U.S. Completes Withdrawal From WHO, Ending 78-Year Membership

On a gray Friday in Washington, the United States quietly stepped away from an institution it helped build.

With a short series of statements on Jan. 22, the Department of Health and Human Services and the State Department announced that the U.S. had completed its withdrawal from the World Health Organization, ending a 78-year membership in the U.N. health agency that coordinated global responses to smallpox, polio and, most recently, COVID-19.

The move capped a one-year exit process triggered by President Donald Trump’s Executive Order 14155, signed on Jan. 20, 2025, his first day back in office. The administration says leaving WHO will free the United States from a politicized, China-influenced bureaucracy and allow it to protect Americans’ health through its own network of bilateral partnerships and domestic agencies. Public health experts and WHO officials warn the decision will weaken disease surveillance, slow vaccine coordination and give other powers greater sway over global health rules.

“The United States has today completed its withdrawal from the World Health Organization,” HHS said in a Jan. 22 news release. “WHO’s mishandling of the COVID‑19 pandemic that arose out of Wuhan, China, and its continued failure to adopt urgently needed reforms have made our continued membership untenable.”

In a joint statement, Health and Human Services Secretary Robert F. Kennedy Jr. and Secretary of State Marco Rubio framed the exit as a campaign promise kept.

“By ending our membership in a politicized, bureaucratic organization that abandoned its core mission, we are freeing the United States from its constraints, as President Trump promised on his first day in office by signing Executive Order 14155,” they said, calling the move “promises made, promises kept.”

They accused the agency of pursuing “a politicized, bureaucratic agenda driven by nations hostile to American interests,” despite U.S. status as a founding member and largest financial contributor.

WHO responds, citing shared security

Two days later in Geneva, WHO responded in unusually blunt language.

“The World Health Organization regrets the United States’ notification of withdrawal,” the agency said on Jan. 24. “This decision makes both the United States and the world less safe.”

The statement recounted U.S. collaboration in eradicating smallpox and fighting polio, HIV, Ebola, influenza, tuberculosis and malaria, and said WHO’s role was to provide scientific advice, not to mandate responses such as lockdowns.

A dispute rooted in the COVID-19 era

The break marks the culmination of a long-running clash that began during the first Trump term. In 2020, as the coronavirus spread, Trump accused WHO of being “China-centric” and formally notified the United Nations that the U.S. would leave, a withdrawal that would have taken effect in July 2021. President Joe Biden reversed that decision on taking office, rejoining the agency and restoring funding.

Trump’s return to office in 2025 reopened the question. Executive Order 14155, titled “Withdrawing the United States from the World Health Organization,” directed the secretary of state to notify WHO and the U.N. secretary-general of U.S. withdrawal, ordered U.S. negotiators to cease participation in talks on a new WHO pandemic agreement and amendments to the International Health Regulations, and instructed agencies to identify “credible and transparent” partners to take over work previously conducted through WHO.

The order argued that WHO “failed to hold the People’s Republic of China to account for its role in the global spread of COVID‑19,” delayed declaring an international emergency and a pandemic, and “demanded unfairly onerous payments” from the U.S. It also asserted that actions under the pandemic accord and updated regulations “shall have no binding force or effect on the United States” during the withdrawal period.

During the year that followed, HHS and the Centers for Disease Control and Prevention said they halted all U.S. government funding to WHO and recalled American personnel embedded at WHO headquarters in Geneva and in country and field offices around the world. The administration said it was redirecting money and experts into bilateral health programs, security-focused bio-surveillance and partnerships with private and nongovernmental organizations.

Is the withdrawal legally complete?

Despite those steps, questions remain about whether the divorce is legally complete.

When the United States joined WHO in 1948, it did so with a reservation: it could withdraw on one year’s notice “provided, however, that the financial obligations of the United States to the Organization shall be met in full for the Organization’s current fiscal year.” According to WHO budget records and independent estimates, the U.S. has not paid its assessed contributions for the 2024–2025 budget cycle, leaving roughly $278 million to $280 million in unpaid dues.

WHO said in its Jan. 24 statement that issues surrounding the U.S. notification, including financial obligations, would be taken up by its Executive Board in early February and the World Health Assembly in May. The governing bodies will decide how to treat the arrears and what they mean for the formal status of the withdrawal.

Inside the United States, the move also revives a constitutional debate over how far a president can go in unilaterally withdrawing from international organizations.

Legal scholars and the nonpartisan Congressional Research Service have previously noted that statutes authorize U.S. participation in WHO and appropriate funds for it, but Congress has not clearly addressed withdrawal. In 2020, Democratic senators introduced the “No WHO Withdrawal Act,” which would have barred the use of federal funds to exit the agency without congressional approval, but the bill did not advance. Courts have not issued a definitive ruling on whether leaving WHO requires consent from Congress.

Funding, surveillance and influence

While those legal questions play out, the practical consequences are already visible for WHO and its programs.

For decades, the United States has been WHO’s single largest donor. HHS estimates that in recent years the U.S. provided about $111 million a year in assessed contributions—mandatory dues based on national income—and roughly $570 million a year in voluntary funding earmarked for specific programs. That money flowed into global disease surveillance networks, polio eradication campaigns, HIV, tuberculosis and malaria initiatives, and efforts to strengthen fragile health systems.

Global health organizations and former WHO officials say the sudden loss of that funding will force cuts or shifts in priorities.

“There is no way to subtract hundreds of millions of dollars from WHO’s budget without slowing or shrinking programs that save lives,” said one public health law expert at a U.S. university. “The question is where those gaps will fall—and who will step in.”

One of the starkest concerns is disease surveillance and early warning. Much of the world’s monitoring of influenza and other respiratory viruses is coordinated through WHO’s Global Influenza Surveillance and Response System, a network of laboratories and reference centers that track circulating strains and meet twice a year to recommend which strains should be included in seasonal flu vaccines.

Without WHO membership, U.S. government scientists no longer have a guaranteed seat at those meetings. Health analysts warn that could complicate and potentially delay decisions about which strains U.S. manufacturers target in their annual influenza shots, although informal technical collaboration is likely to continue.

The withdrawal also places the United States outside the room as WHO member states implement a new pandemic agreement and update the International Health Regulations—the rulebook that governs how countries report and respond to health emergencies. Those negotiations accelerated in the aftermath of COVID‑19, with countries seeking clearer obligations on data sharing, access to countermeasures and support for weaker health systems.

Trump administration officials have argued that those efforts risk infringing on national sovereignty.

“No international body should have the power to dictate how the United States responds to an emergency within our own borders,” Kennedy said earlier this month, defending the decision to quit WHO and reject the pandemic accord.

WHO officials respond that the agreement and regulations reinforce, rather than erode, sovereignty by clarifying expectations and enabling faster, coordinated responses.

“Viruses do not respect borders,” the agency said in its January statement. “In a globalized world, no country is safe until all countries are better prepared.”

The geopolitical implications extend beyond health. China’s Foreign Ministry has publicly backed WHO and criticized the U.S. move, presenting Beijing as a defender of multilateral institutions. Analysts say Beijing, along with the European Union, India and others, is likely to gain influence over WHO’s budget and priorities in the absence of U.S. leadership.

For now, the administration insists Americans will be better protected by going it alone. HHS and CDC say the U.S. will remain “the world’s leading force in protecting public health” through its own agencies, military laboratories and development programs.

Whether that approach can match the reach and coordination of the system the U.S. helped design will likely be tested not in courtrooms or conference halls, but in the early days of the next pandemic.