Leaving the WHO

July 9, 2020

Photo by Ryan Levi

President Trump says the U.S. is leaving the World Health Organization. What might that mean for public health in the U.S. and around the world?

Listen to the full episode below or scroll down for the transcript and more information.

Click here for more of our coronavirus coverage.

Lawrence Gostin: This is the World Health Organization. It’s the pillar of the post-world war global order. And the United States has just thrown a torpedo.

Dan Gorenstein: On Monday, July 6, the Trump administration notified the United Nations that the U.S. would formally withdraw from the World Health Organization.

It’s the latest shot fired in a months-long battle the administration has been waging against the WHO.

President Trump: The World WHO World Health got it wrong. They got it very wrong. In many ways they were wrong. 

Tedros Adhanom, Director General of the World Health Organization: No need to use COVID to score political points. No need.
DG: What does this mean for public health in America and abroad if the World Health Organization loses one of its most important members?
From the Annenberg Studio at the University of Pennsylvania, I’m Dan Gorenstein, and this is Tradeoffs.
Lawrence, in the most basic terms, what is the WHO and what is its purpose?

LW: Its charge is to literally be the global health leader.  

Lawrence Gostin is a professor of global health law at Georgetown University and runs the O’Neill Institute. 

LG: It’s not the one, hero firefighter that goes and puts out pandemics. It doesn’t have the funding or capacity for that. Remember, WHO’s funding is about the same size as one large United States hospital. But most importantly, they coordinate, they declare emergencies, and they give guidance on what countries should do to stem outbreaks and epidemics. 

DG: Let’s talk for a second specifically, and in just a few sentences, what is the role that WHO has played right now during the COVID pandemic?

LG: Well, WHO is currently coordinating trials to find an effective treatment for COVID. They are also spearheading fundraising for a vaccine. And they’ve been sharing intelligence about the virus, what it’s likely to do, where it’s going, and giving early warning systems. So it’s really doing its very best with very limited budget to try to bring the world together. It seems almost hopeless with COVID because the world seems so split apart.

DG: And what is the Trump administration’s rationale for withdrawing from this organization?

LG: Well I can give you its stated rationale, but I also want to say where I think is really behind it. I think it’s an attempt to deflect blame from the Trump administration. You know, we went into the COVID-19 pandemic with the number one world rating and health system capacity.

Vice President Pence: As the President said yesterday, we’re ready. We’re ready for anything.

LG: But once COVID-19 was here, it’s become the epicenter. 

News clip: Florida, South Carolina and Texas among the states notching new daily records with almost 35 states seeing a rise in coronavirus cases.

LG: And so I think that this is an attempt to to deflect blame, and I think it’s mostly political. But the purported reason is because the World Health Organization did not stand up to China.

Trump: Had the WHO done its job to get medical experts into China to objectively assess the situation on the ground and call out China’s lack of transparency, the outbreak could have been contained at its source with very little death. 

LG: Now, I do think that it’s legitimate, that China was not transparent, but WHO had no power to independently verify that information. The United States, and particularly Donald Trump had much greater access to and leverage over China than the WHO ever could.

DG: Lawrence says the WHO has a lot to lose if America takes its ball and goes home.

First, there’s money. 

The WHO’s budget is roughly $2 billion a year and America contributes about 20%

LG: But it’s lost much more than that. It’s lost a global health leader in the United States, and it’s also distracted politically and wounded politically by the Trump administration, just at the time that the world and the United States needs it to be strong.

DG: Lawrence, when you think about the tradeoffs, can you just lay it out for us succinctly? What do we gain by leaving the WHO, and what do we lose?

LG: Secretary of State Pompeo in his letter to Congress justifying this withdrawal, said that it will give America more opportunity to direct our resources where we want to direct them. I don’t accept that. I don’t think you can have an America alone approach to a global problem. What we lose is very, very clear to me. So first of all, we’ve lost our our national influence in in foreign affairs. But it also harms our health. We’re going to be cut out from the WHO’s system of surveillance and disease intelligence. We’re going to be cut out from the global effort on vaccine and drug research and development. 

DG: So what happens next? What’s the actual withdrawal process? 

LG: I’ve argued along with over 750 global health leaders in a letter to Congress that what the president’s done is unlawful. The United States entered the WHO under a joint congressional resolution, and we need both houses of Congress to withdraw from it. So Congress can push back. The courts can push back. And the public can push back. The U.S. has to give one year’s notice, and so in any case, the United States cannot lawfully withdraw until July 6, 2021. By that time, there will be an election. 

DG: On Tuesday, July 7, Joe Biden tweeted, “On my first day as President, I will rejoin the @WHO and restore our leadership on the world stage.”

DG: So at the end of the day, Lawrence, given the opposition to this move and that there’s going to be some legal challenges here, how do you think things are going to play out?  

LG: I think we’re going to go down one of two paths. If the president is re-elected and and holds at least one house of Congress, then I think that ultimately we will withdraw. And what will then happen is we’ll have a fragmented global health world, a much less safe world. The second path is that either the courts rule that this is unlawful or Joe Biden is elected president of the United States, in which case I think we’ll see a resurgence of funding to the WHO, but also significant constructive reform of the WHO because the WHO absolutely needs reform. The path we take will mean that Americans are safer and have greater influence internationally. Or it will make America and the world weaker, less safe, and our leadership in the world will be completely eviscerated. And I think the stakes are that high. I frankly do.

DG: Lawrence, thank you very much for taking the time to talk with us today. 

LG: Take care, bye. 

DG: I’m Dan Gorenstein, and this is Tradeoffs.

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Episode Resources

Select News, Analyses and Resources:

Trump Administration Signals Formal Withdrawal From W.H.O. (Katie Rogers and Apoorva Mandavilli, New York Times, 7/7/2020)

Congress must stop Trump from withdrawing from the WHO (Lawrence Gostin, Harold Hongju Koh and Matthew Kavanagh; The Hill; 7/8/2020)

Explainer: What Does The World Health Organization Do? (Pien Huang, NPR, 4/28/2020)

Timeline of WHO’s response to COVID-19 (World Health Organization)

Episode Credits


Lawrence Gostin, Director of the O’Neill Institute for National and Global Health Law

The Tradeoffs theme song was composed by Ty Citerman, with additional music from Blue Dot Sessions

This episode was produced by Leslie Walker and mixed by Ryan Levi.

Additional thanks to:

Ashish Jha, the Tradeoffs Advisory Board…

…and our stellar staff!