Trump’s WHO withdrawal is a backward step for global healthcare

The Trump administration’s decision on 20 January to withdraw the United States from the World Health Organisation (WHO) marked a profound shift in global healthcare politics, but its implications go far beyond geopolitics. At the core of this withdrawal is a reckless disregard for global health equity, which will undoubtedly widen the already glaring disparities between high- and low-income countries. As the largest financial contributor to the WHO, the US exit jeopardises the organisation’s ability to serve its critical mission of reducing health inequities, particularly in low- and middle-income countries (LMICs), where healthcare systems are already fragile and dependent on global collaboration.

The US withdrawal from the WHO is not merely a political decision; it is a direct blow to the health security of millions in LMICs who rely on the international organisation for essential services. For decades, the WHO has been the backbone of global healthcare equity initiatives, serving as a vital resource for disease prevention, immunisation campaigns and maternal health programmes. Without US funding — which constitutes roughly 16 per cent of the WHO’s biennial budget — critical initiatives targeting preventable diseases will face immediate and long-term setbacks. Polio eradication programmes in Afghanistan and Pakistan, for example, rely heavily on US contributions. A sudden cut could lead to the resurgence of polio, endangering not just the immediate populations, but also global efforts to eliminate the disease by 2030.

Equally worrying is the potential collapse of funding for vaccination programmes in countries that already experience chronic shortages.

In sub-Saharan Africa, where vaccination coverage can dip below 50 per cent in some regions, US funding helps ensure access to vaccines for children, pregnant women and refugees in emergency settings. This funding sustains global vaccination efforts like the GAVI Alliance and the Global Polio Eradication Initiative, both of which are indispensable to achieving Sustainable Development Goal (SDG) 3: “Good health and well-being for all.” Without these funds, we risk losing the progress made in immunisation coverage over the past two decades, with vulnerable populations bearing the brunt.

The true cost of the US withdrawal from the WHO is not just about lost funds; it’s also about the human lives at stake. In many LMICs, the WHO is the only organisation capable of responding to outbreaks of cholera, malaria or dengue, where health systems are overburdened and under-resourced. The Ebola outbreak in West Africa (2014-2016) underscored how swiftly a health emergency can escalate without strong international support. The US, alongside the WHO, played a critical role in containment and support. By pulling out, the US risks undermining international responses to future outbreaks, leaving these countries vulnerable to devastating consequences, especially marginalised groups such as refugees, indigenous populations and women. Increased morbidity and mortality among these groups are foreseeable outcomes if health systems collapse further or fail to scale.

OPINION: We are witnessing a new era of US imperialism

Beyond financial ramifications, the US withdrawal raises fundamental questions about the fairness and inclusivity of global healthcare governance. The WHO has long championed a multilateral approach to health policy, bringing together diverse nations to focus on healthcare as a universal human right. The Trump administration’s exit signals an isolationist, self-serving policy, leaving countries that are already marginalised in a precarious position. Health crises are not confined by national borders; a health emergency in one region can spiral quickly into a global issue, as the COVID-19 pandemic demonstrated. The WHO’s multinational framework ensures that no country is left behind, but without the US, the global healthcare system becomes increasingly fragmented, with the wealthiest nations retreating to prioritise their own interests.

China, which has steadily expanded its influence within the WHO, may step in to fill the vacuum left by the US. However, as seen with China’s handling of the COVID-19 outbreak, unilateral control over global health priorities can exacerbate existing healthcare disparities, particularly when political interests overshadow equity. The WHO’s role in promoting neutrality and accountability is compromised when financial contributions come with political strings attached. If China’s influence continues unchecked, there is a risk that policies and resources could prioritise the interests of one nation over the collective good, further deepening global inequities, especially for vulnerable populations who are already disadvantaged.

The Trump administration’s decision to withdraw cannot be defended simply by pointing to perceived inefficiencies at the WHO.

The truth is that the WHO’s work is irreplaceable. It is the architect of health initiatives that protect the most vulnerable populations across the globe, especially in LMICs. Instead of abandoning the organisation, the US should engage with the reform process, working to improve transparency and efficiency. This would allow the US to maintain its leadership role in shaping global healthcare, while addressing any perceived shortcomings in the WHO’s operations. By choosing to withdraw, the Trump administration not only relinquished US leadership in global healthcare diplomacy, but also sent a message that health equity is a secondary concern on the world stage.

In the face of rising health challenges, including the threat of future pandemics, global climate change and increasing healthcare inequalities, the US withdrawal is a dangerous precedent. It signals a shift away from collaborative solutions that benefit everyone, towards a fragmented approach that places the interests of wealthy nations over the well-being of the global community. The Biden administration’s reversal of Trump’s first-term 2020 decision to cut ties with the WHO showed the world that health security is inseparable from global solidarity. A similar course correction is now needed urgently, not just for the US to reclaim its leadership in global healthcare, but also to ensure that healthcare equity remains a guiding principle for the world’s future health policies.

READ: Doctors Against Genocide urges US Senate to take action on ending Gaza genocide

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.