The US is set to sever its relationship with the World Health Organization (WHO) as President Donald Trump has issued a notice of withdrawal almost five years after his initial attempt to withdraw in 2020 following disagreements regarding the WHO’s handling of the Covid-19 pandemic. Trump’s initial attempt was reversed when President Joe Biden took office in 2021. Since this executive order has been re-issued, the withdrawal is expected to come into effect in January 2026, as the WHO requires one year of notice for a country to withdraw.
The WHO is a United Nations agency that aims to expand universal health coverage to give everyone an equal chance at a safe and healthy life. It coordinates the world’s response to health emergencies, promotes well-being, prevents disease, and expands access to healthcare. Although the WHO does not have the power to enforce health policy, it influences policies worldwide. Its global coordination and leadership efforts enabled the eradication of smallpox and also played a dominant role in the control of polio, HIV, and other infectious diseases that require the global coordination provided by the WHO.
As the US is the largest contributor to the WHO, its withdrawal has the potential to financially impact the organisation, which is already financially suffering, with a loss of jobs predicted. This withdrawal could also impact the clinical trials the WHO can support, which will predominately affect low-income countries. The agency provides a lifeline to low-income countries with affordable drugs and vaccines, as well as assistance with increasing healthcare capacity. Data derived from GlobalData’s clinical intelligence platform indicates that over 44% of the trials that the WHO sponsors or collaborates on have locations in the Asia-Pacific (APAC) region (predominately India), and more than 31% of trials have locations in the Middle East and Africa. This means that funding for the most vulnerable nations is at risk. However, the funding gap created by the US’s exit may be rectified by the remaining member states.
The WHO and several other influential entities have called for the US to reconsider this decision to avoid dire consequences to public health, as the work conducted by the WHO has proven to be vital for both the US and the global community. Insights from GlobalData’s clinical trials intelligence platform show that 70% of all trials for the top five therapy areas that the WHO sponsors are for infectious diseases (Figure 1, below). If progress in these trials is reversed due to a lack of funding, there will likely be consequences regarding fighting infectious diseases. Additionally, the US withdrawal could impact the WHO’s ability to respond to emergencies such as the Covid-19 pandemic. In a scenario with the emergence of a disease, the US may not have visibility or access to vital data, and also may not be part of discussions including decisions regarding threat levels and the mobilisation of resources.
Although national governments disagree with Trump’s decision to withdraw from the WHO, he is not alone in criticising the WHO’s handling of the Covid-19 pandemic, among other decisions. Some Industry experts suggest that the US’s withdrawal will give the WHO a wake-up call regarding the criticisms it receives and stop allowing the organisation to be so reliant on one country. Supporters of the withdrawal hope that this may prompt the WHO to prioritise reform to avoid other member states seeking their own withdrawals.
Figure 1: top five therapy areas in the WHO-sponsored clinical trials since 2001
