Summary
President Trump issued an Executive Order in his first day of office ordering the United States to withdraw from the World Health Organization. Withdrawal from WHO requires a one year notice; however, at issue is determining when the one year period starts. The Executive Order was issued on January 20th, 2025, but President Trump states in the Executive Order that the period starts as of 2020, when he first tried to withdraw from WHO. Scientists and politicians say this decision will have serious implications on public health and safety, foreign policy, and future decision making.
By Niko Piandes, JHBL Staffer
Introduction:
President Trump stated that on his first day back in office he would sign a “flurry” of executive orders to fulfill promises he made on the campaign trial.[1] One such promise was to withdraw the United States from the World Health Organization (hereinafter WHO).[2] On January 20, 2025, President Trump signed an executive order withdrawing the United States from the WHO citing numerous problems he had with the organization.[3] Public health professionals are worried that the withdrawal will have a significant impact on global affairs.[4] Additionally, the Executive Order has drawn confusion as to whether it will take a year to go into effect or instantly went into effect upon signing.[5]
Background
The WHO was established in 1948 as a specialized agency within the United Nations (hereinafter UN) to help coordinate and promote health around the world.[6] The WHO has many functions, but their primary function is to (1) improve universal health coverage, (2) prevent and respond to health emergencies, and (3) promote health and well-being.[7] Although one of their main functions is to prevent and prepare for health emergencies, the WHO was unprepared to respond to the COVID-19 pandemic.[8] President Trump is one of many people unsatisfied by the WHO’s response to crises, which was amplified by the WHO’s alleged failure in handling the COVID-19 pandemic.[9]
President Trump began the WHO withdrawal process during his first term in July of 2020, near the beginning of the pandemic.[10] At the time, the WHO and President Trump were each critical of the others approach to the pandemic.[11] It takes one year to formally withdraw from the WHO after providing notice, but President Biden took office within the year and revoked President Trump’s withdrawal.[12] Any new executive order to withdraw was believed to reset the clock on the one year notice; however, President Trump claims his 2020 withdrawal notice is still valid.[13] The uncertainty on timing, coupled with concern from scientists and health professionals regarding risks of leaving the WHO, could lead to legal battles over implementation of the Executive Order.[14] Scientists and politicians are also concerned that withdrawing from the WHO could hurt the health and well-being of Americans and global populations.[15]
Analysis:
In the United States, supporters of the WHO also acknowledge that the organization has flaws; however, it is agreed that the best way to address these issues is by being a member of the WHO, not by withdrawing from it.[16] The resulting isolation of the United States would be a disservice to members nations of the WHO and Americans.[17] The United States via the Centers for Disease Control and Prevention (hereinafter CDC), work very closely with the WHO’s regional office and fourteen collaborating centers located in the United States.[18] Collaboration between the WHO and the United States is extremely impactful on global health, as evidenced by combined efforts eradicating smallpox and near-eradication of polio.[19] The importance of collaboration to public health is further highlighted by the global impact of the COVID-19 pandemic and global response.[20]
Another of President Trump’s issues with the WHO is the belief that China has too much control over it.[21] The United States withdrawing from the WHO will accomplish what President Trump wanted to avoid: China and/ or Russia filling the void in leadership left by the United States, resulting in a decline of global health.[22] As a leader of WHO, the United States shaped global policy for good by providing assistance to developing nations.[23] Global health could decline under Chinese or Russian control because the majority of their public health decisions are based in politics, not science.[24] President Trump also takes issue with how much the United States spends over countries like China, but the majority of the difference is in voluntary contributions instead of the actual fees which is a small amounts by U.S. standards.[25]
Future involvement and leadership of the WHO will be dependent on if President Trump has the authority to withdraw the United States from the WHO.[26] Unlike most international agreements that form through executive action, membership into the WHO was created through a congressional joint resolution, and therefore might have to be resolved through another congressional joint resolution.[27] Due to President Trump’s first term ending before the one year notice requirement was satisfied, the question of authority and need for congressional joint resolution was never addressed.[28] As President Trump has now begun the withdrawal at the start of his subsequent four-year term, timing will not be an issue and legal battles will likely be the only way to prevent withdrawal.[29] Lawsuits have not currently been filed and Congress has not been particularly vocal on the subject of withdrawal from WHO, but a strong opposition is expected in the near future.[30] President Trump’s withdrawal of the United States from the WHO does not dictate the actions of future administrations and the efforts they take to promote global public health.[31]
Disclaimer: The views expressed in this blog are the views of the author alone and do not represent the views of JHBL or Suffolk University Law School.
