As part of a rash of executive orders completed on his first day back in the White House, President Donald Trump began the nation’s exit from the World Health Organization, the U.N agency dedicated to improving the health of all people.
Although it will be a year before the U.S. can formally part ways with the group, experts have roundly criticized the decision, calling it “cataclysmic,” “dangerous” and “an enormous mistake.”
The U.S. helped found the WHO in 1948 and has been its most influential member and largest donor, helping to facilitate some of public health’s biggest successes, such as the eradication of smallpox and the drastic decline in polio.
Trump’s order was not a surprise. In his previous term, Trump initiated a departure during the COVID-19 pandemic, and he had signaled his intent to do so again — even if many in public health had hoped he would change his mind.
Here, we explain how the withdrawal would work and what it would mean, both domestically and abroad. We also fact-check the president on claims about WHO funding.
What did the executive order say?
The executive order, which Trump signed about eight hours into his second term, effectively serves notice that the U.S. intends to depart the WHO. It revoked the letter that former President Joe Biden sent on his first day of office that ended Trump’s earlier effort — started in July 2020 — to leave the WHO.
As part of the withdrawal, the order directed senior officials to halt the transfer of any funds to the WHO, recall government and contract workers assigned to the WHO, and identify “credible and transparent” partners to replace WHO activities.
The rationale for the U.S. exit, the order said, is the WHO’s “mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.”
The order also alleged that the WHO “continues to demand unfairly onerous payments” from the U.S., “far out of proportion with other countries’ assessed payments.” It went on to note that China has a population of 1.4 billion, “yet contributes nearly 90 percent less to the WHO.” (As we explain below, the U.S. does contribute far more than China does, but the discrepancy is not always quite that large. Most of the difference is due to much larger voluntary contributions from the U.S.)
What does a withdrawal mean for the U.S. and global public health?
Most immediately, without U.S. funding, the WHO will be more limited in what it can do. The programs most dependent on those funds include preventing, preparing and responding to health emergencies; polio eradication efforts; and programs dedicated to fighting tuberculosis, HIV, hepatitis and other sexually transmitted infections, according to information provided to us by the WHO. (For most of the funds the U.S. provides, the government gets to choose which programs the money goes toward.)
As the health policy research organization KFF explains, the WHO is also dependent on the U.S. for technical expertise, and the U.S. is a major player in WHO governance and in advocating for reforms. Thirty CDC staff members are stationed in WHO offices, according to STAT.
Asked what a U.S. withdrawal would mean, a WHO spokesperson said in a Jan. 24 press conference, “It’s the people of the world who will lose out, it’s global health.”
But experts say the U.S. would also be worse off if it severed its ties to the WHO.
“Withdrawing from WHO will harm the US national interests and security,” Lawrence Gostin, a professor of global health law at Georgetown University, told us in an email. “It would weaken WHO’s ability to curb outbreaks before they come to our shores. And the US would not have full access to key scientific information needed to innovate for new vaccines and drugs.”
In particular, the WHO runs the Pandemic Influenza Preparedness, or PIP, Framework, which encourages countries to share their data and samples during an influenza pandemic. Other member countries can then make vaccines, tests and other supplies, and in return, the sharing country is given access to a portion of those helpful products.
The group also runs a surveillance and alert system for outbreaks around the world, helps monitor and fight drug resistance across the globe, tracks influenza, and makes recommendations on which strains of flu virus should be included in seasonal flu shots. The WHO does work in responding to emergencies, such as Ebola outbreaks, that few, if any, other groups do.
“The WHO is essential for the health of the U.S. and the world. It’s the only organization that makes it possible to track deadly health threats in every single country of the world,” former CDC Director Dr. Tom Frieden said in a video posted on X, “even if they hate each other or are political rivals.”
“The WHO is not a perfect organization — most aren’t — but leaving like this is not the way to drive change,” Saskia Popescu, an infectious disease epidemiologist and global health security expert at the University of Maryland, told us in an email. “This ultimately will leave the world more vulnerable to health threats — like emerging infectious diseases — and the U.S. without key resources and partnerships.”
Several experts have noted that departing the WHO is likely to cede power and influence to China.
“If your true concern is that WHO is captured by China, then removing the U.S. from the equation just seals the deal,” Jeremy Konyndyk, president of Refugees International, told Science.
Although Trump’s executive order instructs officials to find other ways of performing essential WHO functions, experts were skeptical.
“This is fantasy land,” Gostin, who also directs the World Health Organization Collaborating Center on National and Global Health Law, said. “It is impossible to replace the worldwide reach and authority of WHO.”
“I’m curious to see what they mean,” Popescu told us, adding that “one of the benefits of the WHO is having a global network for information sharing, accountability, and response.”
When asked to respond to these concerns and criticisms, the White House pointed to a poll showing Americans’ declining confidence in the medical system.
