The United States has officially withdrawn from the World Health Organization (WHO), following through on an executive order signed by former President Donald Trump last year, reigniting concerns about the future of global health financing.

President Trump has long criticised the WHO, accusing the organisation of being overly “China-centric” in its handling of the COVID-19 pandemic. This is not the first time the U.S. has attempted to leave the global health body. In July 2020, several months after the WHO declared COVID-19 a global pandemic and as infections surged worldwide, President Trump announced a similar withdrawal. However, because WHO rules require a one-year notice period, the decision never took effect and was later reversed by President Joe Biden when he assumed office in 2021.

This time, however, the withdrawal has become official, severing one of WHO’s most significant funding relationships. Historically, the U.S. has been among the organisation’s largest donors, contributing between $160 million and $815 million annually over the past decade. For the 2024–2025 budget cycle, the U.S. was projected to contribute about $988 million, accounting for roughly 14 percent of WHO’s $6.9 billion budget.

Health experts warn that the loss of U.S. funding could severely undermine critical global health programmes. These include efforts to eradicate polio, maternal and child health initiatives, and research aimed at identifying and containing emerging viral threats. According to WHO documents, U.S. funding supports about 95 percent of the organisation’s tuberculosis work in Europe and more than 60 percent of TB programmes in Africa, the Western Pacific and at WHO headquarters in Geneva.

Since the executive order was signed, the WHO has attempted to draw down U.S. funds to cover previously approved expenditures. However, many of these efforts have been unsuccessful or delayed. Sources indicate that Washington has not paid its assessed contributions for 2024 and 2025, triggering widespread job losses within the organisation.

While WHO legal advisers argue that the United States remains obligated to settle arrears estimated at $260 million (£193 million), Washington has rejected this position. U.S. authorities say all government funding to the WHO has been terminated, American personnel and contractors have been recalled from WHO offices worldwide, and hundreds of official engagements with the organisation have been suspended or discontinued.

The U.S. exit is expected to have far-reaching consequences for developing countries, particularly in Africa. Several governments are already re-evaluating health and education programmes following cuts to USAID funding. Ghana, for instance, had expected to receive more than $150 million in USAID support last year.

The fear is that the U.S. withdrawal from the WHO further diminishes hopes of alternative funding for health interventions, potentially placing additional strain on already fragile health systems across the continent.