A Us Return To The World Health Organization Could Hinge On Whether Trump Approves Of Its Next Leader

After 77 years, the U.S. is no longer a member of the World Health Organization.

Now, the race is on to convince President Donald Trump he should rejoin. The key to a potential return is who becomes the leader of the WHO next year and whether Trump likes them. Trump has accused the WHO of covering up for China during the pandemic and gouging the U.S. on dues.

The WHO has rejected the accusations of siding with China and its director-general, Tedros Adhanom Ghebreyesus, has touted an ongoing move to get other countries to pay more.

But Tedros, with whom Trump has a personal beef, hasn’t been able to convince him to stay. However, Tedros’ term ends next year, and the WHO’s advocates hope whoever succeeds him will be more effective. Tedros is term limited and cannot run again.

The Trump administration wants the global health body to be led by an American director-general and inspector general, according to Larry Gostin, a global health law professor who directs Georgetown University’s O’Neill Institute.

The WHO’s 193 member states each get a vote on who will replace Tedros in 2027. The agency, an arm of the United Nations, has never had an American at its helm.

American global health experts who have worked closely with the WHO aren’t endorsing any candidate, but they believe a leadership reset would be the next chance for the United States and the WHO to come together.

“Candidates are going to be coming to Washington, D.C., to visit, and those candidates need to come equipped — and they know this — with a further reform agenda for WHO,” said J. Stephen Morrison, who directs the Global Health Policy Center at the Center for Strategic and International Studies, a Washington think tank.

The WHO coordinates global efforts to prevent disease outbreaks and combat those that occur. It led the effort to contain the Covid-19 pandemic and has battled diseases ranging from Ebola to mpox in recent years.

The U.S. has long been the group’s top funder, providing around 20 percent of its $3.4 billion annual budget. Trump cut funding to the group last year, forcing it to lay off staff, reorganize departments and cut its budget for the upcoming two years by 9 percent. Until Thursday, the U.S. had been a member since the WHO’s founding in 1948.

A new face for the WHO

While WHO member countries will elect Tedros’ successor in May 2027, the race is expected to start at the WHO’s general assembly meeting in Geneva in May.

Candidates have yet to officially jump into the race, as their governments must nominate them, but at least two are widely expected to run: Hanan Balky, a doctor from Saudi Arabia who leads the WHO’s eastern Mediterranean branch, and Hans Kluge, a Belgian doctor who’s the head of the WHO’s Europe branch.

Balky grew up in the United States and trained at Massachusetts General Hospital, the Cleveland Clinic Foundation and Case Western Reserve University in Cleveland. A spokesperson for Balky did not respond to a request for comment.

Kluge has in the past kept close ties to the Department of Health and Human Services. A WHO Europe spokesperson did not directly address a question about Kluge’s potential candidacy. The spokesperson referred to theWHO’s process for electing directors-general, noting that the potential candidates will be known later this year once WHO member countries submit their nominations.

Gostin tried to mediate between the WHO and the White House after Trump signed an executive order last year setting in motion the U.S. withdrawal that became effective today.

The White House has not confirmed the demand for American leaders at the WHO and didn’t respond to questions about the withdrawal and whether it would reconsider U.S. membership once a new leader takes over in August 2027.

The U.S. withdrawal is part of a larger break between the Trump administration and the United Nations: Trump recentlywithdrew the U.S. from 66 international organizations, including many U.N. entities, because he said they no longer serve U.S. interests.

Last fall, Tedros saidhe was in touch with Health Secretary Robert F. Kennedy Jr., who helped to evacuate sick kids from Gaza as the Trump-brokered peace deal between Israel and Hamas took hold. But that engagement didn’t lead to any formal meeting about the relationship between the U.S. and the WHO.

What changes now

The official withdrawal Thursday is largely symbolic, since Trump halted most U.S. funding and cooperation with the WHO last year.

“For all intents and purposes, we have already withdrawn, and there won’t be any dramatic cliff that we will fall off,” Gostin said.

Trump’s executive order announcing the withdrawal a year ago stopped payments to the WHO and halted most technical cooperation between the Centers for Disease Control and Prevention and other American institutions and the global health body.

But U.S. officials over the past year have participated in WHO meetings essential to the United States, suchas one on the composition of the flu vaccine ahead of the current flu season.

That’s partof a process in which national influenza centers in more than 100 countries monitor flu viruses as part of the WHO’s global influenza surveillance and response system. The WHO then organizes two meetings a year to determine which flu strains vaccines will target in the northern and southern hemispheres.

Morrison expects this cooperation to continue, albeit under the radar, as well as some other things.

“The polio collaborations will continue; the flu preparations will continue; the surveillance on dangerous outbreaks in remote places where we have no presence or visibility will continue,” he said.

The WHO did not respond to questions about its plans to cooperate with the U.S. now. The Department of Health and Human Services declined to comment.

Demetre Daskalakis, an infectious disease doctor who led the CDC’s National Center for Immunization and Respiratory Diseases before resigning in protest of Kennedy’s policies last August, is not convinced that things will continue to work as smoothly.

He fears that if a new virus starts spreading in countries with which the United States doesn’t have close bilateral relations, the U.S. might not get information and data about it at the same time as WHO members.

Daskalakis said he already saw some cooperation with other countries hampered last year.

Typically, samples of polio, a virus that can cause paralysis, would flow to the CDC from all around the world, he said. “Last year, as an example, for at least the first half of the year, no specimens were coming to CDC because of the rhetoric that hit the WHO,” he said.

The U.S. has made foreign aid contingent on other countries sharing such data, with more than a dozen signing bilateral agreements with the State Department that include commitments to inform the U.S. about any potential outbreak.

The WHO executive board, made up of representatives from 34 countries, is due to discuss America’s withdrawal when it meets in early February.

The U.S. still owes the WHO nearly $200 million in mandatory contributions for 2024 and 2025, according to WHO budget documents. Trump has said other countries should pay more.

Last week, Tedros told reporters that he didn’t want the U.S. withdrawal from the WHO to be seen as all about money.

“I’m not saying money doesn’t matter, but what matters most is solidarity, cooperation and for the whole world to prepare itself for any eventualities to a common enemy, like a virus, like Covid that we have seen,“ he said.