“President Trump was elected with a resounding mandate to Make America Healthy Again by restoring confidence, competence, and accountability in health care, and the Trump-Vance administration will continue to review current processes and healthcare bodies to implement needed reforms,” White House spokesman Kush Desai told us.
Does the executive order do anything else?
Yes. The order states that the U.S. “will cease negotiations on the WHO Pandemic Agreement,” an accord that has been in the works since 2021 and is intended to help the globe better prevent, prepare for and respond to pandemics. A direct response to problems encountered during the COVID-19 pandemic, the agreement is focused on improving global cooperation during a health emergency.
Trump’s order also removes the U.S. from the recently finalized amendments to the International Health Regulations, which are the rules that govern global public health emergencies, such as how quickly a country must report a concerning outbreak and how the WHO defines certain emergencies. They were slated to go into effect in September. (Contrary to the wording of the executive order, the IHR amendments are no longer under negotiation.)
Both instruments have been the target of misinformation, with many on social media falsely claiming that they threaten U.S. sovereignty. They do not give the WHO the power to impose lockdowns or otherwise dictate a particular pandemic response for individual countries, as we’ve written.
Daniela Morich, senior manager and advisor at the Global Health Center at the Geneva Graduate Institute, told us that it’s “likely” that the remaining 193 countries “can still continue to work and achieve a successful outcome.”
But it would mean that the U.S. isn’t a part of what gets decided. “Obviously, you’re losing a voice who’s supporting your views and your shared interests,” she said.
Two sticking points of the negotiations for the agreement, which are set to conclude this May, are related to a pathogen and benefit sharing program and commitments from countries to prevent pandemics under the One Health approach, which recognizes that many novel diseases are passed to humans from animals.
But even from the beginning, Morich said, there was doubt that the U.S. would ratify the accord.
The executive order also revokes a January 2021 Biden executive order that established a COVID-19 response coordinator within the White House and called for increased U.S. leadership in the prevention, detection and response to infectious disease threats, or what is known as global health security.
In addition, Trump’s order stipulates that officials review, rescind and replace the 2024 U.S. Global Health Security Strategy, which the Biden administration published in April.
Popescu told us that the strategy “is very new” and did not know why it would be included, except that “it’s a global health security strategy that emphasizes international engagement.” She added, “I’m waiting to see more reason behind this decision.”
Gostin was more blunt, saying that the order’s removal of the strategy “means the US no longer has a concrete plan for pandemic preparedness and response.”
How would a withdrawal work?
The U.S. joined the WHO in 1948 with a joint resolution passed by Congress. The legislation said that if the U.S. wanted to leave the group, it could, but it would have to give “a one-year notice” and fully meet its financial obligations for the fiscal year.
Because of that, Gostin said that he did not think Trump could unilaterally exit the WHO without approval from Congress. (Last time around, only six months had elapsed before Biden ended the potential exit, thereby avoiding the legal issue.)
The executive order, however, does not acknowledge this. Tom Bollyky, director of global health for the Council on Foreign Relations, noted on X that the executive order could be an effort to make withdrawal immediate, since it revokes Biden’s retraction of Trump’s first attempt at leaving the WHO.
Gostin does not believe that would be lawful. “If Trump exits before the required one year period, he will be in violation of a US law,” he told us. “He has no right to say that the clock was already ticking.”
Still, Gostin said these were “highly plausible legal issues” and that he had been “strategizing with a group of top lawyers” over them.
The White House did not respond to a question about how it was interpreting Trump’s authority, but multiple news outlets reported on Jan. 27 that CDC staff had been ordered to immediately stop working with the WHO and “await further guidance.”
That’s despite the fact that the order itself seems to recognize a waiting period, stipulating that certain negotiations should cease “[w]hile withdrawal is in progress.”
In a Jan. 24 U.N. press conference, a WHO spokesperson said that the U.S. had not yet paid its two required contributions of around $130 million each, one due this month and the other due last January. He said the voluntary contributions, however, could be “cut at any time.”
Morich noted that next week, there is a meeting of the WHO’s executive board, of which the U.S. is a member. It’s now unclear if the U.S. will be present. “It’s a very uncertain time,” she said.
Can Trump change his mind?
Yes. Trump could rescind his executive order and send a letter canceling his intent to leave the WHO. That is what the WHO and many people in public health are still advocating.
In a Jan. 21 statement, the WHO emphasized the importance of its work to all people, “including Americans,” and said it “regrets” the decision and hoped the U.S. “will reconsider.”
At the Jan. 24 U.N. press conference, a WHO spokesperson iterated those sentiments, saying the agency is “committed to engaging in constructive dialogue to preserve and strengthen the historic relationship between the WHO and the USA.” Those comments echoed an internal memo the WHO director general had circulated the day before.
