On January 20, US President Donald Trump signed an order to withdraw his country from the World Health Organization (WHO), claiming disproportionate payments, political discrepancies and inadequate management of the Covid-19 Pandemia. For its part, WHO has recalled that the US is one of its founding members and that this measure will impact not only on the health of the American population, but on that of people around the world.
What’s true? Can this withdrawal have important consequences for public health and relevant ethical implications? The truth is that yes.
Health worsening in the American population
The state of population health in the US, which has never stood out for its equity, has worsened in recent years with new risks, such as the sadly known opioid crises.
Until now, WHO guides and strategies have contributed significantly to US national policies on key issues such as promoting physical activity or maternal-infantile health, problems that also present a marked social character. WHO’s abandonment could have an impact on these policies, with a direct impact on the health of its population and an increase in social inequalities.
Decrease in Funds, Personnel and WHO programs
The US has been, to date, the main donor and partner of this United Nations Organization, contributing $ 1,284 million for 2022-2023 in mandatory and voluntary contributions. Without these funds, there will be programs and actions that cannot be carried out, with important consequences in the most vulnerable populations of low -income countries that depend on health programs financed and supported by WHO.
Ethically this can be considered a negligence towards those who need help. For example, the US contributed to the response to the MPOX with more than 22 million dollars, supporting the delivery of vaccines in African countries.
The Emergency Health efforts of WHO in the prevention and preparation for future threats will be also compromised. Thus, the withdrawal of the organization erodes confidence in its commitment to the ethical values of solidarity, justice and cooperation.
Future pandemics and breach of the International Health Regulations
Health risks do not know borders. WHO is the body that combines the efforts of the different regions to preserve and improve the health of the world’s population, having a fundamental role in preventing the risk of epidemics and pandemics.
For example, WHO promoted in May 2024 the signing of a pandemics treaty that imposes on all member countries the adoption of measures to control their propagation. Failure to comply with these measures implies a threat to global health, as could happen if the avian flu virus (H5N1), currently circulating in cattle – especially in the US -, acquired characteristics that allowed the transmission between humans.
Likewise, the International Health Regulations (RSI-2005) is the legal framework for the detection and response to these risks, of mandatory compliance in the 194 WHO members, and includes measures applicable to those who already travel merchandise in ports and airports, certified of vaccination and the notification of public health emergency of international importance. In addition, the RSI allows supporting the affected states, as well as avoiding stigmatization and negative impact on international tourism and trade.
The abandonment by the US of this multilateral cooperation framework would imply a serious distortion to apply the regulation, which will make the response to future pandemics difficult.
Weakness of responsibility and commitment to global health
WHO is the reference body for World Health Governance, and its weakening compromises the capacity of the international community to face transnational challenges.
Climate change, probably the most important challenge, finds in the Paris agreement an indispensable global framework for your approach. In this case, although the US has traditionally played a leadership role in the planet’s health, being one of the richest and most polluting nations, it has an ethical responsibility for global health. Its OMS departure will then be assessed as an abandonment of this responsibility, at a time when international commitment and agreements are key.
Dispredigy of WHO and science
WHO develops guidelines informed by scientific evidence, so that the abandonment of the US contributes to weakening the prestige of the organization, which is also discrediting science. And it is no accident, since certain policies stimulate the commercial value of science against the achievement of social welfare, promoting competitiveness above collaboration, and thus facing private interests with public health objectives.
In conclusion, the US decision to abandon the WHO undermines international cooperation against global health challenges. Ethically, public health should be a bridge for joint unit and action and cannot become a tool used for partisan purposes.
Article written with the advice of the Spanish Society of Epidemiology.