US completes exit from WHO after 78 years, leaving funding and leadership gap

The United States has formally withdrawn from the World Health Organization, ending a relationship that began in 1948, when the WHO was founded. The US was not just a member, but a founding member, part of the organisation for nearly 78 years.

The exit follows a decision taken in January 2025, when President Donald Trump issued an executive order on the first day of his presidency, triggering the mandatory one-year withdrawal process, which has now been completed. The US government says the move reflects failures in the WHO’s handling of the COVID-19 pandemic, concerns over governance reforms, and what it describes as excessive political influence within the UN health agency.

This was not entirely unexpected. The Trump administration had attempted to exit the WHO in 2020, a move later reversed by the Biden administration, making this a known risk that resurfaced with the change in leadership.

Now, the numbers.

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Historically, the United States was the single largest financial contributor to the WHO, accounting for around 18% of its total funding. This included roughly $110–120 million a year in mandatory membership dues, along with $500–600 million in voluntary contributions, supporting disease surveillance, immunisation programmes and emergency outbreak responses globally.

With the US exit, that funding has stopped. According to reports the departure has triggered a financial crisis at the WHO, forcing the agency to cut its management team in half, scale back work across departments, and reduce budgets. Fewer staff also raises concerns about weakened global preparedness for future pandemics.

So what does this mean in practical terms?

The US says it will no longer participate in WHO-led disease surveillance networks, pandemic response coordination or global standard-setting on vaccines and treatments. Officials say Washington will instead work directly with other countries, shifting to bilateral and regional partnerships. The US has also ruled out participating even as an observer and says it has no plans to rejoin.

Now, the India angle

India’s engagement with the WHO remains unchanged. India is one of WHO’s major partners and a global supplier of vaccines and essential medicines. Indian government officials say existing WHO-India programs will continue as planned.

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The US exit leaves a significant funding and leadership gap at the WHO, raises questions around global health coordination, and reshapes the balance of influence in international health governance - at a time when global health risks remain deeply interconnected.