For decades, the United States has wielded considerable power in determining the direction of global health policies and programs. US President Donald Trump has issued three executive orders first day in office which could mean the end of that era, health experts say.
Trump order to remove from the World Health Organization means the US will likely not be at the table in February when the WHO's executive board next meets. WHO is made up of its members: 194 countries that set health priorities and agree on how to share critical data, treatments and vaccines during international emergencies. With the US absent, they would cede power to others.
“It's just nonsense,” said Kenneth Bernard, a visiting fellow at Stanford University's Hoover Institution who served as the top biosecurity official during the George W. Bush administration. “Withdrawing from the WHO leaves a gap in global health leadership that will be filled by China,” he said, “which is clearly not in America's best interest.”
Executive order to withdraw from WHO and reassess America approach to international aid citing “WHO's mishandling of the COVID-19 pandemic” and saying US aid serves to “destabilize world peace”. In action, they repeat the priorities established in Project 2025“Mandate for leadership”, a conservative policy plan from the Heritage Foundation.
The 922-page report said the US “should be ready” to withdraw from the WHO, citing its “manifest failure” and recommended a State Department review of international aid. “The Biden administration has warped the agency as a global platform for pushing abroad a divisive political and cultural agenda that promotes abortion, climate extremism, gender radicalism and interventions against perceived systemic racism,” it said.
As one of the world's largest funders of global health – both through international and national agencies such as the WHO and the US Agency for International Development – an American withdrawal could curtail efforts to provide vital health care and fight deadly outbreaks, particularly in lower level countries. income countries without the means to do it alone.
“Not only does this make Americans less safe, it makes citizens of other countries less safe,” said Tom Bolicki, director of global health at the Council on Foreign Relations.
“The United States cannot insulate itself from transnational health threats,” he added, referring to policies that block travelers from countries with disease outbreaks. “The majority of evidence surrounding the travel ban points out that they create a false sense of security and distract nations from taking the steps needed domestically to ensure their own security.”
less than 1%
Technically, countries cannot withdraw from the WHO earlier than one year after the official notification. But Trump's executive order refers to his announcement to end layoffs starting in 2020. If Congress or the public pushes backthe administration may object that more than a year has passed.
Trump suspended WHO funding in 2020, a measure that does not require congressional approval. US contributions to the agency have hit a low 163 million dollars in that first year of COVID, lagging behind Germany and the Gates Foundation. Former President Joe Biden restored US membership and payments. In 2023, the country gave WHO 481 million dollars.
As for 2024, Suery Moon, co-director of the Global Health Center at the Geneva Graduate Institute, said the Biden administration has paid I owe two years for 2024-25 early, which will cover some of this year's payments.
The reason for WHO's withdrawal is called “unfairly heavy payments” in the decree. Countries' contributions are a percentage of their gross domestic product, meaning that as the richest country in the world, the United States usually pays more than other countries.
Funds for WHO are about 4% of American funds budget for global healthwhich in turn represents less than 0.1% of US federal spending each year. At about $3.4 billion, WHO's entire budget is about a third of that of the Centers for Disease Control and Prevention, which received $9.3 billion in core funding in 2023.
The WHO funds support programs for the prevention and treatment of polio, tuberculosis, HIV, malaria, measles and other diseases, especially in countries struggling to provide domestic health care. The organization also responds to health emergencies in conflict zones, including places where the U.S. government is not working — parts of Gaza, Sudan and the Democratic Republic of Congo, among others.
In January 2020, WHO warned the world about the danger CORONAVIRUS INFECTION COVID outbreak, declaring the highest alert: a public health emergency of international concern. Over the next two years, he tested diagnostic tests and potential cures for COVID, regularly informed the public and advised countries on measures to keep citizens safe.
Experts cited wrongdoing by the agency, but numerous analyzes show that internal problems are the reason the United States has one of the highest death rates from COVID in the world. “On January 30, all countries received a WHO warning about a public health emergency of international concern,” Bollyki said. “South Korea, Taiwan and others have responded aggressively, but the US has not.”
