Donald Trump has signed an order to remove the US from the World Health Organization (WHO), citing its perceived mishandling of the COVID-19 pandemic and “unfair” payments as a driving force.
The president singled out the WHO executive order as a “big one” as he signed it alongside 100+ others upon his return to the White House on Monday.
But why has the Trump administration moved to leave the WHO and what could the consequences be?
What does the executive order do?
Mr Trump’s order calls for pausing the future transfer of US government funds to WHO, recalling and reassigning federal personnel and contractors working with the WHO and calls on officials to “identify credible and transparent United States and international partners to assume necessary activities previously undertaken by” the WHO.
Before the US can actually leave the WHO – which it joined in 1948 – the move has to get approval from Congress, and the US has to meet its financial obligations to the WHO for the current fiscal year.
The US also has to see out a one-year notice period before leaving.
The executive order also states that the government will review, rescind, and replace the Biden administration’s 2024 US Global Health Security Strategy as soon as practicable, which was described by the former government as a “science-based approach to strengthening global health security”.
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What reasons has Trump given for wanting to leave the WHO?
“World Health ripped us off, everybody rips off the United States. It’s not going to happen anymore,” Trump said at the signing.
The new US government’s grievances over payments took up a significant portion of the executive order itself, with the opening section claiming “WHO continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments”.
It continues: “China, with a population of 1.4 billion, has 300 percent of the population of the United States, yet contributes nearly 90 percent less to the WHO.”
But before the mention of money comes a hefty criticism of the WHO’s handling of the COVID pandemic and other global health crises, with the executive order claiming it failed to “adopt urgently needed reforms and showed an “inability to demonstrate independence from the inappropriate political influence of WHO member states”.
Mr Trump initially tried to leave the WHO during his first term.
In July 2020, he officially notified United Nations Secretary-General Antonio Guterres the US was planning to pull out of the WHO and suspend funding to the agency, after claiming it had been “colluding” with China to hide the extent of the coronavirus’ spread in the early days of the pandemic.
He claimed WHO aided China in efforts to “mislead the world” about its origins.
Democrat successor Joe Biden reversed Mr Trump’s decision to leave the WHO on his first day in office in 2021, but Mr Trump made no secret of his intention to pick up where he left off if he got a second term.
At a campaign rally last September, Mr Trump said he would “take on the corruption” at the WHO and other public health institutions he said were “dominated” by corporate power and China.
The WHO has always denied Mr Trump’s allegations over colluding with China and has maintained it continues to press Beijing to share data to determine whether COVID emerged from human contact with infected animals or due to research into similar viruses in a domestic laboratory.
What is the WHO and what does it do?
It is the UN’s specialised health agency and is mandated to coordinate the world’s response to global health threats, including outbreaks of mpox, Ebola and polio.
It also provides technical assistance to poorer countries, helps distribute vaccines, supplies and treatments and sets guidelines for hundreds of health conditions, including mental health and cancer.
It typically issues advice to its member countries about how to handle health crises, but it has no authority to compel countries to act.
What impact could the withdrawal have?
Experts have warned it could weaken the world’s defences against dangerous new outbreaks capable of triggering pandemics, because the US has historically been among its biggest donors and has provided it with hundreds of staffers with specialised public health expertise.
The US has given the WHO about $160m to $815m every year for the past decade, contributing to its yearly budget of about $2bn to $3bn.
Because of this, experts say losing the country’s support could cripple numerous global health initiatives, including the effort to eradicate polio, maternal and child health programmes, and research to identify new viral threats.
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Dr Tom Frieden, president and CEO of the US advocacy group Resolve to Save Lives, explained in a statement: “Withdrawing from WHO not only cuts crucial funding from the agency, but it also surrenders our role as a global health leader and silences America’s voice in critical decisions affecting global health security.
“Real reform requires engagement, not abandonment. We cannot make WHO more effective by walking away from it. This decision weakens America’s influence and increases the risk of a deadly pandemic.”
Lawrence Gostin, director of the WHO Collaborating Centre on Global Health Law at Georgetown University, warned the WHO losing American resources would devastate its global surveillance and epidemic response efforts.
“It would make it more likely that we could see novel diseases spinning out of control, crossing borders, and potentially sparking a pandemic,” he said.
How has the WHO responded?
In a statement released on Tuesday, the WHO said it “regrets” the announcement from the US, adding: “WHO plays a crucial role in protecting the health and security of the world’s people, including Americans, by addressing the root causes of disease, building stronger health systems, and detecting, preventing and responding to health emergencies, including disease outbreaks, often in dangerous places where others cannot go.
“The United States was a founding member of WHO in 1948 and has participated in shaping and governing WHO’s work ever since, alongside 193 other Member States, including through its active participation in the World Health Assembly and Executive Board.
“For over seven decades, WHO and the USA have saved countless lives and protected Americans and all people from health threats. Together, we ended smallpox, and together we have brought polio to the brink of eradication. American institutions have contributed to and benefited from membership of WHO.
“With the participation of the United States and other Member States, WHO has over the past 7 years implemented the largest set of reforms in its history, to transform our accountability, cost-effectiveness, and impact in countries. This work continues.
“We hope the United States will reconsider and we look forward to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe.”