If the United States withdraws from membership of the World Health Organization (WHO) under the new Trump administration, the World Health Organization (WHO) may be in trouble in the coming years. The troop withdrawals promised on the first day of Donald Trump's new administration will actually reduce the multilateral agency's funding by a fifth.

Deep cuts would be uncharted territory for the WHO and could limit global public health efforts, force the organization to attract private funding and provide opportunities for other countries to influence the organization. Other countries are not expected to make up for the financial losses.

The World Health Organization works to improve the health of millions of people around the world — from working to eradicate polio and tuberculosis to coordinating U.S. HIV and AIDS prevention efforts in Africa.

“He has a lot of influential people around him who say he’s going to pull out of the World Health Organization on his first day in office,” said Lawrence Gostin, an expert on global health law at Georgetown University who opposes the U.S. withdrawal from the WHO. "The threat is real, clear and possible."

The World Health Organization declined to comment on any potential preparations for such a move.

At a press conference on Thursday, WHO spokesperson Dr. Margaret Harris told reporters: "This is a government in transition, and as a government in transition, they need time and space to make their mark. decision, we will not make any further comment.”

On the same day, the World Health Organization issued an "urgent appeal" for funds, citing the threat climate breakdown and conflict pose to world health. In addition, the World Health Organization held its first "investment" round in May 2024, pledging to use the financial commitments of member states to save 40 million lives by 2028.

U.S. divestment will also put pressure on the WHO foundation to make up the shortfall. The independent Swiss entity was set up during the pandemic to raise funds from "non-state actors" including wealthy individuals and businesses. The foundation was announced in May 2020, the same month the president-elect last threatened to withdraw U.S. funding for the World Health Organization.

"WHO plays a critical role in global health security, disease outbreaks and eradication, international emergencies and mobilizing global cooperation," WHO Foundation CEO Anil Soni said in a statement.

"This organization is critical to protecting U.S. business interests around the world. Its programs for disease surveillance, outbreak response and pandemic preparedness help prevent disruptions to supply chains, international markets and trade. No other organization has the capacity and bandwidth to coordinate International rapid response efforts, sharing medical research and innovation, and disseminating critical intelligence around the world.”

Past donors to the WHO Foundation include global food giant Nestlé, cosmetics company Maybelline and Facebook and Instagram parent company Meta. The foundation has allowed some donors to remain anonymous, a practice criticized by academics for making it difficult to detect conflicts of interest.

As an affiliate of the United Nations, the United States helped establish the World Health Organization in 1948 through a joint resolution of Congress. The United States remains its largest funder, providing about 22% of all member states' assessments. The United States is the only member state that can withdraw from the agency.

The United States provided $1.2 billion to the WHO in 2023, a fraction of the federal government's $6.1 trillion budget and equivalent to what Joe Biden spent in a 2024 round of student loan debt relief.

Although the U.S. is legally required to provide written notice of its intention to withdraw one year before taking any action, legal experts worry that WHO funding could effectively disappear overnight.

Trump's renewed attempt to withdraw funding and support from the World Health Organization was first reported in December -- one of many potential day-one actions. As with much of Trump's health policy agenda, the pandemic has dogged his promises. Trump believed that the WHO had been too deferential to the Chinese government during the epidemic and announced that it would withdraw troops from the United States in May 2020.

"The world is suffering now because of the malfeasance of the Chinese government," Trump said when announcing his withdrawal plan in a Rose Garden speech in May 2020. "Countless lives have been lost and severe economic hardship has been experienced across the globe."

When Biden won the 2020 election, Trump's decision became moot and he quickly reversed course. Gostin doesn’t think there will be such a reprieve under the next administration.

"He has four years this time to make it happen," Gostin said.

Dissatisfaction with the World Health Organization has been simmering in Republican circles since the pandemic began. Some conservatives have accused the agency of threatening U.S. sovereignty in a new pandemic treaty aimed at equitably distributing vaccines around the world. The first Covid-19 vaccine was released in the United States in December 2020. In the years since, much of the global South has been short of vaccines, although wealthy countries have continued to stockpile them.

Ironically, legal experts worry that the United States' withdrawal from the World Health Organization will open the door to the influence of the Chinese government, which Trump views as one of the United States' main global competitors.

Experts say withdrawing from the WHO could also harm U.S. national security interests by cutting off participation in projects such as pandemic preparedness and seasonal flu strain sequencing, which is used to develop annual flu vaccines.