When and how the United States withdraws from the World Health Organization (WHO) is an “open question” for member states to discuss, according to Steven Solomon, the body’s legal officer.

This is because the US has failed to pay its WHO membership dues for the past year in violation of a 1948 agreement with the body.

According to the terms of this agreement, the US needs to give the WHO a year’s notice and pay its membership fees in full for that year before withdrawing.

Next Tuesday – 20 January – will be the first anniversary of US President Donald Trump’s announcement that the US would be leaving the WHO. 

But while the one-year notice period is up, member states need to discuss how to deal with the US failure to pay its membership fees. This discussion will take place at next month’s executive meeting and at the World Health Assembly in May, Solomon told a media briefing on Tuesday.

The US is the only country to have negotiated exit terms from the WHO, as the WHO Constitution makes no provision for member states to withdraw, he added.

“In 1946, the drafters [of the treaty that established the WHO] understood the historic struggles against the international spread of disease, and they saw how a truly universal organisation would make the world safer, so they did not include a withdrawals clause,” said Solomon.

“Instead, they provided flexibilities within the treaty so it could accommodate all countries,” said Solomon, who added that the United Nations (UN) Charter also does not include a withdrawal clause as it is “based on the principle of the importance of universality for that instrument”.

Meanwhile, WHO Director-General Dr Tedros Adhanom Ghebreyesus appealed to the US to stay in the WHO, saying that it was not safe for the US or for the world that it was outside the fold.

“It is not really the right decision. I want to say it bluntly, because I believe there are many things that are done through WHO that benefit the US. The US cannot be safe without working with WHO,” Tedros told a media briefing on Tuesday.

“It’s not 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-19. We need cooperation and solidarity for that.”

The WHO also lost some $264 million in US membership fees for 2024/ 25 – and significantly more in “voluntary contributions”. In 2022/ 23, the US contributed $1.284 billion to the WHO, with voluntary contributions to a range of programmes including pandemic preparedness.

WHO had to implement drastic financial reforms to stay afloat, cutting posts by around 22%.

“The senior management is reduced by half, the middle management department reduced by half, and then that goes all down to the expert level, and we have made all the adjustments based on the prioritisation process we have set for ourselves,” said Tedros.

The body has raised three-quarters of its budget for 2026/27, and Tedros said that the financial turbulence has “stabilised”.

He added that countries’ membership fees, “assessed contributions”, would make up 50% of the WHO’s budget by 2031, as agreed by the World Health Assembly in 2022 and this would also assist with financial stability.