Donald Trump’s withdrawal from the WHO undermines global health security, jeopardising disease control efforts, climate resilience programs, and pandemic preparedness. As the world faces rising health threats, the absence of US leadership weakens international cooperation and leaves a dangerous gap in global health governance.
On 20 January 2025, President Donald Trump signed an executive order withdrawing the United States (US) from the World Health Organization (WHO). This decision reverberated across the globe, not just for its immediate financial implications but for the far-reaching consequences for global health security. At a time when the world faces complex challenges—including climate change-driven health risks, the rise of new pathogens, and the growing dual-use concerns of artificial intelligence (AI) and synthetic biology—this withdrawal significantly weakens a key pillar of international health governance. As the single largest financial and technical contributor to the WHO, the withdrawal puts billions of lives at risk and undermines global progress on disease control, health equity, and pandemic preparedness.
For decades, the WHO has been a cornerstone of global health, particularly in supporting developing nations. Its efforts have brought monumental achievements, including the eradication of smallpox and the near-elimination of polio. Through its Global Polio Eradication Initiative, since 1988, the WHO has reduced polio cases by 99 percent. However, progress remains fragile. In 2024, Pakistan reported 73 cases of wild poliovirus, while Afghanistan recorded 25, up from six the previous year. Polio cases are expected to rise further due to disrupted vaccination campaigns, including Taliban-imposed restrictions on female healthcare workers in Afghanistan, coupled with resource shortages. A senior WHO official has warned that polio eradication efforts in both Afghanistan and Pakistan are now at risk following the suspension of US funding, which has historically supported immunisation efforts in these countries. The United States has historically contributed nearly 20 percent of the WHO’s total budget—amounting to between US$100–$122 million annually in membership dues, plus US$1.3 billion in voluntary funding in 2022–2023. This financial deficit will be nearly impossible to fill, as no single nation can match the scale of US contributions without introducing political and operational biases that could compromise the WHO’s neutrality.
Additionally, the WHO has been indispensable in addressing the health impacts of climate change. Rising global temperatures and changing ecosystems have expanded the geographic range of disease vectors, such as mosquitoes, leading to surges in diseases like malaria and dengue fever. In 2024, the Americas reported a record 12.6 million dengue cases, nearly triple the previous year’s figure. The WHO’s Climate Change and Health Unit has been pivotal in helping over 30 countries build climate-resilient health systems. Through initiatives like the “Health in the Context of Climate Change” framework and the Framework for Climate Resilient and Low-Carbon Health Systems, the WHO provides technical support and guidance to mitigate the health effects of rising temperatures. However, these programs rely heavily on sustained funding and international cooperation. Without US contributions, such initiatives risk collapse, leaving developing nations—already the most vulnerable to climate change—without the support needed to adapt their health systems to these mounting challenges. The WHO’s biennial budget for 2024–2025 is $6.83 billion, with the US previously contributing around 15.6 percent. Without US funding, the WHO faces a major shortfall, potentially forcing budget cuts and diverting funds from new initiatives—such as AI governance and climate-resilient health systems—to more urgent programs like polio eradication and health emergencies.
The interplay between climate change and zoonotic diseases further amplifies global health risks. A 2022 study published in Nature Climate Change revealed that 58 percent of human infectious diseases have been exacerbated by climate hazards, including floods, droughts, and heatwaves. The WHO has led global efforts to address these risks through its Global Strategy for Zoonotic Diseases, which focuses on early detection, research funding, and coordinated responses. The organisation also plays a central role in global disease surveillance, maintaining systems that track emerging pathogens in real-time. Yet, the US withdrawal undermines these surveillance efforts, increasing the likelihood of delayed responses to the next pandemic. COVID-19 showed how quickly zoonotic diseases can disrupt global health and economies, and weakening the WHO’s capacity to contain such threats is a gamble the world cannot afford. However, Trump and his supporters have long criticised the WHO’s handling of the pandemic, alleging that it failed to act decisively in politically sensitive situations, which became a key justification for withdrawing US funding and pushing for WHO reforms.
