The United States is set to formally withdraw from the World Health Organization on Thursday, a move that has drawn sharp warnings from public health experts who say it could undermine both domestic and global health efforts.
The exit also raises legal questions at home, as U.S. law requires Washington to clear roughly $260 million in outstanding dues to the U.N. health agency, an obligation that remains unpaid as the withdrawal takes effect.
President Donald Trump signaled the move on his first day back in office in 2025, issuing an executive order to notify the World Health Organization of the U.S. intent to withdraw. Federal law, however, sets clear conditions for leaving, requiring a full year’s notice and the settlement of all outstanding financial obligations before the exit can be completed.
On Thursday, a State Department spokesperson defended the decision, accusing the WHO of failing to contain outbreaks, manage crises and share critical information in a timely manner. Those shortcomings, the spokesperson said, had cost the United States trillions of dollars, adding that the president had used his authority to halt any future transfer of U.S. government funding, support or resources to the agency.
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“The American people have paid more than enough to this organization and this economic hit is beyond a down payment on any financial obligations to the organization,” according to the spokesperson said by email, as per Reuters.
Even so, pressure has been mounting from global health leaders over the past year for Washington to reverse course, most recently from WHO Director General Tedros Adhanom Ghebreyesus. “I hope the U.S. will reconsider and rejoin WHO,” he told reporters at a press conference earlier this month. “Withdrawing from the WHO is a loss for the United States, and it’s a lose for the rest of the world.”
The WHO has also said the United States has yet to settle the contributions it owes for 2024 and 2025. According to a WHO spokesperson, member states are expected to take up the U.S. withdrawal and the way forward at the organization’s executive board meeting in February.
Lawrence Gostin, founding director of Georgetown University’s O’Neill Institute for Global Health Law and a longtime observer of the WHO, said the move runs afoul of U.S. law. “This is a clear violation of U.S. law,” Gostin said, adding that despite this, “Trump is highly likely to get away with it.”
Adding to the skepticism, Bill Gates said he does not see Washington reversing course anytime soon. Speaking to Reuters on the sidelines of the World Economic Forum in Davos, the Gates Foundation chair, whose organization is a major backer of global health programs and several WHO initiatives, said he did not expect the United States to reconsider the decision in the short term.
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“I don’t think the U.S. will be coming back to WHO in the near future,” Gates said, adding that, he said, “The world needs the World Health Organization.”
For the WHO, the U.S. exit has triggered a deep financial strain, forcing the agency to slash its management ranks by half and scale back operations across departments. Washington has long been the WHO’s single largest contributor, accounting for roughly 18% of its total funding. As a result of the shortfall, the organization has said it expects to cut about a quarter of its workforce by the middle of this year.
The agency said it continued to work with U.S. officials and share information over the past year, though it remains unclear how that cooperation will function once the withdrawal is finalized.
Public health experts warn the fallout could extend well beyond the WHO itself. “The U.S. withdrawal from WHO could weaken the systems and collaborations the world relies on to detect, prevent, and respond to health threats,” said Kelly Henning, public health program lead at Bloomberg Philanthropies, a U.S.-based non-profit.