Niko Piandes is a second-year law student at Suffolk University Law School interested in criminal and business law. He received a Bachelor of Science in Corporate Finance and Accounting from Bentley University in 2022.
___________________________________________________________________________________________________________________________________________
[1] See Colleen Long & Bill Barrow, Trump is set to sign a slew of executive orders on Day 1. What are his priorities?, PBS News (Jan 20, 2025), https://www.pbs.org/newshour/politics/trump-is-set-to-sign-a-slew-of-executive-orders-on-day-1-what-are-his-priorities [https://perma.cc/3V9N-TM2P] (reporting President Trump’s promise of signing many executive orders on first day in office).
[2] See Jessica Glenza, Uncharted territory for the WHO if Trump withdraws US membership, Guardian (Jan 18, 2025), https://www.theguardian.com/world/2025/jan/18/world-health-organization-trump [https://perma.cc/G46G-NCCY].
[3] See Exec. Order No. 14,155, 90 C.F.R. § 8361 (2025) (establishing United States withdrawal from WHO through executive order).
[4] See Stefano Bertozzi, U.S. withdrawal from WHO could bring tragedy at home and abroad, U.C. Berkeley (Jan. 24, 2025), https://publichealth.berkeley.edu/news-media/opinion/withdrawal-from-who-could-bring-tragedy [https://perma.cc/PLJ2-J6NR] (noting President Trump’s announcement not surprising, but jarring for public health community); see also Alice Park, What Leaving the WHO Means for the U.S. and the World, Time (Jan 21, 2025), https://time.com/7208937/us-world-health-organization-trump-withdrawal/ [https://perma.cc/4NAW-JBKZ] (arguing possible impacts of United States resigning WHO); Amy Maxmen, What a U.S. exit from the WHO means for global health, Cbs News(Jan. 24, 2025), https://www.cbsnews.com/news/trump-withdraw-who-global-health/ [https://perma.cc/6VKL-B767] (predicting effect of United States leaving WHO).
[5] See Exec. Order No. 14,155, 90 C.F.R. § 8361 (2025) (citing first withdrawal attempt in Executive Order instead of declaring order equals new withdrawal attempt); see also Maxmen, supra note 4 (proposing potential legal battle over when withdrawal officially started). For a country to formally leave the WHO they must give a one-year notice, but by quoting his first attempt to withdraw, President Trump has made the withdrawal timeline unclear. Maxmen, supra note 4.
[6] See About WHO, WHO, https://www.who.int/about [https://perma.cc/F4N3-YELN] (detailing WHO’s creation and organization’s purpose);World Health Organization, U.N., https://www.un.org/en/academic-impact/who [https://perma.cc/GPR8-RSVB] (declaring WHO directs and coordinates authority on international health within United Nations system).
[7] See What We Do, WHO, https://www.who.int/about/what-we-do [https://perma.cc/YK3F-HUUF] (affirming commitment that billion more people gain access to three listed goals). The three most important goals to the WHO involve helping more people gain access to universal health care, prepare and help prevent health emergencies, and promote health and well-being. Id.
[8] See Current context: the COVID-19 pandemic and continuing challenges to global health, WHO (May 17, 2022), https://www.who.int/about/funding/invest-in-who/investment-case-2.0/challenges [https://perma.cc/7BN7-YZCA] (admitting pandemic “most significant health challenge . . . confronted in over 70 years of WHO’s existence”).
