Trump May Face Lawsuit Over US Withdrawal from WHO
Donald Trump gives a speech in Arizona, the state with one of the fastest rising coronavirus caseloads in the US, on 23 June 2020.

United States President Donald Trump may face a lawsuit over his failure to get the approval of US Congress to withdraw from the World Health Organization (WHO).

“Trump made a unilateral decision to pull out of WHO. But we joined WHO in 1948 by an Act of Congress. Trump needs Congress’ approval to withdraw,” said Professor Lawrence Gostin, who directs the  O’Neill Institute and is the Chair of Global Health Law at Georgetown University in Washington DC.

“His decision is too catastrophic to be made without Congress and the courts. As director of a WHO Center, I am considering a lawsuit,” added Gostin, who also heads the WHO Center on Global Health Law.

Meanwhile, German Health Minister Karl Lautenbach wants to persuade Trump to change his mind, describing the decision as “a catastrophe for the poorest people on the planet” who need WHO support, such as those in Gaza.

The US is obliged to give a year’s notice of its intention to withdraw from the WHO, yet Trump’s Executive Order directs State officials to “take appropriate measures, with all practicable speed” to “pause the future transfer” of US of government “funds, support, or resources to the WHO”.

The order also recalls all US “personnel or contractors working in any capacity with the WHO”.

A senior WHO official told Health Policy Watch that “it has been a long night”, but that the UN health agency will survive if all its remaining 193 member states stick together in the coming days. The tiny European monarchy of Liechtenstein is the only other country that is not part of the WHO.

China ‘rationale’

Trump’s rationale for withdrawing from the WHO is the same as he advanced during his first presidency: WHO’s “mishandling” of the COVID-19 pandemic, its “failure to adopt urgently needed reforms”, and its “inability to demonstrate independence from the inappropriate political influence of WHO member states” – primarily China.  

Trump also noted that the WHO “continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments”, such as that of China.

Of the 196 WHO member states, the US is by far the largest funder. It is due to pay over $261 million in “assessed contributions” (membership fees) during 2024/5.  

US contribution to WHO in 2023

China, the second-largest contributor in terms of assessed contributions, is only due to pay $181 million for the period. As China is still classified as a “developing country”, it benefits from lower rates.

 

China’s contribution to WHO in 2023

While blaming the WHO for mishandling COVID-19, it is worth remembering that US Republicans died of COVID-19 at a significantly higher rate than Democrats, in all likelihood because of the anti-vaccine rhetoric and confusing treatments being suggested by Trump and his party.

After the introduction of COVID-19 vaccines, the excess death rate amongst Republicans was 10.4% higher than that of Democrats, according to a study published in the American Journal of Public Health.

Between January 2018 and December 2021, there were 15% more COVID-19 deaths amongst Republicans in Florida and Ohio than Democrats, ballooning to a 43% higher excess deaths amongst Republicans once vaccines were introduced, according to a 2023 study in JAMA Internal Medicine.

Excess Death Rates and Vaccination Rates in Florida and Ohio During the COVID-19 Pandemic

WHO asks Trump to ‘reconsider’

In a measured response, the WHO said that it “regrets” the decision and hopes the US will “reconsider”.

“We look forward to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe,” the WHO stated.

“WHO plays a crucial role in protecting the health and security of the world’s people, including Americans, by addressing the root causes of disease, building stronger health systems, and detecting, preventing and responding to health emergencies, including disease outbreaks, often in dangerous places where others cannot go.”

It also noted that the US was a founding member of WHO in 1948 and assisted in saving “countless lives”, ending smallpox and bringing polio to the “brink of eradication”. 

The WHO also noted that, in the past seven years, it has “implemented the largest set of reforms in its history, to transform our accountability, cost-effectiveness, and impact in countries”.

In 2022, the World Health Assembly adopted in full recommendations for financing reform made by the Sustainable Financing Working Group, which also include proposals to increase the body’s efficiency, as previously reported by Health Policy Watch.

US condemnation

Dr Tom Frieden, CEO of Resolve to Save Lives, said that Trump’s decision makes Americans and the world less safe and increases “the risk of a deadly pandemic”.

“The plain truth is that WHO is irreplaceable. WHO’s track record demonstrates its value to the world. The historic US-Soviet collaboration through WHO to eradicate smallpox – one of humanity’s greatest achievements – shows how cooperation on global health can transcend political differences to protect everyone,” said Frieden, a former head of the US Centers for Disease Control and Prevention.

“Withdrawing from WHO not only cuts crucial funding from the agency, but it also surrenders our role as a global health leader and silences America’s voice in critical decisions affecting global health security,” he added.

“Real reform requires engagement, not abandonment. We cannot make WHO more effective by walking away from it.”

Physicians for Human Rights executive director Sam Zarifi said that the withdrawal “needlessly, heedlessly, endangers the tremendous advances in global public health over the last century” as “diseases respect no borders and demand global collaboration”. 

US domestic health is also under fire

US domestic health measures were also the target of the swathe of executive orders signed by Trump on Monday, reports Stat.

Trump rescinded Biden-era orders aimed at lowering medicine costs for Medicare and Medicaid, expanding access to the Affordable Care Act, COVID-19 treatments and vaccines, as well as various protections for race, gender and sex discrimination.

Foreign aid is frozen

Trump has also frozen US foreign aid for 90 days in an executive order aimed at “re-evaluating and realigning” aid.

“All department and agency heads with responsibility for United States foreign development assistance programs shall immediately pause new obligations and disbursements of development assistance funds to foreign countries and implementing non-governmental organizations, international organizations, and contractors pending reviews of such programs for programmatic efficiency and consistency with United States foreign policy, to be conducted within 90 days of this order,” according to the order.

Excerpt from Trump’s executive order on foreign aid 2025

The rationale given is that the “foreign aid industry and bureaucracy are not aligned with American interests and in many cases antithetical to American values”.  

Furthermore, they “serve to destabilize world peace by promoting ideas in foreign countries that are directly inverse to harmonious and stable relations internal to and among countries”.

The controversial right-wing blueprint for Trump’s victory coordinated by the Heritage Foundation, Project 2025, proposes that all US aid including humanitarian assistance, is conditional on the rejection of abortion.

“Proposed measures for USAID [US Agency for International Development] include a significant restructuring, and reduction of budget, the removal of diversity, equity, and inclusion programs, and dismantling of the apparatus that supports gender equality and LGBTQ+ rights,” notes researcher Malayah Harper in an analysis of Project 2025.

So far, Trump is following the mandate of Project 2025 despite feigning ignorance about it during his election campaign.

Image Credits: Gage Skidmore, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2807617#google_vignette.

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