The United States has formally completed its withdrawal from the World Health Organization (WHO), a move that has drawn sharp criticism and raised concerns about global health security.
The decision comes as the US reportedly owes the global health agency more than $130 million. Officials within Donald Trump's administration have conceded that unresolved issues remain, including the potential loss of access to crucial international data that could provide early warnings of future pandemics.
Public health law expert Lawrence Gostin, from Georgetown University, warned that the withdrawal would severely hamper the international community's ability to respond to new outbreaks. He added that it would also impede American scientists and pharmaceutical firms in their efforts to develop vital vaccines and medicines against emerging threats. "In my opinion, it's the most ruinous presidential decision in my lifetime," Mr Gostin stated.
The WHO is the United Nations' specialised health agency and is mandated to co-ordinate the response to global health threats, such as outbreaks of mpox, Ebola and polio. It also provides technical assistance to poorer countries; helps distribute scarce vaccines, supplies and treatments; and sets guidelines for hundreds of health conditions, including mental health and cancer.
Nearly every country in the world is a member.
US officials helped lead the WHO's creation, and America has long been among the organization's biggest donors, providing hundreds of millions of dollars and hundreds of staff members with specialised public health expertise.
On average, the US pays 111 million dollars (£82 million) a year in member dues to the WHO and around 570 million dollars (£421 million) more in annual voluntary contributions, according to the US Department of Health and Human Services.
In an executive order issued immediately after taking office, Mr Trump said the US was withdrawing from WHO because of the organization's mishandling of the Covid-19 pandemic and other global health crises. He also cited the agency's "failure to adopt urgently needed reforms" and its "inability to demonstrate independence from the inappropriate political influence of WHO member states".
WHO, like other public health organizations, made costly mistakes during the pandemic, including at one point advising people against wearing masks. It also asserted that Covid-19 was not airborne, a stance it did not officially reverse until 2024.
Another Trump administration complaint was that none of WHO's chief executives - there have been nine since the organization was created in 1948 - have been Americans. Administration officials view that as unfair given how much the WHO relies on US financial contributions and on US Centres for Disease Control and Prevention personnel.
Experts say the US exit could cripple numerous global health initiatives, including the effort to eradicate polio, maternal and child health programmes and research to identify new viral threats.
Dr Ronald Nahass, president of the Infectious Diseases Society of America, called the US withdrawal "shortsighted and misguided" and "scientifically reckless".
The US has ceased official participation in WHO-sponsored committees, leadership bodies, governance structures and technical working groups. That would appear to include the WHO group that assesses what flu strains are circulating and makes critical decisions about updating flu jabs.
It also signals the US is no longer participating in global flu information-sharing that guides vaccine decisions.
Such disease intelligence has helped Americans be "at the front of the line" when new outbreaks occur and new vaccines and medicines are quickly needed to counteract them and save lives, Mr Gostin said.
Trump administration officials say they already have public health relationships with many countries and are working to ensure direct sharing of that kind of information, rather than having WHO serve as a middleman. But US officials did not give specifics about how many such arrangements are in place.
Mr Gostin, an expert on international public health treaties and collaborations, said it is unlikely the US will reach agreements with more than a couple dozen countries.
Many emerging viruses are first spotted in China, but "is China going to sign a contract with the United States?" Mr Gostin said. "Are countries in Africa going to do it? Are the countries Trump has slapped with a huge tariff going to send us their data? The claim is almost laughable."
Mr Gostin also believes Mr Trump overstepped his authority in pulling out of WHO. The US joined the organization through an act of Congress and it is supposed to take an act of Congress to withdraw, he argued.
The US is legally required to give notice one year in advance of withdrawal - which it did - but also to pay any outstanding financial obligations.
The US has not paid any of its dues for 2024 and 2025, leaving a balance of more than 133 million dollars (£98.31 million), according to WHO.
A Trump administration official denied that requirement on Thursday, saying the US had no obligation to pay prior to withdrawing as a member.
Starmer condemns Trump for ‘diminishing’ UK’s war dead over false Afghanistan claims
Trump’s New Gaza is first step to the end of any Palestine state, Gaza families warn
Donald Trump ‘wrong’ about Nato in Afghanistan, says Downing Street
Dana White declares he would ‘do anything for Trump’ and reveals they speak monthly
Don Lemon baits Pam Bondi: ‘Make me the new Jimmy Kimmel’ after charges fall apart
Greenland latest: Trump claims deal will give him ‘total access’ to Danish territory
