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Upon assuming office for the second time on 20th January 2025, US president Donald Trump issued an executive order announcing USA’s intention to exit World Health Organization (WHO). This is going to end the future funding of US to the WHO. The WHO is one of the credible UN Organizations with 194 member states (countries). WHO has been working with support of member states protecting the health and security of the world’s people. The good works that have been planned would likely to have massive set back as USA has been the biggest financial contributor for WHO activities. Though Trump’s decision is challengeable, the WHO’s image as UN’s health agency is damaged.
The WHO as specialized agency of United Nations established with its own constitution on 7th April 1948 when the 26th of the 61 governments had signed. The first Health Assembly opened in Geneva on 24 June 1948 with delegations from 53 of the 55 member states. 7th April is observed as world health day as mark of establishment of WHO. At present, there are 194 member states which shows more than 3 times of the number at the time of inception, a remarkable growth signifying the peoples’ trust on WHO. Almost all the member states of UN are the members of WHO. WHO’s head quarter is located in Geneva, Switzerland. It has 6 regional offices and 150 country offices through which WHO works with a vision of a world where everyone can live healthy and productive life. WHO leads global efforts to expand universal health coverage. It directs and coordinates the world’s response to health emergencies and promotes healthier lives – from pregnancy care through old age. South East regional office and India’s country office are located in New Delhi. India has been the member since 1948. Like all other countries India derives benefit from WHO’s activities. Usually, WHO country office plans for its activities in consultation with the National government. For its activities, the WHO should have enough financial resources to initiate and carry out people centric health activities.
The WHO designs its usual activities on biennium basis. The current period is for 2024-2025 and the next biennium is for 2026- 2027. There is no issue in programme implementation for the current period. There may be funding issues once withdrawal of US is formalised which may come in effect in January 2026. There are two sources for funds for WHO activities: assessed contributions (set amounts expected to be paid by member-state governments, scaled by income and population) and voluntary contributions (other funds provided by member states, plus contributions from private organizations and individuals). Assessed contributions are member states’ commitment to WHO and is considered “core” funding. The core funds are flexible funds that are often used to cover general expenses and program activities. On the other hand, voluntary contributions are often “specified” funds, meaning they are earmarked by donors for certain activities. The voluntary contributions are not flexible. US’s contribution is around 18% of its overall funding annually, consisting of $400 million in voluntary contributions and $130 million in assessed contributions. The assessed contributions are decided for the member states based on the size of their economy. Funding issues can be managed by additional contribution from other countries. The crowd funding is being explored. In addition to funding issues, there are other impacts too. There are many collaborating centres and US Centre for disease control have been supporting WHO as a source of scientific knowledge. Sharing of scientific knowledge would get adversely affected with US’s exit. The WHO would get weakened as a central agency supporting countries with reliable and trust worthy information related to health and illness.
US has been working with WHO for all these years since the days of foundation of WHO. Severing the relationship is not easy but a unilateral decision of USA to exit WHO is likely to impact beyond the financial contribution though finance is primary requirement for carrying out any activity. US has been providing technical support to WHO through a variety of activities and partnership: providing technical support through US experts participating in collaborating centres. Participation of US in WHO executive Board would be missing in times to come. US wisdom in WHO’s policy and activities would not be available. Nightmare of Covid-19 has not faded away from peoples’ mind. Covid-19 has taught us if neighbours are not safe, we are not safe. There is no strict boundary/barrier which can prevent the entry of infections and infectious organisms. We need an organization like WHO as a part of health security.
The Guardian, prestigious British newspaper, reported “President Trump wants to leave, arguing that the US shoulders too much of the burden of WHO expenditure, while the WHO listens to China, which, he says, pays only a small portion towards the organisation. China, with a population of 1.4 billion, has 300% of the population of the United States, yet contributes nearly 90% less to the WHO.” It mentions that the world can not forget the coordinated cross-border efforts have successfully eradicated smallpox, brought tuberculosis and polio closer to elimination, reduced AIDS related deaths substantially over the years. WHO is successful in eliminating at least one neglected tropical disease in 54 countries. This achievement is not small one. Two recent infectious disease reports: mpox detection in East Sussex, France, Germany, Belgium, Sweden, Canada and the US as mpox spreads out of Africa; Outbreak of Ebola-like virus Marburg in Tanzania are the contribution of WHO. Tanzanian Health Minister initially denied but only to confirm by its President only after the WHO independently reported an outbreak of nine suspected cases and eight deaths. This shows the crucial role the WHO plays.
It has been reported that WHO has failed to investigate the origin of devastating Covid-19. We should understand the limitation of a bilateral agency. One issue can not be justified for pulling out of WHO which it has built up along with others but nourished in the interest of humanity by being the major funder. Trump has suggested the US could return if the WHO reforms without providing details on what that would require. The reform proposal has been under discussion since before Trump took office but to what extent it would be able to satisfy USA’s intention. The US’s exit would formally take place after one year of conveying this intention that means there are enough times for negotiations and finding pathways to fill the funding deficiency by generating revenue from other countries or sources. Even if funding is managed, WHO would lose its lustre as Global Health Body. The US administration should realize sooner than later that WHO is necessary for all not just poor countries. Wish the good sense prevail in the interest of peoples’ health!
(Authors are Professors, C. L. Baid Metha College of Pharmacy, Thoraipakkam, Chennai – 600 097)
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