• US Withdrawal from WHO: The United States has withdrawn from the World Health Organization (WHO), citing inefficiencies in managing global health crises
• Funding Gap: The US is the largest financial contributor to WHO, providing approximately 18%
• Global Health Implications: May compromise WHO's ability to respond to global health emergencies, potentially jeopardizing critical programs

Harare- United States’ 47^th President, Donald Trump has pulled out from the World Health Organization (WHO), citing systemic inefficiencies in managing global health crises.

Trump has articulated concerns regarding the WHO's compromised autonomy and its disproportionate financial requisitions from the U.S. compared to nations like China.

China, despite being the second-largest economy globally, contributes the least, falling behind France, Japan, Germany, and the United Kingdom.

Trump believes that China is not sufficiently committed to contributing to global welfare. Trump argues that the World Health Organization (WHO) is ignoring this issue, especially given that China is the largest polluter in the world and contributes to other challenges faced by the organisation.

Over the last century, the U.S. federal debt has risen dramatically from US$395 billion in 1924 to US$35.46 trillion in 2024.

Withdrawing from WHO is expected to save the U.S. nearly US$1 billion annually, which could be crucial in addressing the national debt. Additionally, the U.S. has exited the Paris Climate Agreement, allowing it to reduce investments in expensive cleaner energies, further alleviating financial pressure.

This strategy extends to limiting aid to Ukraine, encouraging negotiations that could reduce costs.

Reducing membership fees to global organizations is a straightforward approach for Trump, and the WHO is not the only entity in his crosshairs.

During his previous presidency, Trump cut U.S. funding to the UN Population Fund (UNFPA), effectively reducing the budget of this global sexual and reproductive health agency by approximately 7%. He once again invoked the "China bogeyman," mistakenly accusing the agency of supporting coercive population control programs in China, including forced abortions.

In June 2017, Trump immediately halted all implementation of the Paris Agreement, a global commitment aimed at limiting warming to 1.5°C. He argued that the agreement undermined the U.S. economy, restricted the opening of new oil and coal fields, and placed the U.S. "at a permanent disadvantage to other countries."

During last year’s election campaign, Trump officials indicated to Politico that he plans to pursue similar actions in a potential second term, including the possibility of withdrawing the U.S. from the UN Framework Convention on Climate Change.

Historically, the U.S. has been a cornerstone of global funding for various initiatives, but Trump advocates for a shift towards a more self-reliant approach, emphasizing that other nations should contribute their fair share. His "America First" policy reflects this belief in prioritising national interests.

This strategic pivot means that the U.S. will formally disengage from the UN health agency within a 12-month timeline, ceasing all financial contributions to its operational budget.

The United States represents the largest financial stakeholder for WHO, contributing approximately 18% of its overall funding portfolio.

For the 2024-2025 fiscal year, WHO has projected a budget of $6.8 billion, heavily dependent on U.S. financial input. Following the U.S., Germany ranks as the second-largest donor, providing around 3% of WHO’s funding.

Among the 196 WHO member states, the United States is the largest contributor, slated to pay over $261 million in assessed contributions for 2024/2025.

In addition to this, the U.S. made voluntary contributions exceeding $367 million in 2023. In stark contrast, China’s contributions were significantly lower, totaling just under $4 million. This disparity highlights the contrasting levels of financial commitment to global health initiatives between the two countries.

Over the past decade, U.S. contributions have fluctuated between $160 million and $815 million annually, supporting initiatives against tuberculosis, HIV/AIDS, and emergency responses like COVID-19.

The U.S. has been the principal investor and collaborator with WHO, channeling $1.284 billion during the 2022-2023 funding cycle closely by Germany at US$856 million and Gates Foundation at US$830 million.

WHO's core mandate is to deliver healthcare to underserved populations, particularly in developing countries, thereby mitigating the risk of infectious disease outbreaks spreading to other regions.

WHO’s latest two-year fiscal plan for 2024-2025 stands at US$6.8 billion. The U.S. exit could jeopardize critical programs aimed at combatting tuberculosis, which has emerged as the leading cause of infectious disease mortality in 2023, as indicated in a recent WHO report.

Last year, approximately 8.2 million new tuberculosis cases were reported, marking the highest incidence since WHO began global monitoring in 1995, up from 7.5 million in 2022.

While tuberculosis-related fatalities decreased to 1.25 million in 2023 from 1.32 million in 2022, the overall disease burden saw a slight uptick to an estimated 10.8 million cases.

WHO’s funding model relies on two primary streams: assessed contributions from member states, which constitute under 20% of the total budget, and voluntary contributions, which account for the remaining 80%.

Chinese President Xi Jinping claimed a US$1 trillion trade surplus, suggesting that China is well-positioned to step in and fill the gap left by the U.S. withdrawal from global health initiatives.

However, China has shown minimal interest in supporting multilateralism in global health. Its engagement with the WHO is often subdued and lacks proactive initiatives.

Instead, China tends to favor bilateral agreements, allowing it to exert direct influence over the nations it supports. 

While the U.S. also uses bilateralism as a political tool to secure loyalty and support, it has simultaneously asserted its influence through multilateral bodies of the UN.

In Europe, the situation is further complicated by the ongoing war in Ukraine. The region is financially stretched and preoccupied with this conflict. “Since the start of the war, the EU and our member states have made available over $140 billion in financial, military, humanitarian, and refugee assistance,” the EU states.

With Trump threatening to end U.S. military assistance to Ukraine, the EU may feel pressured to increase its own financial support.

 Moreover, several key European nations that historically supported multilateralism now have right-wing parties in power, intent on cutting foreign aid.

Countries like Croatia, the Czech Republic, Finland, Italy, the Netherlands, and Slovakia, alongside Hungary, are experiencing a shift toward right-wing governance. Support for right-wing parties has risen significantly across Europe, particularly in Germany, Austria, France, and Portugal.

Consequently, the EU currently lacks both the means and the will to increase funding for global health initiatives, leaving a considerable void in the international response to health challenges.

Zim Context

 WHO has played a crucial role in supporting Zimbabwe’s public health infrastructure, with external donors estimated to finance up to 55% of the system. At the heart of this funding is the United States.

In collaboration with USAID and UNAIDS, the WHO has been instrumental in combating HIV and AIDS, resulting in a decline in prevalence among adults aged 15 to 49 from 12.69% in 2019 to 10.49% in 2023. Zimbabwe has successfully achieved the 95-95-95 UNAIDS Fast-Track targets, highlighting significant progress in the fight against the epidemic.

However, WHO estimates that over half of Zimbabwe’s health expenditure comes from external sources, with the 2025 national budget expecting US$461 million from donors, an increase from $353 million in 2024. This heavy reliance on outside funding raises concerns about sustainability and the ability to maintain health initiatives in the long term.

The potential withdrawal of the U.S. from the WHO could have profound implications for Zimbabwe. With the U.S. being a major contributor to WHO funding, its exit could lead to a significant reduction in financial support for vital health programs. This could jeopardize ongoing initiatives, particularly in TB, Cholera and HIV/AIDS treatment and prevention, and undermine the progress made toward achieving health targets.

A looming decrease in funding could force Zimbabwe to allocate a larger share of its limited national budget to health care, which is already projected to drop from 4% of GDP in 2024 to only 2.1% in 2025.

This reduction could lead to diminished healthcare resources, increased strain on public health systems, and ultimately, adverse outcomes for the population's health. The ripple effects of U.S. disengagement from WHO could thus threaten not only Zimbabwe’s health advancements but also its overall public health infrastructure.

Equity Axis News