[9] See Exec. Order No. 14,155, 90 C.F.R. § 8361 (2025) (arguing WHO mishandled COVID-19 pandemic); see also Bertozzi, supra note 4(believing WHO too slow in acknowledging COVID-19 airborne pathogen); Park, supra note 4 (stipulating some of WHO’s biggest supporters criticized bureaucracy and inefficiencies of organization).
[10] See Sheryl Gay Stolberg, Trump Withdraws U.S. From World Health Organization, N.Y. Times (Jan. 20, 2025), https://www.nytimes.com/2025/01/20/us/politics/trump-world-health-organization.html [https://perma.cc/B9Y3-RJC5] (tracing President Trump’s initial steps in withdrawing from WHO in 2020).
[11] See id. (recalling President Trump criticizing WHO’s approach to COVID-19); see also Michael D. Shear, Trump Attacks W.H.O. Over Criticisms of U.S. Approach to Coronavirus, N.Y. Times (Apr. 7, 2020), https://www.nytimes.com/2020/04/07/us/politics/coronavirus-trump-who.html [https://perma.cc/ZT7M-Q84C] (reporting WHO’s criticism of Trump administration’s handling of COVID-19 pandemic).
[12] See Maxmen, supra note 4 (stating countries cannot withdraw from WHO until one year after official notice).
[13] See Exec. Order No. 14,155, 90 C.F.R. § 8361 (2025).
Sec. 2. Actions. (a) The United States intends to withdraw from the WHO. The Presidential Letter to the Secretary-General of the United Nations signed on January 20, 2021, that retracted the United States’ July 6, 2020, notification of withdrawal is revoked. (b) Executive Order 13987 of January 25, 2021 . . . is revoked.
Id. (showing specific wording used in Executive Order withdrawing from WHO and revoking President Biden’s order).
[14] See Maxmen, supra note 4 (arguing potential pushback from Congress and public); see also Park, supra note 4 (detailing director of O’Neill Institute considering lawsuit claiming President Trump needs congressional approval). Although if President Trump does not need Congress’approval, any lawsuit will just draw out the inevitable of the United States leaving the WHO since President Trump will have to wait out a year as his worst-case scenario. See Park, supra note 4.
[15] See Apoorva Mandavilli, Leaving the W.H.O. Could Hurt Americans on a Range of Health Matters, N.Y. Times (Jan 29, 2025), https://www.nytimes.com/2025/01/29/health/who-us-withdrawal.html [https://perma.cc/X9J4-9JM5] (listing many potential ways leaving WHO can hurt Americas); see also Bertozzi, supra note 4 (stating possibilities if United States leaves WHO); Park, supra note 4 (noting ways withdrawal from WHO could engender United States and rest of world).
[16] See Park, supra note 4 (acknowledging how some of WHO’s biggest supporters criticized bureaucracy and inefficiencies of organization); see also Mandavilli, supra note 15 (stressing WHO continues having many issues, but still necessary organization). A former CDC director who worked with the WHO for decades even stated that there are many things the WHO could be better at, but “are they indispensable? Yes.” Mandavilli, supra note 15.
[17] See generally Mandavilli, supra note 15 (stating no other organization matches WHO’s reach or influence); Park, supra note 4 (arguing funding WHO means investing in own health care in United States); Maxmen, supra note 4 (concluding leaving WHO “not in America’s best interests”).
[18] See WHO Organizational Structure, WHO, https://www.who.int/about/structure [https://perma.cc/W6JA-A9EN] (showing map of all regional and country offices of WHO); see also WHO Collaborating Centers Global Database, WHO, https://apps.who.int/whocc/List.aspx?USZdN9B/p/yKUq4QHE2keA== [https://perma.cc/KMC8-6KCK] (listing location of all WHO Collaborating Centers in United States).
