America Goes Solo: The Real Cost of Leaving WHO Behind

In late January 2026, the United States officially severed ties with the World Health Organization—exactly one year after President Trump signed the withdrawal order on his first day back in office. It wasn't just a policy shift. It was the end of a 70-year partnership that shaped how the world responds to health crises.

The numbers tell the story: In 2023, US contributions to WHO nearly tripled those of the European Commission and exceeded Germany's by 50%. Now that funding—and influence—is gone.

Why Walk Away Now?

The Trump administration's official reasoning centers on "unfair burden-sharing." China, despite having three times the US population, contributes 90% less to WHO than America does. The administration also cites WHO's COVID-19 response failures and lack of transparency.

But health experts counter with a different calculation: preventing disease outbreaks costs far less than managing them after they spread. The Infectious Diseases Society of America called the withdrawal "a shortsighted and misguided abandonment of our global health commitments," noting that "germs do not respect borders."

The timing raises questions. Why exit during a period of emerging health threats? Why abandon influence when China is actively seeking to expand its global health footprint?

Immediate Fallout

WHO has already announced dramatic cuts: 2,300 jobs (a quarter of its workforce) will be eliminated by summer 2026, and 10 divisions will be consolidated into four. The organization is scrambling to maintain core functions with significantly reduced resources.

The US still owes WHO approximately $260 million in dues for 2024-25, creating legal complications around the withdrawal process. While most countries lack withdrawal clauses in their WHO agreements, the US negotiated this option when it joined, requiring one year's notice and payment of outstanding dues.

For American health security, the implications are immediate. The US-WHO partnership has been crucial in containing Ebola outbreaks, addressing mpox globally, and managing the Marburg virus outbreak in Rwanda and Ethiopia. Both Ebola and Marburg have 50% fatality rates on average—containment before pandemic-level spread was literally a matter of life and death.

The Flu Vaccine Problem

Perhaps the most immediate impact involves something millions of Americans encounter annually: the flu shot. The US will no longer participate in WHO's Global Influenza Surveillance and Response System, operational since 1952.

Here's how flu vaccines work: they're developed one year in advance using global data analyzed by international expert teams. WHO convenes panels twice yearly to predict which strains will dominate the following year. Without US participation, American experts lose their voice in this process, and the US loses access to detailed methodology and early data.

The CDC estimates that annually, millions of Americans get flu, hundreds of thousands are hospitalized, and tens of thousands die. Diminished vaccine preparation capability will likely mean higher hospitalization and death rates—a concrete cost of withdrawal that will be measured in American lives.

Data access presents another challenge. WHO members receive detailed information about collection methods and gain earlier access to emerging threat data. Non-members get public data, but later and with less context. In a fast-moving outbreak, those delays could prove critical.

China Steps In

China has already signaled its intentions, pledging an additional $500 million to WHO over the next five years. This represents more than opportunistic funding—it's a strategic move to fill the leadership vacuum America is creating.

The reputational damage extends beyond dollars. The US built its position as a global health leader over decades, becoming the largest developer and implementer of international health programs. Surrendering this position diminishes American ability to influence global health strategies—important because global health directly affects domestic health security.

When the next pandemic arrives, the US may find itself on the outside of coordinated international responses it once led.

States Chart Their Own Course

Not everyone is following Washington's lead. California announced it will join WHO's Global Outbreak Alert & Response Network, which accepts participants beyond member nations. The state also helped found the West Coast Health Alliance, now including 14 US states committed to collaborative public health efforts.

California Governor Gavin Newsom has enlisted former CDC leaders Susan Monarez and Deb Houry, along with epidemiologist Katelyn Jetelina, to build alternative public health infrastructure. These initiatives suggest that while federal policy may change, state-level cooperation continues.

The Path Back

WHO has clearly signaled its desire for US re-engagement, expressing regret over the withdrawal and hoping America will reconsider. The door remains open for a future administration to reverse course—rejoining would likely be straightforward from a procedural standpoint.

But the damage to relationships and trust may take longer to repair. International partners now know that American commitments can shift dramatically with electoral cycles, potentially affecting their willingness to rely on US leadership in future crises.