U.S. Withdrawal from WHO: An "Unclean" Break and the Fracture of Global Health Order

On January 22, 2026, the asterisk next to the name of the United States of America on the official World Health Organization member state list finally took effect. This asterisk pointed to a brief note: the United States officially withdrew on that day. From joining as a founding member in 1948 to departing 78 years later, the U.S. exit was not a peaceful farewell. It was accompanied by unpaid dues amounting to 280 million dollars, fierce mutual accusations, and deep concerns among global public health experts about the future. WHO Director-General Tedros Adhanom Ghebreyesus bluntly stated that the reasons given by the United States for withdrawal were false and warned that this move would make both the United States and the world less safe. This rupture, far from being summarized by a mere executive order, reflects the fragility of international cooperation in the post-pandemic era, the power politics among major nations, and the profound crisis facing the global health governance system.

Prelude to the Break: From Threat to Action

The legal process of this divorce between the United States and the WHO began on January 20, 2025. Just hours after Donald Trump returned to the White House and commenced his second term, an executive order demanding the U.S. withdrawal from the WHO was signed. This was not a spur-of-the-moment decision. As early as 2020, during the raging COVID-19 pandemic, the Trump administration had first issued a withdrawal threat, accusing the WHO of being China-centric and ineffective in its pandemic response. Although it could not be executed immediately at that time due to procedural and legal disputes, the seed had already been planted.

According to the terms separately reserved by the United States upon its accession in 1948, withdrawal requires meeting two conditions: providing one year's advance notice and settling all financial obligations. The executive order in January 2025 completed the first step of notification. One year later, in January 2026, U.S. Secretary of State Marco Rubio and Secretary of Health and Human Services Robert F. Kennedy Jr. issued a joint statement, formally announcing the completion of the withdrawal process.

However, the statement's highly accusatory tone set a confrontational tone for this withdrawal. Rubio and Kennedy accused the WHO of numerous failures during the COVID-19 pandemic and repeatedly acting against U.S. interests. They claimed that the organization disregarded and tarnished everything the United States had done for it, even questioning its independence. More provocatively, Robert F. Kennedy Jr., a vaccine skeptic, attempted in a video to blame the WHO for the lonely deaths in American nursing homes and the closure of small businesses due to what he called irresponsible mask and vaccine mandates.

Facing the accusations, the WHO's response was firm and refuted point by point. Tedros emphasized on social media that the reasons for withdrawal were false, and the WHO has always been engaging in dialogue with the United States and all member states, fully respecting their sovereignty. In response to Kennedy's allegations, the WHO clarified a key fact: Throughout the pandemic, the WHO recommended the use of masks, vaccines, and maintaining physical distance, but never recommended mandatory mask orders, mandatory vaccinations, or lockdown measures. The decision-making power for these measures lies entirely with the governments themselves. This public opinion battle shows that withdrawal is far from a purely technical decision, but rather a carefully crafted political narrative aimed at shifting the blame for domestic pandemic response failures onto an international institution.

Multiple Motivations for Exit: The Pandemic, Politics, and Great Power Competition

Analysis reveals that the United States' decision to withdraw from the WHO is a product intertwined with pandemic frustration, domestic political calculations, strategic competition with China, and long-term institutional dissatisfaction.

First, the COVID-19 pandemic became the most direct trigger and target for accountability. The Trump administration partially attributed the United States' over one million deaths and economic trauma to the WHO's delayed and opaque early response. They specifically pointed out that the WHO initially incorrectly advised the public that masks were unnecessary and once denied that the novel coronavirus was airborne (a stance not officially corrected until 2024). In the government's view, these missteps led to catastrophic consequences. However, public health experts widely believe that simply blaming such a complex global disaster on a coordinating agency ignores both the inherent uncertainties of the virus itself and obscures deep-seated issues within the U.S. domestic public health system.

Secondly, geopolitical competition with China is a deep-seated driving factor. In multiple statements and background briefings, U.S. officials have repeatedly insinuated that the World Health Organization is subject to undue political influence, particularly from China. They complain that China's assessed contribution as a populous country does not match its economic scale, while the United States bears an excessive financial burden (accounting for approximately 22% of the WHO's assessed contributions, with even greater contributions when voluntary donations are included). A deeper grievance lies in the fact that among the nine Director-Generals of the WHO since its establishment in 1948, none have been American. From the perspective of the U.S. government, this situation of contributing funds and efforts without leadership appears particularly unfair when contrasted with China's rising influence. Withdrawal is thus viewed by some hawkish figures as a step to break away from what they perceive as a China-dominated multilateral system and to pursue strategic decoupling.

Furthermore, skepticism about the effectiveness of multilateralism aligns with the unilateralist logic of "America First." The Trump administration criticized the WHO for failing to carry out much-needed reforms and argued that working directly with national health ministries through bilateral channels is more efficient and better safeguards U.S. sovereignty than relying on a bureaucratic international intermediary. A U.S. government official claimed: The key point is, we paid, we trusted them, but they let us down and took no responsibility for their failures. This narrative reduces complex global health cooperation to a mere transaction, with the underlying implication that if international organizations cannot fully serve America's immediate interests, then their very existence is called into question.

