WHO member states on Thursday agreed to suspend the voting rights of the United States in the World Health Assembly as of May 2027 if some $280 million in outstanding 2024–25 dues remain unpaid – despite the US announcement of withdrawal last year. In the same decision, Iran’s voting rights, tabled for suspension, were reinstated after it caught up on outstanding debts.

The decision by WHA’s Committee B, which was approved by consensus and without any debate, signals that member states won’t recognize the US announced withdrawal from WHO in 2025 until the back dues are paid, in accordance with a Congressional decision made at the time when the US joined WHO in 1948.

Former WHO Legal Counsel, Gian Luca Burci, described the little-noticed technical decision as politically and legally “consequential,” in a comment to Health Policy Watch. 

“Even with all the ambiguities, WHO has not accepted its withdrawal because the US did not fulfil the terms that they [the US] themselves imposed back in 1948. So for WHO, the US is still a member until it receives its assessed contribution.” The self-declared American exit in January 2025 forced the global health body to reduce its upcoming base budget by 21%, to $4.2 billion, leading to layoffs of nearly 25% of WHO staff in a convulsive year of internal programme cuts and reorganization. 

According to the WHO Constitution, there is no real provision for member states to withdraw. The sole exception was the US, which made the right to withdraw a condition of joining the global health body in 1948, a stipulation that WHO accepted at the time. However, according to the US’s own rules set by Congress, that right would only be activated if outstanding dues were paid, stating: “The United States reserves its right to withdraw from the organization on a one-year notice, provided, however, that the financial obligations of the United States to the organization shall be met in full for the organization’s current fiscal year.”

And, if the following limbo continues, more years of unpaid US dues would technically pile up in 2026 – until the issue is otherwise resolved.

WHA to decide on voting rights and Argentina’s exit

Tomorrow, the Assembly is also set to address the self-declared departure of Argentina last year in what is likely to lead to a more prolonged debate. Draft resolutions currently circulating propose to contradictory paths forward. A proposal put forward by Paraguay would formally recognize Argentina’s withdrawal – despite the absence of a legal exit ramp in the WHO constitution. 

However, a competing draft decision proposed by a separate group of countries, including Germany, takes a decidedly more passive approach.

This alternate draft merely “takes note of the request from the UN legal counsel for a WHO clarification on the status of Argentina’s request to withdraw,” Burci explained. This manoeuvre intentionally leaves “the situation ambiguous because the membership is divided on whether Argentina has the right to withdraw, and so effectively the WHA doesn’t take any decision.”

Looking ahead, the silent committee approval of the American suspension could, nonetheless, hearken more debate – and diplomatic fallout on the issue at Saturday’s final, plenary session.  Typically, the decisions of the WHA’s two Committees (A and B) are merely gavelled to approval in rapid succession in the final plenary, with no further debate. But nothing about the US withdrawal from WHO has been typical. See related story:

Stars and Stripes No Longer Flying at WHO – But US Can’t Really Leave Until Dues are Paid, Agency Says

US suspension set for next year along with eight developing nations

Along with the United States, the draft resolution also noted the suspension by 2027 of eight other developing nations, due to unpaid dues, including: Burundi, Djibouti, Equatorial Guinea, Nigeria, Panama, San Tome and Principe, Timor-Leste, and Turkmenistan. Strikingly, while African delegates urged members to pay their debts, the committee approved the penalty measure without any direct debate or remark regarding Iran or the ongoing US withdrawal.

In the morning proceedings, the WHO Secretariat formally proposed reinstating two other countries that had previously amending ended the suspension move, striking Iran from the penalty list, alongside Grenada. “Grenada and Iran, Islamic Republic of, have made sufficient payment to clear their arrears, therefore are no longer at risk of losing voting privileges,” said the WHO Controller during the session.

Before the assembly, Iran owed $3.29 million in arrears that triggered an automatic suspension warning under Article Seven of the WHO Constitution. Furthermore, Tehran carried a $7.15 million remaining balance under a special long-term settlement arrangement.

However, it remains unclear exactly how much Tehran actually paid, as officials only confirmed the sum was “sufficient” to avert the penalty.

According to the draft resolution A79-17, the voting rights of nine other countries, including Afghanistan, Dominica, Myanmar, Saint Lucia, Somalia, South Sudan, Sudan, Venezuela and Yemen were already suspended at the time of the opening of this year’s World Health Assembly, and will remain so until their outstanding dues are paid.

Image Credits: Felix Sassmannshausen/HPW.