Trump withdraws US from World Health Organization as he assumes presidency
One of the many executive orders that US President Donald Trump signed after being sworn in for another term in office was to withdraw the US from the World Health Organization.
He cited the organization’s “mishandling of the COVID-19 pandemic” and “failure to adopt urgently needed reforms” as reasons for the withdrawal. He also criticized the agency’s demand for “unfairly onerous payments” from the US.
The World’s Host Carolyn Beeler discussed the move with Devi Sridhar, a professor of global health at the University of Edinburgh and co-author of the book “Governing Global Health: Who Runs the World and Why?” which she wrote with Chelsea Clinton.
Carolyn Beeler: How significant is this decision?
Devi Sridhar: This will probably be the most significant event for the WHO since its creation post-World War II. What you’re likely to see, hopefully, is other countries and Europe, around the world, you know, the emerging economies trying to step up to make sure that the agency can maintain the work that it does around global health security and health systems. And so, best-case scenario, other countries will step up. But then, in that case, it’s the United States that loses because it loses the information-sharing and being at the table when this kind of crucial information is being shared around other countries.
So, just for folks who might not remember exactly all the things that the WHO does, can you give me a couple of examples of global health responses that might be impacted by this? And then what that also means for the US not being able to get access to that information?
The WHO was set up post-World War II to act as the director and coordinator of international health work. So, think of an outbreak of Ebola in West Africa or Zika virus in Brazil. What the WHO does is go in, gets the information, works with the country to make sure we have as much information as possible and then shares it around its member states, which is those governments which are signed up to the United Nations. And so, it plays an essential role in terms of disease detection and response and technical guidance to governments of, “How do you actually do this?”
I know, for example, that the WHO monitors viruses that are spreading and helps supply information so that the flu vaccine can be updated every year. Is that something that the US would no longer have access to if it pulls out of the WHO?
If you’re not willing to pay the dues, then you remove yourself from that. Of course, the US can set it up on its own. They could say, “Well, actually, we’re just going to set up our own chains of information.” But it is actually going to cost more. And it’s kind of ironic that, given we have a new statement around trying to cut costs, reduce inefficiencies, streamline, why would you be trying to duplicate what you already have an agency doing?
One of President Trump’s reasons for pulling the US out of the WHO is the imbalance between what the US contributes financially versus what China contributes. Can you break that down for us?
Well, the WHO has two streams of funding. The first is called core contributions, which is what you have to pay to be part of the agency. That’s based on a UN formula on your GDP. And that you just have to pay to be part of it. And all, including China and the United States, pay that. The second stream is voluntary contributions. And this is where the United States, Britain, the Gates Foundation become very important. This is what they pledge year to year to say, “Hey, we want you to work on polio. We’re going to give you money for it. Hey, we want you to work on malaria.”
And that’s where the US contributes a huge amount and China does not. So, where I was a bit puzzled is why wouldn’t the United States say, “Well, actually, we’re just going to pull back to our core contributions, remain at the table, but we’re not going to give you this extra money unless actually we see whatever changes he might want to see in the agency or other countries step up.”
There are ways that they could stay at the table, but actually negotiate a better deal for the United States and reasonably ask other countries like China or Brazil or India to step up a bit more.
And that’s where the US contributes a huge amount and China does not. So, where I was a bit puzzled is why wouldn’t the United States say, “Well, actually, we’re just going to pull back to our core contributions, remain at the table, but we’re not going to give you this extra money unless actually we see whatever changes he might want to see in the agency or other countries step up.”
There are ways that they could stay at the table, but actually negotiate a better deal for the United States and reasonably ask other countries like China or Brazil or India to step up a bit more.
What is the timeline for this actually taking effect?
Well, you have to have Congressional approval. And so, it’s unlikely to happen this week. But could it happen in the next few months? Definitely so. And where the WHO is, it’s trying to say, “Hey, what can we do to talk to you and negotiate what might keep you at the table?” But at the same time, looking to other countries, especially across Europe, and saying, “Can you step up?” So, if they do, in fact, exit, we’re not going to completely fall through, that we actually have some kind of safety net.
Public health officials are increasingly concerned about bird flu. How could leaving the WHO affect the global coordination to prevent its spread?
First, you need to detect it. So, imagine, I know right now it’s in dairy cattle in the States, but it’s also been detected across the world. So, imagine you have samples out of Malaysia or Indonesia. Those would be used to actually work toward different diagnostics and vaccines. Would the US have access to that information and to those technologies if they’re moving towards that?
If a country is going to respond, they share that information with the WHO. What is their domestic response going to be? And that information comes out of the WHO. So, if the United States is not part of it, they wouldn’t get that internal information of what’s happening in other countries. They can get it through other channels, but obviously it’s slower and more inefficient.
If a country is going to respond, they share that information with the WHO. What is their domestic response going to be? And that information comes out of the WHO. So, if the United States is not part of it, they wouldn’t get that internal information of what’s happening in other countries. They can get it through other channels, but obviously it’s slower and more inefficient.
This interview has been lightly edited and condensed for clarity.
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