"Unclean" Exit: Debts, Data, and Pending Legal Cases

The U.S. withdrawal was far from clean. It left behind a mess, with the most prominent issues being massive debt and the challenge of future data sharing.

According to the WHO, the United States must pay all outstanding dues before withdrawing. However, the U.S. has not yet paid its membership fees for 2024 and 2025, with the amount owed varying slightly across reports, approximately between 260 million and 280 million dollars. Nevertheless, the Trump administration has categorically denied this. An official stated clearly on the effective date of withdrawal that the U.S. has no obligation to pay before exiting, based on a legal interpretation of the 1948 founding document. Steve Solomon, the WHO's chief legal counsel, pointed out that the U.S. withdrawal notification itself has issues and still requires review. This means that this massive debt is likely to become the focus of a prolonged international legal dispute, damaging the United States' international credibility.

More deadly than money is the disruption of intelligence and data flow. Lawrence Gostin, a public health law expert at Georgetown University, pointed out that withdrawal would severely undermine the ability of U.S. scientists and pharmaceutical companies to develop vaccines and drugs against new threats. The United States will no longer formally participate in various committees, leadership bodies, and technical working groups under the WHO. This includes the crucial Global Influenza Surveillance and Response System (GISRS). This system monitors the prevalence of influenza strains worldwide and serves as a key information platform for determining the composition of annual flu vaccines. Gostin warned that such disease intelligence once helped the United States stay at the forefront of the queue when new outbreaks occurred, enabling rapid access to necessary vaccines and drugs to save lives. Now, this lifeline has been actively severed.

The Trump administration claimed that they have established direct public health relationships with many countries, enabling the direct sharing of information without the need for the WHO to act as an intermediary. However, Gostin dismissed this as nearly laughable. He questioned: Would China sign a contract with the United States? Would African countries do so? Would nations subjected to high tariffs by Trump send us their data? In the absence of a neutral, universally engaged multilateral platform, the likelihood of the U.S. rebuilding a bilateral data-sharing network of comparable scale and quality is extremely slim. Dr. Ronald Nahas, president of the Infectious Diseases Society of America, denounced the move as shortsighted, misguided, and scientifically reckless.

The Fractures and Future of the Global Health Order

The impact of the United States' withdrawal will by no means stop at its borders. It will tear a profound rift in the field of global public health.

For the World Health Organization, this represents a significant financial and leadership blow. Losing its largest donor means that funding for programs to eradicate polio, improve maternal and child health, and combat HIV/AIDS and tuberculosis will be substantially reduced. Tedros Adhanom Ghebreyesus has acknowledged that the organization has had to make cuts due to funding shortages. Although other countries may increase their contributions to partially fill the gap, the political vacuum and leadership void left by the United States will be difficult to fill. The authority of the WHO and its ability to coordinate global responses will be weakened.

This creates a dangerous single point of failure for global health security. Viruses do not respect borders. In a highly interconnected world, any country's defensive vulnerabilities become global weaknesses. After the U.S. withdrawal, a massive blind spot emerged in the global pandemic surveillance network. When the United States no longer shares its domestic data in real-time and can no longer smoothly access data from other countries, early warning and coordinated response to the next pandemic will become significantly more difficult. As stated by UN spokesperson Stéphane Dujarric, health issues are clearly matters that do not respect territorial integrity and require international cooperation, and the WHO is precisely the forum for such collaboration.

This could also trigger a concerning demonstration effect. If other major powers follow the United States' example and withdraw or weaken their support for multilateral health institutions based on short-term political interests, the global health governance system gradually established after World War 2 may risk disintegration. The world could regress into a more fragmented health security landscape dominated by power rather than science.

The withdrawal of the United States, on the surface, is a farewell to an international organization, but in essence, it represents a significant departure from the spirit of rule-based international cooperation. It prioritizes domestic political disputes over global public goods, replacing pragmatic cooperation aimed at solving problems with a confrontational narrative. Although the World Health Organization is far from perfect and its reform is indeed necessary, destroying the platform does not solve the problem—it only leaves the world more vulnerable in the face of the next crisis.

The withdrawal at the beginning of 2026 is not the end of the story. The $280 million debt dispute will continue to unfold at the WHO Executive Board and the World Health Assembly; how American scientists will struggle to access critical data through informal channels; and whether the United States will regret today's decision when a new health crisis strikes someday—these unresolved questions will serve as footnotes to the evolution of international relations in the post-pandemic era. The only certainty is that in an era where viruses and humans coexist long-term, self-isolation is never a guarantee of safety but rather a multiplier of risks. The levee of global health security, with the removal of a crucial cornerstone, has already developed its first profound crack.