The United States has formally completed its withdrawal from the World Health Organization (WHO), closing the door on nearly eight decades of membership and reopening a debate about how global health crises should be managed. On January 22, Washington cut funding, recalled staff, and ended its institutional ties with the UN agency, confirming a decision that had first been set in motion by President Donald Trump a year earlier, following a failed attempt during his first term in office.
The administration considers the break to have been long overdue. In a statement announcing the move, the U.S. Department of Health and Human Services said the WHO had failed in its mission during the COVID-19 pandemic, accusing the agency of reacting too slowly, avoiding hard questions and failing to subsequently reform itself.
The WHO rejects these accusations. In a sharply worded response, the agency stated the U.S. version of events was “untrue” and warned that the decision would leave both Americans and the rest of the world “less safe”.
A messy legal divorce
The terms under which the U.S. joined require a one-year notice period. The Trump administration did so in January 2025, with this week’s exit marking the formal end of that process.
But the financial side of the separation remains far from settled.
According to WHO officials, the United States still owes over US$260 million in unpaid dues for 2024 and 2025. Some experts argue that Washington is not legally required to settle this bill, as the WHO 1948 constitution contains no provisions for withdrawal. Several international lawyers disagree. The issue is expected to resurface at the World Health Assembly later this year.
For decades, the United States was the WHO’s largest single donor. Its membership contributions and significant voluntary funding that exceeded US$400-600 million helped to implement programs ranging from disease surveillance to vaccine development.
The White House’s alternative plan
The administration states it does not intend to disengage from global health altogether.
It announced plans to rely on bilateral agreements with other countries and partnerships with NGOs and faith-based organizations in order to bypass working through the WHO.
So far, however, officials have offered few details about how this system will work in practice and how it can replace the dense web of data sharing and early-warning mechanisms built around the WHO over the decades.
A widely criticized decision
The Trump administration insists the withdrawal is about sovereignty, accountability and reform. Yet, many in the public health sector sense something else – a retreat from cooperation at a moment when the next pandemic might not be a question of if, but when.
Some experts describe the decision as politics with real-life consequences.
“When the U.S. withdraws from the WHO, that risks delays in information and important responses from infectious diseases. When we leave, Americans suffer because our health is at stake here,”Dr Omer Awan, University of Maryland School of Medicine, explained.
The withdrawal is “shortsighted and misguided,” according to Dr. Ronald Nahass of the Infectious Diseases Society of America.
“Germs don’t respect borders, so global cooperation is critical to protect citizens.”
Even among U.S. states, the reaction has not been uniform.
California described the decision as “reckless” and announced it would join the WHO’s Global Outbreak Alert and Response Network on its own.
“California will not bear witness to the chaos this decision will bring. We will continue to foster partnerships across the globe and remain at the forefront of public health preparedness,”Governor Gavin Newsom said.
What to expect next
Beyond the technical fallout, diplomats and analysts see a broader strategic shift underway.
With the U.S. gone, other countries are expected to gain more influence inside the WHO.
“Countries like India, Saudi Arabia, Russia, and China are stepping in to make up some of the void left by the U.S.,” Judd Walson, Chair of International Health at the Johns Hopkins Bloomberg School of Public Health, told Time. “That has consequences for who is setting priorities and who has influence in the halls of WHO to guide policy and guidelines,” he added.
Meanwhile, the WHO is pushing ahead with negotiations on a new global pandemic agreement, a framework the United States will no longer help to design or shape.