[19] See WHO comments on United States’ announcement of intent to withdraw, WHO (Jan. 21, 2025), https://www.who.int/news/item/21-01-2025-who-comments-on-united-states–announcement-of-intent-to-withdraw [https://perma.cc/NJ4B-UZZH].
[20] See Bertozzi, supra note 4 (contending many issues today that cross borders).
[21] See Exec. Order No. 14,155, 90 C.F.R. § 8361 (2025) (describing reasons for leaving WHO); see also Mandavilli, supra note 15 (providing numbers explaining President Trump thinks U.S. pays too much and China pays too little).
[22] See Maxmen, supra note 4 (worrying leaving WHO leaves gap in global health leadership); see also Mandavilli, supra note 15 (declaring nobody wants world where Russia has larger voice in global health governance).
[23] See WHO, supra note 19 (acknowledging good work WHO and United States did together); see also See Park, supra note 4 (describing WHO being neutral body allows for nations who disagree to come together and discuss). During the Cold War, when the United States and Soviet Union were constantly in conflict, the nations were able to work together through the WHO to eradicate smallpox. Park, supra note 4. The CDC also works through the WHO as there are places where Americans cannot be for safety or political reasons. Id. The WHO provides a space for adversary countries to help one another. Id. An example is in India where Americans with the CDC, working through the WHO, were able to help with the reduction of the spread of tuberculosis. Id.
[24] See Mandavilli, supra note 15 (citing China and Russia’s politically controlled public health decisions make them dangerous with more power).
[25] See Mandavilli, supra note 15 (showing disparity in payments between United States and China). The United States’ two-year budget for 2024 to 2025 was $264 million compared to China’s $181 million. Id. While that is a 31% difference in payments, the voluntary contributions in the same timeframe are starkly different – with the United States giving $442 million as opposed to China’s mere $2.5 million contribution. Id. While the United States pays about 30% more in fees to the WHO, the amounts are small by U.S. standards, with the WHO fees making up only 4% of the country’s budget on just global health. Id. The entirety of the WHO’s budget is only slightly above the budget of just the health department of Rhode Island. Id.; see also Maxmen, supra note 4 (comparing WHO fees to total United States health spending). The biannual funds the United States sends to the WHO represent around 4% of the country’s budget for global health, which is less than half a percent of the government’s yearly expenditures. See Maxmen, supra note 4. The WHO’s entire budget is also around a third of the CDC’s budget, despite the WHO servicing the whole world instead of a single country. Id.
[26] See Mandavilli, supra note 15 (questioning whether President Trump can withdraw from WHO with executive order).
[27] See id. (discussing how WHO membership enacted in United States). However, experts acknowledge it is unclear whether President Trump can unilaterally sever ties since no U.S. president has tried to before so there is no precedent. Id.
[28] See Stolberg, supra note 10 (outlining how President Biden blocked withdrawal from going into effect on first day in office).
[29] See Maxmen, supra note 4 (comparing Executive Order to policy agendas expressed by Project 2025); see also Glenza, supra note 2(addressing President Trump’s plan to withdraw from WHO on first day of four year term).
[30] See Park, supra note 4 (quoting O’Neill Institute Director considering lawsuit based on United States’ withdrawal from WHO); see alsoMaxmen, supra note 4 (suggesting potential Congress or public push back against executive order withdrawing from WHO); Kathryn Watson et al., Trump signs flurry of executive actions and memos on Day 1, Cbs News (Jan. 20, 2025), https://www.cbsnews.com/news/trump-energy-emergency-executive-orders-inflation/ [https://perma.cc/FBC3-3L4A] (listing all executive orders signed by President Trump on first day and establishing cabinet appointments).
[31] See Stolberg, supra note 10 (detailing issues President Trump has with WHO since pandemic); see also Shear, supra note 11 (highlighting issues between WHO and President Trump have over handling of pandemic).