Global health governance stands at a pivotal moment. The U.S.-WHO saga underscores the volatility of multilateral health institutions in the face of political and financial pressures.
The fate of global health governance has become a high-stakes geopolitical chess match. In a move that has sent shockwaves through the global health community, President Donald Trump, on his first day back in office on January 20, 2025, signed Executive Order initiating the United States’ withdrawal from the World Health Organization (WHO). This decision, aligned with Trump’s “America First” foreign policy, reminiscent of his 2020 attempt, has been met with widespread criticism from public health experts and international allies.
The administration cited the WHO’s alleged mishandling of the COVID-19 pandemic and undue political influence from member states as primary reasons for the withdrawal. Critics argue that this move undermines global health security, jeopardizes decades of progress in combating infectious diseases, and diminishes America’s influence in international affairs.
The financial ramifications are significant, as the U.S. has historically been one of the largest contributors to the WHO’s budget. The executive order also mandates a 90-day suspension of all U.S. foreign aid, pending a comprehensive review, further exacerbating concerns about America’s commitment to global health initiatives.
Meanwhile, the WHO itself is undergoing financial restructuring, implementing cost-cutting measures that may have far-reaching consequences, especially for developing nations. These two developments—one driven by geopolitical shifts and the other by financial constraints, raises pressing questions: Who controls the global health agenda? What happens when funding dries up? And most importantly—who suffers?
The U.S., previously the WHO’s largest donor, had been a critical player in funding disease eradication, vaccine programs, and pandemic response initiatives. The withdrawal led to immediate concerns regarding WHO’s financial sustainability and the future of international health security.
The fate of global health governance has become a high-stakes geopolitical chess match. In a move that has sent shockwaves through the global health community, President Donald Trump, on his first day back in office on January 20, 2025, signed Executive Order initiating the United States’ withdrawal from
the World Health Organization (WHO). This decision, aligned with Trump’s “America First” foreign policy, reminiscent of his 2020 attempt, has been met with widespread criticism from public health experts and international allies.
Dr. Ashish Jha, Dean of the Brown University School of Public Health, emphasized the potential risks, stating that the withdrawal “increases the odds of public health disasters” by severing critical channels for disease surveillance and response coordination.
Key Consequences of the U.S. Withdrawal
As the largest single financial contributor, the U.S. provided approximately 15% of WHO’s budget, funding critical programs focused on maternal health, infectious disease surveillance, and emergency response mechanisms. Its abrupt exit will leave a financial vacuum, jeopardizing these initiatives and forcing WHO to scramble for alternative funding sources.
The decision will also have direct consequences for disease control efforts worldwide. Global vaccination programs, particularly those targeting polio and measles, may face delays and uncertainty, threatening decades of progress toward eradication. Without the financial and logistical support of the U.S., the world risks setbacks in combating infectious diseases, increasing vulnerability in regions already struggling with fragile healthcare systems.
Beyond financial and health repercussions, the withdrawal also reshapes geopolitical dynamics within WHO. In the absence of U.S. leadership, other nations, particularly China, will move to fill the void, recalibrating the power structure within the organization. This shift will raise concerns about transparency, decision-making priorities, and the broader direction of global health policies. The withdrawal not only will weaken WHO’s ability to respond effectively to public health emergencies but also alter the strategic alliances that have long shaped international health diplomacy.
The impact will be starkest in developing nations, where WHO-led health initiatives play an outsized role. Programs targeting maternal and child health saw reduced capacity. Food fortification efforts—essential in malnutrition-prone regions—were scaled back. Digital-first policies, while cost-effective, risked alienating countries with limited internet infrastructure. The concern among health officials was clear that, was WHO becoming a weaker force in global health governance just when the world needed it most?
An Emerging Global Health Order
Yet, crisis breeds opportunity. The turbulence surrounding WHO and U.S. global health policy has triggered discussions on alternative strategies for financing and leadership in global health governance.
According to the Guardian, critics argue that this move could leave the U.S. more vulnerable to emerging health threats by isolating it from vital international health networks and data sharing. The decision has been described as “sowing seeds for the next pandemic,” reflecting fears that diminished global cooperation may hinder effective responses to future health emergencies.
WHO’s Financial Tightrope: Survival or Stagnation?
If the U.S. withdrawal exposed WHO’s dependence on a single donor, the organization’s internal budget struggles revealed a deeper problem—a system operating at the edge of financial viability.
The WHO has embarked on a significant financial restructuring to address budget constraints. The organization has introduced cost-saving measures, including a recruitment freeze, reduced travel expenditures, and procurement limitations. While these steps aim to enhance financial sustainability, they risk weakening global health initiatives, particularly in developing nations reliant on WHO-led interventions.
Regional health organizations—such as Africa’s CDC and ASEAN health initiatives—are stepping up, aiming for more localized responses to pandemics and public health challenges. Countries are exploring ways to reduce reliance on WHO funding, investing in domestic health systems and strengthening regional coalitions. The private sector, from pharmaceutical giants to tech firms, is becoming a bigger player, funding vaccine research and expanding telemedicine initiatives.
Alternative financing models are also gaining traction. Health-focused taxes, social impact bonds, and climate-health funding mechanisms could offer WHO and other global health institutions new revenue streams. Digital health innovations—from AI-driven diagnostics to remote healthcare platforms—could help bridge gaps created by WHO’s financial limitations.
An Emerging Global Health Order
One truth remains evident: no country can go it alone. The COVID-19 pandemic proved that global health security is only as strong as its weakest link. What happens next will define international health cooperation for decades to come.