“It's a red herring”
Still, Trump's executive order accuses the WHO of “mishandling” the pandemic and “failing to make urgently needed reforms.” In fact, WHO has made some changes through bureaucratic processes that include input from member countries. Last year, for example, the organization adopted several amendments its provisions on health emergencies. These include provisions for transparent reporting and coordinated funding.
“If the Trump administration tried to push for certain reforms for a year and then got frustrated, I might find the reform line credible,” Moon said. “But it's a red herring for me.”
“I don't believe in explanations,” Bernard said. “It's not a question of money,” he added. “There is no reasonable justification for withdrawing from the WHO, including our problems with China.”
Trump has accused the WHO of complicity in China's failure to openly investigate the origins of COVID, which he calls “improper political influence” in the executive order.
“The World Health Organization shamefully covered the footprints of the Chinese Communist Party at every step,” Trump said. video posted on social media in 2023.
In several cases, WHO did called for transparency from China. The agency has no legal authority to force China or any other country to do what it says. The fact also belies Trump's warnings that the pandemic agreement being negotiated at the WHO impinges on American sovereignty. Rather, the agreement aims to help countries better cooperate in the next pandemic.
Trump's executive order calls on the US to “cease negotiations” on the pandemic agreement. This means that as the debate unfolds, the pharmaceutical industry may lose one of its staunch advocates.
In the negotiations so far, the USA and the European Union have acted on the side of lobbying from the side pharmaceutical industry advocate strict patent rights for drugs and vaccines. They have resisted efforts from middle-income countries in Asia, Africa and Latin America to include licensing agreements that would allow more companies to produce drugs and vaccines when supplies are short in a crisis. A a study published in Nature Medicine It is estimated that more than a million lives would be saved if COVID vaccines were available worldwide in 2021.
“With the US gone, for better or for worse, there will be less pressure on certain positions,” Moon said. “In the pandemic agreement negotiations, we may see a weakening of opposition to more health-oriented approaches to intellectual property.”
“This is a moment of geopolitical shift because the US is making itself less relevant,” said Ayoade Alakiya, chairman of the African Union Vaccine Supply Alliance. Alakiya said emerging economies in Asia and Africa can now put more money into the WHO, change policies and set an agenda previously opposed by the US and European countries fighting the war in Ukraine. “Power is changing hands,” Alakiya said. “Maybe it will give us a more equal and just world in the long run.”
Echo of project 2025
However, the WHO is unlikely to fully recover its losses in the near term, Moon said. Funds from the US usually make up about 15% of its budget. Along with Trump executive order which suspends international aid for 90 days, the lack of money could prevent many people from receiving life-saving treatment for HIV, malaria and other diseases.
Another loss is the scientific collaboration that takes place through the WHO and about 70 centers located at US institutions such as Columbia University and Johns Hopkins University. Through these networks, scientists share findings, despite political enmity between countries.
A third executive order directs the secretary of state to ensure that the department's programs are “consistent with the foreign policy of America First.” It follows an order to suspend international aid while it is reviewed for “consistency with United States foreign policy.” The order said that US aid served “to destabilize world peace by promoting ideas in foreign countries that are directly opposed to harmonious and stable relations.”
These and executive orders on climate policy are consistent with the policy agenda expressed by the 2025 project. Although Trump and his new administration have distanced themselves from the Heritage Foundation playbook, Reviewed by CBS News work histories of 38 named primary authors and found that at least 28 of them worked in the first Trump administration.
One of its main architects was Russell Vaughtwho served as director of the Office of Management and Budget during Trump's first term and has been nominated again. Several members of Project 2025 belong to the America First Legal Foundation, a group led by Trump adviser Stephen Miller that has filed complaints against “woke corporations.”
Project 2025 recommends cutting international aid to programs and organizations focused on climate change and reproductive health, and directing resources to “strengthening the foundations of free markets,” lowering taxes and deregulating businesses as a path to economic stability.
Several experts said the executive orders appear to be about ideological rather than strategic positioning.
The White House did not respond to questions about its executive orders on global health. Regarding the order that US aid serves to “destabilize world peace,” a USAID spokesman wrote in an email: “We are directing you to the White House.”
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