In one of his first orders after assuming office last week, President Donald Trump withdrew the US from the World Health Organisation (WHO), citing the international body's mishandling of the Covid-19 pandemic, lack of political independence, and the disproportionate contributions the US makes to the organisation financially.
The executive order said, “The United States noticed its withdrawal from the World Health Organisation (WHO) in 2020 due to the organisation’s mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.”
“In addition, the WHO continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments. China, with a population of 1.4 billion, has 300 per cent of the population of the United States, yet contributes nearly 90 per cent less to the WHO,” the order added.
First Check spoke to Professor Mukesh Kapila, a global health expert who has served as the Director, Health Action in Crisis, at WHO, to check the veracity of these claims. He explained that while Trump is correct in saying that the US is the largest contributor to the WHO, he is mistaken in claiming that China is not contributing enough based on its population.
“WHO contributions are based on a country’s Gross Domestic Product (GDP), rather than its population size,” Dr Kapila explained. “On that metric, The United States is the world's wealthiest economy and is therefore required to pay the highest membership contribution.”
He also said that the President's assertions about China's "disproportionate influence over the WHO are also generally valid," but this was achieved by "means beyond financial contributions."
Here are excerpts from the interview:
Q: What will be the impact of President Trump's decision to withdraw the US from the World Health Organisation (WHO)?
A: The United States provides very significant financial support to WHO. Its assessed contribution (or “membership fee”) is about 260 million USD over the 2024-25 biennium, which is more than a fifth of all states’s total assessed contributions of $1.2 billion. The assessed budget provides for the core staffing and programmes of WHO and so, removing the American share could have a profound impact, especially in helping the world’s poorest countries in areas of disease control and pandemic response.
Q: How do contributions to the WHO work, and why does the US contribute more than other countries?
A: WHO contributions are based largely on a country’s Gross Domestic Product (GDP), rather than its population size. The United States, as one of the world's wealthiest economies, is required to pay the highest contribution. In contrast, China, despite being the second-largest economy, contributes somewhat less at about 175 million USD over the same biennium. The reason China pays so little is for reasons of history. It used to be classified as a developing or low-income country, and it refuses to be upgraded to a higher status for the purpose of its assessed contribution.
However, assessed contributions do not provide the full picture, as that only covers around 10 per cent of the cost of what WHO does. Its total budget over the 2024-25 biennium as approved by its 194 member states is over 6.8 billion USD. That is made up of additional voluntary contributions targeting activities and programmes favoured by donors.
Thus, the US provides voluntary financing exceeding 1 billion USD on top of the earlier mentioned obligatory assessed contributions. In contrast, China has habitually provided less than 50 million USD. President Trump is, therefore, correct in stating that China’s contributions do not align with its economic weight.
Q: What role does China play in influencing the WHO when it doesn’t invest much financially?
A: President Trump’s assertion that China wields disproportionate influence over the WHO is also valid but for different reasons. China's strategic influence within international organisations is achieved through political pressure and using its nationals who are employed by these bodies – and not through its modest financial support.
China has a very assertive diplomatic machine that deploys significant indirect controls. For example, Chinese companies that operate globally are often closely linked to the Chinese Communist Party and follow its directions. As also the tens of thousands of Chinese students and researchers in Western Universities.
The debate around TikTok and Huawei has also illustrated how China uses its technologies to garner sensitive or confidential interests in industry and academia to advance its own interests. That poses a security threat to other nations. International organisations such as the UN and WHO are very vulnerable and can find themselves in the middle of this too.
President Trump and many others have also criticised WHO for having been overly influenced by China in its handling of the early stages of the Covid-19 pandemic, where the organisation was accused of not acting forcefully enough to hold China accountable.
The evidence suggests that WHO could, indeed, have done better at that time. But subsequently, WHO moved on to challenge China more strongly for the latter’s lack of co-operation and transparency, and the Organisation’s leadership of the global pandemic response has been very good and appreciated by many countries.
Q: If the US withdraws, how will the WHO compensate for the funding loss?
A: The immediate consequence of the US withdrawal would be a substantial funding gap. While private foundations, such as the Bill & Melinda Gates Foundation, could step in, they and other countries cannot make up the missing dollars. Besides reliance on private sector funding would raise concerns about impartiality and credibility.
Pharmaceutical companies and other private donors have obvious commercial interests that could potentially influence policy decisions. The WHO traditionally avoids direct funding from commercial entities to maintain its neutrality, but if government contributions decrease, the organisation may have no choice but to seek alternative sources, which could impact global trust in its decision-making processes.
Q: How much does India contribute to the WHO, and does it have the potential to increase its influence?
A: India’s net assessed contribution to WHO is set at nearly 12 million USD for the 2024-25 biennium. This is very small considering India’s growing economic stature, ranking fifth on global GDP tables, behind the US, China, Japan, and Germany. India also does not make significant voluntary contributions to WHO.
So, some of the earlier criticism in terms of contributions to WHO could also apply to India. But on the matter of asserting influence, India is doing well. But not through undue political or diplomatic coercion as that is not in the Indian government’s tradition of engagement in international affairs.
Indians do well anyway through their soft power that comes from having a large stock of well-trained and educated human resources, especially in the health sector and health-related industries and services, including pharma.
It is always better for the world that way than when countries push their own nationals to be installed in international bodies, regardless of whether they have the necessary skills and competencies, or not.
Q: Should India increase its financial contributions to counter China's growing influence?
A: Yes, India should increase its contributions to WHO and other UN bodies. But that is for reasons of playing a more constructive role in the world. And not for buying greater leverage inside WHO or other organisations, or to compete with China, the US, or any other nation.
Indian national interests, in the long-term, are best served by behaving morally and ethically in global affairs so that the world comes to respect and trust India, more and more. That especially matters in sectors such as global health and development, where the conduct of nations has a direct impact on the survival and well-being of billions of people.
Q: What impact will the US withdrawal have on the WHO’s proposed pandemic treaty?
A: The US had already made many objections to the pandemic treaty, negotiations over which have been dragging on for so long. American withdrawal makes the treaty’s adoption more difficult, but this is not a showstopper. Other countries who wish to co-operate with future pandemic control can do so. Perhaps the US withdrawal may even incentivise them to hurry up to finalise the agreement which is in the common good of the whole world.
Although the effectiveness of its implementation could be compromised without US support but reducing dependence on the US on global health matters is not a bad idea, anyway.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.
