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One day into his second term and President Trump is already metaphorically turning off the country’s smoke alarms.
On Monday evening, Trump signed an executive order stating the country’s intention to leave the World Health Organization. It’s a decision that’s likely to imperil public health both in the U.S. and globally.
Many of you may be experiencing a bad sense of deja vu right about now. In April 2020, Trump announced temporary funding cuts to WHO; roughly a month later, he formally declared his plans to have the U.S. leave WHO, founded by the United Nations in 1948.
That threat never fully came to fruition. Congressional approval is required for the U.S. to officially depart from the WHO, though Trump continued to withhold funding and prevent staff from working with the organization. The White House restored the country’s relationship with the WHO almost immediately after President Biden entered office in January 2021—a stance now twice-reversed.
An organization under fire
The new executive order reinstates the U.S.’ notification of withdrawal previously issued by Trump in 2020 (a withdrawal requires a year’s advance notice). Then as now, Trump’s reasoning for leaving WHO largely centers around the covid-19 pandemic. In justifying the decision, the executive order cites the WHO’s “mishandling” of the pandemic, its failure to adopt certain reforms, and its “inability to demonstrate independence from the inappropriate political influence of WHO member states”—likely an allusion to China.
WHO certainly isn’t perfect. Notably, the organization took several months into 2020 to declare covid-19 a pandemic, long after many public health experts and scientists began doing so. Some experts also criticized its delay in recognizing covid-19 as an airborne disease, and others accused it of not doing enough to impartially investigate the origins of the pandemic in China (though many scientists do believe that covid-19 likely emerged naturally from animals in the wild, the possibility remains that it was caused by a lab accident).
Putting the world at higher risk
But even experts strongly critical of the WHO have pushed back against Trump’s decision to leave it, instead arguing that the U.S. should push for extensive reforms. Far from improving the situation, this departure—assuming it clears congressional approval—has understandably left many public health experts on edge.
“Leaving the WHO is like a local fire station in LA announcing during the wildfires, ‘Our neighborhood is fine on its own: we don’t want your help and we’re not going to provide help to anyone else,'” Rebecca Wurtz, a public health researcher and director of health policy and management at the University of Minnesota, told Gizmodo. “In leaving the WHO, we put the whole world—but most particularly ourselves—at higher risk of health catastrophes.”
Over the past decade, the U.S. has provided the WHO between $160 million and $815 million in funding yearly, according to the Associated Press. And it’s historically been the single largest contributor to the WHO, accounting for about 20% of the organization’s dues from member nations. This funding helps shore up the WHO’s extensive vaccination programs in low-to-middle income countries, along with many other vital health initiatives.
A vital role in global heath
As the WHO noted in its response to the Trump administration, released this morning, the cooperation between the U.S. and WHO has led to tremendous public health victories like the eradication of smallpox. The world is now on the brink of eradicating polio through vaccination, while substantial progress has been made against other diseases like HIV, but all that progress is substantially at risk of being unraveled.
More than just that, the WHO has often acted as a sentinel, alerting the rest of the world to public health threats on its radar. The departure of the U.S. would not only hinder the WHO financially, it would greatly hamper the cooperation possible between scientists in the U.S. and everywhere else—cooperation that’s essential for countries to recognize and ideally prevent major disasters in the making.
“From a public health perspective, it’s a very bad decision: WHO plays a critical role in central data collection and monitoring of diseases, coordinating epidemic and outbreak responses, setting up guidelines and policies, as well as collaborating with other health agencies such as the CDC,” Terry McGovern, a senior associate dean of academic and student affairs at the CUNY Graduate School of Public Health and Public Policy, told Gizmodo.
Prepping for the next big one
This issue isn’t just theoretical. Since 2024, the U.S. and other countries have been seeing an alarming rise of H5N1 avian influenza cases in birds, cattle, and other animals. While human infections have remained sporadic and generally mild for the time being, H5N1 or other bird flu strains could plausibly evolve into a more serious threat that can spread widely between people and commonly cause severe illness.
Of course, public health agencies in the U.S. are tracking bird flu locally. But there’s always the chance that H5N1 or other emerging germs will first shift into a more deadly problem somewhere else in the world. So any added delays in catching these shifts as they’re happening would be playing with fire.
“At the end of the day, it’s really about the global governance of health. We’re in a society where health information, as well as diseases, move at rapid speed. And our ability to contain those diseases, to better understand them, depends on our ability to share information in an organized way,” George Benjamin, executive director of the American Public Health Association, told Gizmodo. “Right now, for example, there’s an effort to negotiate a pandemic treaty. And I assume that the US won’t be part of that process.”
Speaking of flu, the loss of the U.S. in the WHO might also slow down more mundane but still important public health programs. Every year, for instance, the WHO organizes the selection of which flu strains our seasonal flu vaccines should target, in partnership with the FDA, CDC, and other health agencies. Benjamin notes that researchers may also be delayed in accessing data that’s being maintained by the WHO. And while it may take some time for the U.S. to officially dissolve its membership, he adds that the decision will likely have an immediate chilling effect on researchers who once regularly collaborated with their international counterparts.
In ways big and small, the U.S. leaving the WHO will be disastrous not just for Americans, but for everyone else, too.
