The U.S. leaving the WHO is a chance to reshape global health

• The US government’s decision to withdraw from the World Health Organization (WHO) on January 20, 2025, has raised concerns about potential reduced funding impacting WHO’s functionality.

• The decision raises questions about why a single country’s exit from WHO is causing so much concern, how it can be turned into an opportunity to create a stronger WHO, and the need for a greater role of Asia and Africa in global health.

• WHO’s funding system includes two categories: assessed contribution (AC) and voluntary contributions (VC). AC is a fixed amount each WHO member-state must pay annually, which is disproportionately high for the U.S. and is used to pay regular staff salaries and maintain day-to-day operations. VC funds are voluntary, time-bound, and linked to specific activities, making them unpredictable.

• The financial impact on WHO is likely to be far greater than the direct share of U.S. government funds for WHO.

• Critics argue that WHO is bureaucratic, slow, and in need of urgent reforms, but this is partially true. In the era of emerging and multi-sectoral challenges, a stronger WHO is needed more than ever.

Why Institutions Fail: A Global Perspective

• Daron Acemoglu and James A. Robinson’s book, Why Nations Fail: The Origins of Power, Prosperity, and Poverty, suggests that nations thrive on the foundation and strength of functioning and stronger institutions.

• The world needs stronger institutions for peace and global health, but the recent decades have seen a rise in nationalism and ‘Nation first’, which often undermines global institutions.

• The U.S.’s exit from WHO has limited the likelihood of key multi-country alliances supporting and funding WHO.

• The global south, including countries like India, Brazil, South Africa, Thailand, Egypt, and others, needs to step up to support WHO and the United Nations.

• There is a significant gap in global health priorities and funding, with health challenges in Asia and Africa being grossly underfunded.

• The decision to recall U.S. government personnel seconded to WHO reflects how global health agencies are too dependent on subject experts from a single or select few countries.

• The global south must act immediately by partnering up to supplement WHO funding gap, investing in training of experts in public health and global health, setting up premier institutions at the country or regional levels, and reducing the headquarters’ operational costs.

• The U.S.’s withdrawal from WHO should be explored as an opportunity for the public health community and political leadership in the global south to initiate collaborative actions to reshape the global health agenda, which is much under the influence of high-income countries