U.S. Withdrawal from the World Health Organization: What’s At Stake?

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As expected, President Trump signed a “day-one” executive order (EO) on January 20, 2025, announcing his intention to withdraw the U.S. from the World Health Organization (WHO). Trump took similar action to end WHO membership and halt funding during his first term, though the clock ran out and Biden reversed this. The EO also sends a political message about the Trump administration’s view of the U.S. role in the world: the U.S. will go it alone if others don’t align with its values (two other EOs also carry this message: America First Policy Directive to the Secretary of State and Reevaluating and Realigning United States Foreign Aid).

Specifically, the EO calls for the U.S. to withdraw from WHO membership (a process that takes a year) pause any future funding or other resources to WHO (assessed contributions must be paid through the fiscal year), recall and reassign any US Government personnel or contractors working with WHO and end negotiations on the Pandemic Agreement and implementation of the amendments to the International Health Regulations. What will this mean?

For the WHO, it is significant. The U.S. is generally its largest donor, primarily through voluntary (project-based) funding, but it also provides the most in assessed contributions, which are based on GDP size (China is second in this regard). The U.S. also offers extensive technical expertise, often seconding experts to WHO. Finally, the U.S. plays a large role at the WHO governance table in pushing for reforms, as well as its own agenda, in the international arena.

For the U.S., the implications are less clear and less immediate but could also be significant. By not being at the table, the U.S. will cede this role to others – China in particular – and take itself out of influencing international negotiations. The U.S. can certainly do a lot on its own but likely can’t do it all – not in the age of globalization and the rapid movement of information, people, and pathogens. For example, the WHO oversees the process that tracks seasonal and pandemic flu and provides recommendations for the composition of flu vaccine each year. WHO also serves as a first alert system when a new outbreak occurs, including those that can affect the U.S. Without being part of WHO, it is unclear how quickly, and in what way, the U.S. could obtain needed information and cooperation to help its own citizens.

While debates about the WHO may not be ones that most people in the U.S. are following, Americans do seem to want the U.S. to take steps to protect the public from disease threats. Indeed, our latest poll found that the majority of people (54%) do not think we are spending enough on preventing infectious diseases and preparing for the next pandemic.