U.S. Exit From the World Health Organization Takes Effect Over Unpaid Dues

The United States’ withdrawal from the World Health Organization takes effect Thursday, Jan. 22, according to the Trump administration, ending a membership that began when the U.S. joined in 1948. The departure comes with a dispute over money and law that the WHO says has not been settled.

President Donald Trump signed an executive order on his first day back in office in January 2025 to leave the agency, citing its handling of COVID-19, a failure to adopt reforms and what the order called political influence by member states, NPR reported. Mr. Trump began a similar withdrawal in 2020, which President Joe Biden reversed on his first day in office.

At the center of the dispute are unpaid bills. The U.S. owes about $278 million in assessed contributions, the equivalent of dues, for 2024 and 2025, according to both NPR and STAT. STAT reported that the U.S. also committed $490 million in voluntary contributions for those two years, and that several hundred million dollars promised for 2025, and a smaller amount for 2024, has not been delivered. Those funds were meant to support work such as the WHO’s health emergency program, tuberculosis control and polio eradication.

A State Department spokesperson told STAT that the U.S. will not make any payments before the withdrawal and will “ensure that no more U.S. funds are routed to this organization.” NPR reported that the department called the cost to taxpayers too high and holds that the withdrawal arrangement does not require paying dues.

The 1948 congressional resolution that allowed the U.S. to join reserved a right to withdraw, which no other member has, but it requires one year’s notice and payment of obligations for the current fiscal year, according to STAT. NPR said the text of that agreement contradicts the administration’s reading. The WHO’s constitution has no withdrawal clause. Steven Solomon, the agency’s principal legal officer, told NPR that this was deliberate and that the other 193 member states will decide whether and when the U.S. exit takes effect, with or without payment. The question is expected to come before the WHO Executive Board in late February and the World Health Assembly in May.

Outside experts disagree on the stakes. Lawrence Gostin, a Georgetown University professor of global health law, told NPR that leaving without paying is unlawful, but he noted there is no pending litigation or congressional move to stop the president. Tom Bollyky of the Council on Foreign Relations told STAT that if anyone could block the exit, “it would be Congress, not the member states of the WHO,” and STAT reported that Republicans, who control both chambers, have not pushed to enforce the payment condition.

Defenders of the withdrawal say the U.S. is within its rights. Brett Schaefer, a senior fellow at the American Enterprise Institute, told NPR that a sovereign country can leave and called the WHO’s position juvenile. He said he is less worried about the practical impact and hopes the WHO will not bar U.S. participation in programs such as its open-source outbreak intelligence platform, which he said it would be very petty to do.

Gostin warned that a lockout could cut the U.S. off from the WHO’s influenza surveillance network and measles monitoring, delaying outbreak notices and vaccine development. NPR reported that the WHO has so far let the U.S. attend some events, including a February flu strain meeting, and that a senior HHS official said the agency is discussing sending scientists and expects a decision soon. The State Department said it will not take part in WHO-led events beyond withdrawal-related functions.

WHO Director-General Tedros Adhanom Ghebreyesus has called the situation “lose-lose” and said he hopes the U.S. will reconsider. STAT reported that Argentina, which gave notice last year, is due to leave on March 17, and that the WHO’s 34-country executive board has been asked to report on both departures to the World Health Assembly in May.