Trump “could, and should, do a deal with WHO to exact major reforms in return for the US continuing to be a member and paying our assessed dues,” Gostin told us in an email.
Still, the WHO is already preparing to tighten its belt. In the internal memo, which AFP and Politico obtained, the director general said the group needed to identify its “key priorities” and was “freezing recruitment, except in the most critical areas” and “significantly reducing travel expenditure.”
What has Trump said about the planned exit?
Trump has consistently spoken about leaving the WHO in terms of monetary fairness, even if he sometimes says that is not the motivation.
Just before signing the order, Trump talked exclusively about the cost of being part of the WHO. “So we paid $500 million to World Health when I was here and I terminated it,” he said. Speaking of China and noting its much larger population, he said, “They were paying $39 million. We were paying $500 million. It seemed a little unfair to me. So that wasn’t the reason, but I dropped out.”
He proceeded to say that the WHO “offered me to come back” for $39 million but that Biden did so for $500 million. Trump then hinted that perhaps the current WHO exit is not a done deal, even as he repeated the figures.
“They wanted us back so badly. So we’ll see what happens,” he said. “Pretty sad though. Think of it. China pays $39 million and we pay $500 million, and China’s a bigger country.”
Just after signing the executive order, a reporter asked Trump if he saw the value of a group coordinating a global response to something like a pandemic. “Sure, I do,” he replied, “but not when you’re being ripped off like we are by the World Health.”
On Jan. 25, at a rally in Las Vegas, Trump relayed a nearly identical story, claiming to have rejected a counteroffer from the WHO, while suggesting he might be open to being part of the WHO.
“I turned them down because it became so popular I didn’t know if it would be well received, even at $39 [million],” he said. “But maybe we would consider doing it again, I don’t know. Maybe we would. They have to clean it up a little bit. But China pays $39 million for 1.4 billion and we’re paying $500 million for 325 million. I don’t know what the hell is wrong with these people.”
The WHO did not comment on any kind of attempted negotiation that might have occurred, but Trump’s description of the situation doesn’t fit with how the WHO organizes its funding — and to be clear, the U.S. never left the WHO. His cited figures also aren’t accurate, according to information provided to us by the WHO.
How much does the U.S. actually give to the WHO?
The WHO collects dues, or what it calls assessed contributions, from its more than 190 member countries. These required amounts, which are approved by member states at the World Health Assembly, are based on gross domestic product, so larger countries with larger economies pay more, while poorer countries pay less.
For the two-year period of 2020 and 2021, when Trump first tried to leave the WHO and when Biden canceled the attempt, the United States’ assessed contribution was 22% of the world’s total dues, or $232 million, while China’s was 12%, or $115 million, according to the WHO.
These required payments, however, make up only a fraction of the WHO’s total funding. In addition to donations from nonprofits and other philanthropists, most of the group’s funding comes from voluntary payments that countries make on top of their dues. This is where the U.S. vastly outspends China.
For 2020 and 2021 combined, the U.S. voluntarily contributed some $461 million, for a total of $693 million, or 9% of total WHO revenue, while China voluntarily contributed just under $53 million, for a total of $168 million, or about 2% of total revenue — and about 75% less than the U.S.
In 2022 and 2023, that gap widened, as the United States’ total contributions topped $1.3 billion, accounting for 18% of revenue, while China’s contributions fell to just $132 million, or 2% of revenue — and 90% less than the U.S.
The White House did not respond when asked for the sources of Trump’s figures, but this is a possible source of the executive order’s statement that China contributes “nearly 90 percent less to the WHO.” (According to WHO’s budget portal, which the WHO told us uses different numbers that can include leftover funds from previous years, China’s total contributions were 87% less than the U.S.)
For the current years of 2024 and 2025, the difference between the two nations has narrowed a bit. China has contributed a total of $184 million, nearly all of it in dues, which accounts for 5% of all revenue. The U.S., which has not yet paid for either year, is again set to give 18% of revenue, or $706 million, of which $264 million are in dues. That’s a total of about $350 million each year.
Trump is therefore broadly correct that the U.S. gives significantly more than China, and particularly so per capita. On this point, Gostin agreed with Trump, saying that China “should pay its fair share” and increase its overall payments “considerably.”
But China is paying more than $39 million — and the discrepancy is not always quite as extreme as Trump claims. Critically, the difference is largely not due to a requirement, but rather comes down to a difference in voluntary payments.
In 2024 and 2025, China’s dues, which are the second highest after the U.S., increased to 15%. Since 2001, the WHO has capped the United States’ assessed contribution at 22%.
The U.S. nevertheless remains the single largest funder, typically contributing close to a fifth of the WHO’s entire budget. (A notable exception was in 2020 and 2021, when Germany — a nation about a quarter the size of the U.S. — was the top funder.) This is a key reason why the United States’ exit from the WHO could be so damaging to the group.
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