A WHO Exit Is a Huge Mistake

Dear President Trump,

On your first day in office, you signed an executive order to withdraw the U.S. from membership in the World Health Organization (WHO). By a joint resolution of Congress in 1948, you are required to give 1-year’s notice of the intention to withdraw and to pay WHO all obligated funds.

I believe withdrawal from WHO is a grave strategic mistake. Yes, the loss of one of WHO’s greatest friends and funders would be a grievous wound to global health. But it will be even more damaging to our national interests, making Americans less safe and secure and diminishing U.S. influence and leadership. An “America First” agenda must help build a more agile, robust, and resilient WHO, not tear it down.

It appears that your animus toward WHO arose during the COVID-19 pandemic, when you viewed the agency as dominated by China. It certainly appeared true that China acted as a malign actor, initially failing to accurately report the Wuhan outbreak and then blocking WHO scientists from entering the country to investigate the origins of SARS-CoV-2. But as someone who has worked closely with WHO for more than 30 years, I steadfastly believe that the U.S. has always had far greater influence over WHO than China ever has. The hand of America permeates WHO, from senior WHO staff on loan from the CDC to policy experts that advise WHO committees. U.S. diplomates lead key negotiations on WHO regulations and treaties.

Here’s a potent example: On the final day of the World Health Assembly (WHA) on June 1, 2024, negotiations of amendments to the International Health Regulations had collapsed. But then, I witnessed HHS Secretary Xavier Becerra enter the room and warn: if diplomates failed to agree, the U.S. was walking away. Virtually every country fell in line.

If America withdraws from WHO, U.S. diplomats will be on the outside looking in. Negotiations for a pandemic treaty are scheduled to conclude at the May 2025 WHA. The treaty will govern pandemic prevention and response in ways directly affecting U.S. national interests, including scientific exchange, equity, and One Health. We don’t want the terms of that treaty set by others — but that is exactly what could happen if we walk away. The irony is that if the U.S. does exit WHO, that would cede influence to our adversaries, especially China. And decisions taken by WHO won’t reflect American interests and values.

Let’s look at some real-life scenarios of a world with a weakened WHO, and with the U.S. isolated and alone. The U.S. has been an essential voice at WHO in calling for rapid and reliable exchange of scientific information, as this data support national health and security. The CDC needs global surveillance data to detect outbreaks and monitor dangerous viral mutations. The NIH makes critical research decisions based on up-to-date information on pathogens circulating in human and animal populations. U.S. pharmaceutical companies need access to pathogen samples and genomic sequencing data to develop innovative diagnostics, vaccines, and therapeutics. The U.S. was among the first to develop mRNA vaccines under Operation Warp Speed — and early access to data from the WHO helped make that possible, as well as ongoing updates of COVID-19 vaccines. But our public health agencies and companies may be at the back of the line after we withdraw from WHO. It is vital to our national security that when a health emergency hits, we have early and ample access to lifesaving countermeasures such as vaccines and therapeutics. Withdrawing from WHO will only make that harder.

Let’s fast-forward to a developing infectious disease threat: the U.S. is currently the epicenter of an international avian influenza outbreak, with H5N1 circulating in dairy cows. To understand how H5N1 is evolving and to develop effective vaccines, the U.S. needs the vast network of WHO laboratories operating under the Global Influenza Surveillance and Response System (GISRS). In fact, GISRS helps determine the composition of up-to-date seasonal vaccines, and also provides vital data for novel influenzas. The U.S. would be less prepared if we lost full access to global influenza surveillance data, and that could contribute to a deadly pandemic if H5N1 developed the capacity for efficient human-to-human transmission.

WHO membership provides extensive networks to secure U.S. health security, safeguarding American lives and economic growth. WHO’s Global Outbreak Alert and Response Network provides real-time data on novel outbreaks needed for early detection and response. Even in recent years, novel diseases such as mpox, Ebola, and Zika have continued to bring sweeping challenges to America’s shores.

Without WHO, the world may never have eradicated smallpox. And without WHO, I believe it will be nearly impossible to eradicate wild polio. In fact, just a few years ago, in 2022, poliovirus was found in the wastewater system of New York City following a case of paralytic polio in the area. If Robert F. Kennedy Jr. is confirmed as HHS secretary, we are likely to see childhood immunizations fall even faster than they are now. That could risk all kinds of childhood diseases, including polio. The support of WHO would be essential in this scenario.

There is so much that WHO does that doesn’t make headlines but is vital to our own security and for global health. WHO sets norms and standards for healthcare, such as definitions of diseases, diagnostic criteria, and treatment guidelines. WHO collects and analyzes data on health trends and outbreaks, providing early warning of potential threats. It coordinates an international response to major health crises, such as pandemics and natural disasters. And it advocates for equity and health-for-all. In every major crisis, WHO is there, from polio in Gaza and mpox in the Congo to Marburg in Rwanda.

In summary, withdrawal from WHO entails three fundamental errors that are averse to America’s national interests. First, China does not have a major influence at WHO, but withdrawing from WHO would open a large vacuum that China could try to fill. Second, withdrawal from WHO would not make Americans healthier and safer. It would do the opposite by weakening our ability to rapidly detect and respond to health emergencies. Third, withdrawal from WHO would be harmful to our industries and economy. By diminishing the availability of crucial scientific data, both NIH and our pharmaceutical companies would be impaired in their ability to innovate and bring lifesaving products to the marketplace.

I can’t imagine a world without a powerful WHO. The U.S. helped create WHO more than 75 years ago. Mr. President, I implore you to remain in WHO and to build it into a responsive, well-funded, and accountable partner to the U.S. Yes, that would be good for the world, including the poorest and most marginalized people. But it is every bit as much in America’s vital national interests.