United States to Quit World Health Organization: What Does It Mean for the World?


S Faizi (s.faizi111@gmail.com) is an ecologist specialising in international policy affairs, and has been a United Nations negotiator.
6 August 2020

President Donald Trump has recently announced that the United States will pull out of the World Health Organization, after accusing the global body of being biased towards China in the wake of the COVID-19 pandemic. Although it appears that without the US, WHO would be weakened in terms of its significance and resources at its command, the fact remains that, in reality, it bodes well for the democratic functioning of WHO without the intimidating presence of a global superpower.   


The United States (US) government had sent out a one-year advance notice to the United Nations (UN) Secretary General in the first week of July intimating its decision to withdraw from the UN’s World Health Organization (WHO). The decision was reached after an aggressive campaign by US President Donald Trump against WHO, and has refused to meet the country’s financial commitment to WHO. That a decision such as this has been taken when the global health body needs more support to fight the COVID-19 pandemic makes it significant. Yet, the world does not have to worry as WHO could emerge as a better place without the US in its fold. The US has always been looking for opportunities to throttle the democratic arms of the UN—except the veto-enabled Security Council—which are operated on the democratic mandates provided by the member states, on a one-country-one-vote basis (Faizi 2004). 

As the US emerged as a global hotspot for COVID-19, and the failure of the Trump administration as well as the country’s profit-driven healthcare system become glaringly obvious, Trump, as his wont, has been looking for scapegoats to gloss over his gross mismanagement of a health emergency. Trump has not spelt out what is wrong with the WHO beyond alleging that it has been showing undue deference to China, and has failed to provide accurate information about COVID-19 (Business Line 2020). On the other hand, in a tweet on 24 January, Trump praised China: “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency…” However, on 31 July, he went on to bar the entry of foreign nationals into the US who had a history of travelling to China in the past few months. This decision did not have a sanction from WHO, and Trump did point this out. 

Trump’s allegation that WHO has been China-centric, without giving any specifics, is hollow. It is to be noted that WHO’s policy decisions are made by its World Health Assembly (WHA) comprising 194 countries as members and two countries as associate members, Puerto Rico and Tokelau. The conduct of WHA is based on a set of democratic rules of procedure and on the issues of the global North–South divide. It has often been the case that decisions adopted are fair and balanced due to the majority enjoyed by the developing countries. This has always been a point of concern for the US, as with other democratic UN fora.  

However, if there is any bias with the WHO Secretariat in terms of its bureaucracy, it is towards the US. A large part of the procurement of medical and health equipment and services by or through WHO is from the US companies. This has been widely criticised at the global level. Public health policy experts hold the concern that Western multinational pharmaceutical companies, especially those from the US, lobby with WHO bureaucracy to influence health policy decisions in favour of their commercial interests (Gopakumar 2015). Halfdan Mahler, a three-time director general of WHO, in a 1988 article in the Danish daily Politiken, had cautioned the world against the “unhealthy influence” the pharmaceutical industry has over WHO. He warned that “the industry is taking over WHO” (Ventegodt 2015).  It is indeed a welcome move that Trump has started this debate on that bias, and one needs to take it forward. Let us also figure out if a country from the global South is a threat to the mandate of WHO or is it from the Western multinationals.  

The Seminal Role of WHO and the Dubious Character of the US   

WHO has been playing a significant role in managing the COVID-19 crisis globally, by increasing awareness on the disease, coordinating with multiple countries, setting up protocols, promoting cooperative research, securing supplies to the needy countries, among others. No doubt WHO has to be reformed, but not in line of Trump’s accusations and what he feels should be the way forward for the global health body. Instead, the changes should be to strengthen the internal democracy in the functioning of WHO, and to set up accountability protocols on every decision made. The world would have been much worse without WHO at a critical time like this. We also want the serious involvement of WHO as well as the UN Secretary General not only in the development of COVID-19 vaccines but also to make emerging vaccines accessible to developing countries on affordable terms, and to save such exercises from undue patent protection and over-commercialisation.   

Whereas, what Trump has done in the “global spirit” amounts to outright piracy. A large shipment of protective equipment kits meant for Tamil Nadu from China has been forcefully diverted to the US (New Indian Express 2020). Similarly, the shipments of protective equipment kits meant for Germany, Canada, and France have also been diverted to the US (Willsher et al 2020). While the political leadership in these countries protested the US’ deceitful role in tackling the global pandemic, India has remained silent.  

US Is a Strain on WHO and UN Resources  

The US’ refusal to pay mandatory annual dues to WHO reflects the country’s disregard for the multilateral democratic organisations. UN organisations are run on the mandatory annual contributions made by the member states, which is worked out on an agreed scale of assessment relative to the wealth and population of a country. Accordingly, the US has to pay 22% of the annual budget to WHO, China 12%, Japan 8%, European Union 30%, and India 0.83%. Of the total budget of $489 million of WHO for 2020, the assessed contribution of the US is $ 115 million, China $57 million, and India $4 million. However, the US has been a regular defaulter on its contributions to WHO and the UN secretariat. For 2019, the US only paid one-third of its assessed contribution (WHO 2020). When a member country fails to pay dues equivalent to the full contributions for the preceding two years, it loses voting rights in the organisation as per Article 19 of the UN Charter. However, voluntary contributions are not covered under this provision.

The US’ efforts to financially throttle UN agencies are not new. They have been consistently refusing to pay the dues to the UN secretariat on flimsy grounds. In 2018, the US paid $ 482 million less than its agreed assessed contribution to the UN. This has been the case with the US, despite its largest economy in the world and while low-income countries have been duly paying their statutory contributions. 

Furthermore, it is not only WHO that has come under the US’ attack but also the United Nations Educational, Scientific and Cultural Organisation (UNESCO). Trump pulled the US out of UNESCO in December 2018 following UNESCO General Conference’s decision, by an overwhelming majority, to admit Palestine as a member, and the 2017 decision designating the Palestinian city of Hebron as a UNESCO world heritage site (Al Jazeera 2019; Beaumont 2017; Cornwell 2011). It was not the first time that the US quit UNESCO. The US had also quit UNESCO in 1984 after levelling charges of politicising the organisation against Mahtar M’Bbow of Senegal, an eminent African, who had been heading the organisation. The US returned to UNESCO in 2013 only after realising that the US’ boycott would not cause a dent to the organisation.   

The US’s boycott of UNESCO hurt the country in multiple ways, including serious decline in UNESCO procurements of services, books, among others from the US companies, and the decrease in the number of US nationals on UNESCO staff list. With the US not around, UNESCO had one of its most creative periods after 1984, without the intimidating presence of the US in the meeting halls of UNESCO. The decision of the US to leave WHO, following its refusal to pay the membership dues, is likely to even make WHO a better place. 

While the US’ assessed contribution is 22%, a larger percent of WHO’s expenditure ends up in the US.  It tops in terms of orders made by WHO for procurement of medicines, equipment and services, meaning that the US takes back more than it brings to WHO. Without the US on board, the proceedings of decision-making bodies in WHO will be smooth, as the US has, time and again, exploited global concerns for its vested interests. In any case, the US is outside of many global democratic multilateral initiatives, including the Convention on Biological Diversity and its protocols, Kyoto Protocol, International Criminal Court and Basel Convention, and has also withdrawn from the Paris Agreement and the UN Human Rights Council, besides UNESCO in 2018. Although the US’ attack on WHO is politically driven, the world need not worry about its departure from the organisation.   


S Faizi (s.faizi111@gmail.com) is an ecologist specialising in international policy affairs, and has been a United Nations negotiator.
6 August 2020