Trump's exit from the WHO could harm global health programs and backfire on the United States.

Public health programs around the world could be reduced due to the United States' withdrawal from the WHO.

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In one of his first executive orders as president, Donald Trump began the process of withdrawing the United States from the World Health Organization (WHO). One year's notice is required to withdraw from the international public health body, after which the United States will stop contributing financially. The impact could be enormous. In recent years, the United States has contributed nearly a fifth of the WHO's $6.8 billion budget.

In a statement released with the order, the Trump administration said the decision was due in part to “the organization's mishandling of the COVID-19 pandemic.” However, WHO is essentially a coordinating body for global public health. It makes recommendations, but it cannot tell governments what to do and it has no legal power to enforce anything.

This is not the first time that Trump has tried to withdraw the United States from the WHO, the same thing happened in 2020, but this decision was reversed by former US President Joe Biden before it does not come into force. This time, a reversal is less likely, although in theory the US Congress could block the move, and other countries are hoping Trump will change his mind.

The statement made alongside the order also falsely claimed that the WHO was demanding unfair payments from the United States. Contrary to these claims, the vast majority of American contribution is voluntary. It is not obligatory as part of membership. The U.S. contribution, and indeed the entire WHO budget, is also a fairly small sum compared to the $5 trillion U.S. health budget or the estimated $16 trillion cost of the United States from the Covid-19 pandemic.

To put things in perspective, the Gates Foundation contributes almost as much as the US government does voluntarily; it is the third largest donor after the United States and Germany.

The loss of a fifth of its budget will obviously have a significant impact on the activities of the WHO. These include coordinating vaccination campaigns which in the past included successful efforts to eradicate smallpox to control infectious diseases such as tuberculosis and HIV/AIDS and monitoring potential new pandemics.

These programs are especially important for low-income, under-resourced countries, but they matter to everyone on the planet because, as we saw during the last pandemic, infectious diseases can now spread across the world in a few weeks. Vaccinating children in Accra, Ghana, may ultimately protect children in Orlando, Florida.

Diseases have no borders, says Krutika Kuppalli, an infectious disease doctor at the University of Texas Southwestern Medical Center who worked for the WHO during the covid-19 pandemic. This will ultimately have a negative impact on the United States.

She also emphasizes that the American contribution goes beyond money. Many of the experts and collaborating centers that WHO relies on are based in the United States. For example, two of the labs that monitor flu infections and help decide which variants should go into the flu vaccine are in the United States.

A US withdrawal also raises questions about what would happen if, for example, a bird flu virus began to spread among the US population. Would the United States promptly notify the WHO if it is no longer a member? Indeed, would it still have the capacity to quickly detect such a flu and react to it effectively? The WHO withdrawal could be just the start of broader cuts to various U.S. health initiatives, Kuppalli believes.

It would be ironic if the United States ended up not promptly informing the world of a potential H5N1 pandemic, given that Trump claims the WHO helped China cover up the early days of COVID-19 allegations that lack any factual basis, says Kuppalli. This is completely false. I was there, I saw it with my own eyes.

There are of course some problems with the WHO itself. Some of these relate to the ineffective nature of an international organization that works by consent and must consult its members. That's not to say there isn't room for improvement, Kuppalli says, but the best way to do that is for the United States to remain a member and push for reforms from within.

For its part, the WHO said it regretted the American decision. For more than seven decades, WHO and the United States have saved countless lives and protected Americans and all people from health threats. Together we ended smallpox and together we brought polio to the brink of eradication, the WHO said in a statement responding to Trump's announcement.

We hope that the United States will reconsider its decision and look forward to engaging in constructive dialogue to maintain the partnership between the United States and WHO, benefiting the health and well-being of millions of people in the world.

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