Modern technologies, while offering transformative solutions, also introduce new risks that the WHO has actively worked to mitigate. Artificial intelligence and synthetic biology have revolutionised healthcare, enabling faster vaccine development, more accurate diagnostics, and enhanced disease modelling. However, these technologies carry significant dual-use concerns: AI can be exploited for bioterrorism, and synthetic biology could accidentally or deliberately create highly contagious pathogens. Recognising these risks, the WHO introduced its 2022 “Global Guidance Framework for the Responsible Use of the Life Sciences,” which provides comprehensive guidelines for managing the dual-use nature of scientific advancements. Moreover, the WHO’s 2021 “Ethics and Governance of Artificial Intelligence for Health” report established global principles to ensure equitable and safe deployment of AI in healthcare. The US withdrawal not only weakens the funding for such initiatives but also risks fragmenting the governance of these critical technologies, leaving gaps that malicious actors could exploit.
The withdrawal’s impact on developing nations is particularly severe. Many low- and middle-income countries depend on WHO programs for essential health services. For example, during the COVID-19 pandemic, the WHO-coordinated COVAX initiative ensured vaccine access for poorer nations, distributing billions of doses that would have otherwise been out of reach. The WHO also supports health systems in these countries through its Results Framework, which focuses on strengthening data collection, improving healthcare delivery, and building institutional capacity. In 2016, global vaccination coverage for the third dose of the diphtheria-tetanus-pertussis (DTP3) vaccine reached 86 percent, thanks largely to WHO-led efforts. However, one in ten children worldwide still do not receive even their first dose, and without the organisation’s support, such gaps are likely to widen.
The geopolitical ramifications, meanwhile, are likely to further complicate the situation. Losing the US as a key contributor diminishes the WHO’s financial stability and creates a power vacuum that other nations, particularly China, may attempt to fill. While China increased its funding to the WHO after Trump’s initial funding freeze in 2020, contributing an additional US$30 million, its contributions fall far short of the scale required to sustain the organisation’s operations. Moreover, over-reliance on a single donor risks creating perceptions of bias, which could undermine trust among member states, particularly if contributions are unevenly distributed or perceived as influencing the WHO’s priorities. The loss of US leadership also means forfeiting valuable “public health diplomacy,” where American scientists and policymakers influence global health priorities. The absence of US experts embedded within the WHO—such as those from the Centers for Disease Control and Prevention (CDC)—further weakens the organisation’s technical capabilities and its ability to respond effectively to emerging crises.
Domestically, the US is not immune to the fallout of this withdrawal. The WHO’s global surveillance systems provide critical information on influenza strains and emerging pathogens—data essential for developing vaccines and preparing for outbreaks. Without WHO membership, the US may still access some public data but risks losing real-time updates, direct collaboration, and priority insights, potentially delaying responses to emerging health threats. For example, approximately 30,000 elderly Americans die annually from flu complications. Without coordinated international efforts, these numbers could rise significantly. Public health experts have warned that the withdrawal undermines not only global health but also the safety and well-being of Americans.
Trump’s decision reflects a short-sighted approach to global health governance. It jeopardises decades of progress in combating diseases, addressing climate-driven health crises, and governing the risks of modern technologies. The US withdrawal, further, undermines the financial and operational stability of an organisation that is central to global health security. Reengaging with the WHO is not just a matter of funding—it is a strategic imperative to safeguard the health of Americans and people worldwide. Anything less risks undoing decades of progress and leaving the world unprepared for the health challenges of the future.
Nimra Javed is a Research Officer at the Center for International Strategic Studies AJK & holds an M.Phil Degree in Strategic Studies from National Defence University, Islamabad.
This article is published under a Creative Commons License and may be republished with attribution.
