘Wrecking Ball’: RFK Jr. Moves to Fire Thousands of Health Agency Employees. Science; 2025. Available from: https://www.science.org/content/article/wrecking-ball-rfk-jr-moves-fire-thousands-health-agency-employees.
  30. Lay K. Trump Aid Spending Freeze Halts Leading Malaria Vaccine Programme. The Guardian; 2025. Available from: https://www.theguardian.com/global-development/2025/feb/02/trump-aid-spending-freeze-halts-leading-mvdp-malaria-vaccine-programme.
  31. Morton S, Pencheon D, Squires N. Sustainable Development Goals (SDGs), and their implementation: a national global framework for health, development and equity needs a systems approach at every level. Br Med Bull. 2017;124(1):81-90. doi:1093/bmb/ldx031
  32. Brown MD, Bergmann JN, Novotny TE, Mackey TK. Applied global health diplomacy: profile of health diplomats accredited to the United States and foreign governments. Global Health. 2018;14(1):2. doi:1186/s12992-017-0316-7

Articles in Press, Corrected Proof
Available Online from 18 March 2025
  • Receive Date: 05 March 2025
  • Revise Date: 14 March 2025
  • Accept Date: 15 March 2025
  • First Publish Date: 18 March 2025