To the consternation of the international health community, President Donald Trump withdrew from the World Health Organization (WHO) on the very first day of his second term. This restored his decision to withdraw from and suspend funding to the WHO in his first term. But his 2025 executive order went further, including recalling U.S. government personnel working with the WHO. The decision presents four rationales: mishandling of the COVID-19 pandemic, its vulnerability to inappropriate political influence, the failure to adopt reforms to focus on core priorities, and disproportionate dependence on the United States for funding.
These complaints have merits.
The COVID pandemic was the international health crisis for which the WHO was built. Instead, it failed. From the very beginning, the WHO leadership appeared more concerned with kowtowing to Beijing than acting quickly and decisively to contain the pandemic.
China’s actions relating to COVID were appalling and the WHO covered for Beijing. It was Taiwan, not China, that first alerted the WHO about potential human-to-human transmission of COVID-19, only to have WHO Director-General Tedros Adhanom Ghebreyesus echo Chinese misrepresentations: “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus.” Beijing impeded timely access by international experts into Wuhan, China, early in the pandemic. Yet, the WHO thanked China for its cooperation. WHO Director General lavishly praised China’s willingness to “immediately” share genetic sequencing information about the virus when, in fact, they did the opposite. The WHO downplayed the possibility that COVID-19 originated from a laboratory in Wuhan while evidence increasingly supports that conclusion.
China’s actions relating to COVID were appalling and the WHO covered for Beijing.
To this day, the Chinese government has failed to disclose the most basic information about the provenance of the COVID virus, and the WHO has never formally condemned Beijing for its lack of cooperation.
On the budget, the trend is sharply upward, increasing from $2.73 billion in 2004-2005 to $6.83 billion in 2024-2025. The WHO relies heavily on voluntary contributions, and the U.S. has historically provided the lion’s share, especially voluntary contributions, to support WHO efforts on contagious disease. Meanwhile, China provided almost nothing in voluntary contributions. WHO reported donor information confirms that the U.S. remained the largest government contributor to the WHO in both assessed and voluntary contributions as of March 2025 providing 16 times more voluntary funding than Beijing.
You would think that this generosity would be reflected in WHO priorities. But complaints of multiple U.S. administrations that the WHO focused too much on health issues that pose no threat of contagion are often disregarded. Currently, the WHO claims to address nearly 200 health topics, including earth quakes, obesity, road safety, and volcanic eruptions, most of which have little connection to communicable diseases or pandemics. In a world of limited resources, these activities divert from the core WHO mission.
Exactly how much of the budget goes to these activities is unclear, which is another problem. An article from over a decade ago noted that 61 percent of the regular budget, funded by assessed contributions, was allocated to communicable diseases compared to 91 percent of voluntary extra-budgetary funds focused on communicable diseases. More recent budgets obscure this information. The 2024-2025 budget outline lists broad categories like health emergencies or healthier populations, but even the detailed budget documents provide little specificity in 62 pages of jargon. The WHO website provides also categorizes expenditures generically. The fact that the WHO does not forthrightly provide this data undermines confidence.
And then there are persistent problems of misconduct, mismanagement, and politicization. The WHO had to create a special unit in 2021 to investigate 287 allegations of sexual misconduct by its staff. Whistleblowers allege corruption and misallocation of funds. WHO has also been a partisan in the conflict between Israel and Hamas terrorists largely ignoring repeated violations by Hamas of hospitals in the Gaza strip while simultaneously condemning Israel for demanding evacuation of civilians from health facilities that Hamas misused to hide facilities and weapons.
In short, while the WHO provides valuable services and is uniquely placed in the international system to address health issues of global scope, the Trump administration is not wrong to express deep concern about prioritization, budgetary imbalances, vulnerability to politicization, and the need for reforms.
While the WHO provides valuable services and is uniquely placed in the international system to address health issues of global scope, the Trump administration is not wrong to express deep concern about prioritization, budgetary imbalances, vulnerability to politicization, and the need for reforms.
The real mystery is why the WHO leadership and the other member states, instead of expressing disappointment in the decision, have not proposed changes to convince the U.S. to reconsider. Trump expressed willingness when he signed the executive order: “They wanted us back so badly; so, we’ll see what happens.”
If the WHO isn’t interested in implementing changes to keep the U.S. engaged, the U.S. will pursue those goals elsewhere whether bilaterally or multilaterally inside the UN system or outside. Reducing infant and maternal mortality, immunization, bolstering health in developing nations, and detecting and preventing new pandemics are indisputable goods and the U.S. won’t abandon them even if it adjusts funding or shifts avenues to pursue them.
Brett D. Schaefer is a senior fellow at the American Enterprise Institute.