Donald Trump vs the WHO

"Oooh, that's a big one." So said US president Donald Trump, as, among his first-day flurry of executive orders, he withdrew America from the World Health Organization (WHO).

It's a move that may have flown "below the radar", given Trump's other headline-grabbing executive orders, but it's the "most momentous of all", said Lawrence O. Gostin, global-health law professor at Georgetown University – and a "cataclysmic presidential decision".

Founded in 1948, the WHO's stated mission is to "put science to work to build a healthier, safer world", championing "global efforts" to "give everyone everywhere an equal chance at a safe and healthy life". The WHO has brought countries together to confront everything from Covid-19 and Zika to HIV, malaria and tuberculosis, it supports countries in health crisis, and anticipates and tracks emerging global health threats.

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'Unfairly onerous payments'

This is not the first time Trump has ordered the US to pull out of the UN's global health agency: he took formal steps to withdraw in 2020, only for his decision to be reversed when Joe Biden replaced him as president. At the time, lawyers and health experts, writing in The Lancet, said that Trump's "unlawful" and "reckless" move would have "dire consequences for US security, diplomacy, and influence".

Monday's executive order declared the US was withdrawing "due to the organisation's mishandling of the Covid-19 pandemic", as well as "its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states". Pointedly, the order also stated that the WHO "continues to demand unfairly onerous payments from the United States, far out of proportion with other countries' assessed payments".

It is true that the US is by far the biggest funder of the Geneva-based organisation, typically contributing about one-fifth of the WHO's total $6.8 billion (£5.5 billion) biennial budget. Although this is a tiny fraction of the total US federal budget, "resentment against the WHO has simmered in Republican circles since the pandemic", said The Guardian.

In 2020, Trump was highly critical of the WHO for being too "China-centric" in its tackling of Covid-19, and the organisation has since become a "target" of US conservatives over its work on a global pandemic treaty that they view as a "threat to American sovereignty", said the The New York Times.

'Political vacuum'

The fact that "this executive action" was carried out "on day one" means it's "more likely" that the US will actually leave the WHO this time, said the BBC.

Under terms adopted by Congress when WHO was founded, the US is required to give 12 months' notice of withdrawal but, were US funding eventually to be pulled, it would leave the WHO in "uncharted territory", said The Guardian. It may have to curtail its worldwide public-health works, "pressuring the organisation to attract private funding, and providing an opening for other countries" to exert an influence.

And here is the irony. "WHO is a pretty essential organization" and, with US withdrawal, there will be "a political vacuum that only one country can fill – and that is China", Dr Ashish Jha, The White House Covid-19 response coordinator during the Biden administration, told CNN.

Right on cue, China's foreign ministry announced that the WHO's role in global-health governance "should be strengthened, not weakened", and that Beijing would continue to support it in "fulfilling its responsibilities", said China Daily.

"If your true concern is that WHO is captured by China, then removing the US from the equation just seals the deal", said Jeremy Konyndyk, president of Refugees International, in Science.