Intended for healthcare professionals


US to withdraw from WHO as China has “total control” over it, Trump claims

BMJ 2020; 369 doi: (Published 01 June 2020) Cite this as: BMJ 2020;369:m2178

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  1. Elisabeth Mahase
  1. The BMJ

The US will withdraw from the World Health Organization, according to the country’s president, who has claimed that China had “total control” over it.

Donald Trump gave an ultimatum to director general Tedros Ghebreyesus on 18 May1 saying that if WHO did not “commit to major substantive improvements within the next 30 days” he would permanently freeze US funding to the UN health agency and reconsider its membership.

Speaking on 29 May, Trump said WHO had “refused to act” and as such he would be “terminating” the relationship and redirecting funds to other “urgent global public health needs.”

Health leaders have criticised the decision to withdraw, suggesting that it is being used as a distraction from the situation in the US. The country has had over 100 000 covid-19 related deaths and more than 1.8m cases.2

They have also pointed out that it is likely the US will have to give one year’s notice to leave and settle any payments, meaning the decision could be reversed if a new president takes over following the November elections.

Trump’s announcement came after the US halted funding to WHO on 15 April while it investigated whether the agency had mismanaged or covered up the spread of covid-19.3

Trump has previously criticised WHO, saying that it reacted too slowly to covid-19. This was despite WHO warning countries in early January that they needed to prepare and that human to human transmission was a strong possibility (14 January). Just over a week later (30 January) it declared the virus a public health emergency of international concern. Despite this, Trump continued to downplay concerns over covid-19, repeatedly comparing it to flu and suggesting that public health warnings were a conspiracy against him.4

The US is the largest contributor to WHO, providing around 15% of WHO’s 2018-19 budget, equal to $400m (£320m; €367m), although payments are reported to be $200m in arrears.

Speaking from the White House on 29 May Trump said, “China has total control over WHO, despite only paying $40m a year, compared with what the US has been paying which is approximately $450m a year. The world needs answers from China on the virus. Why is it that China shut off infected people from Wuhan to all other parts of China, it went nowhere else, it didn’t go to Beijing, it went nowhere else. But they allowed them to travel freely throughout the world including Europe and the US. The death and destruction caused by this is incalculable. We must have answers not only for us but for the rest of the world.”

In the letter sent to Ghebreyesus, Trump said his administration’s review had confirmed many of his “serious concerns.”

“The only way forward for WHO is if it can demonstrate independence from China. My administration has already started discussions with you on how to reform the organisation,” he wrote. “I cannot allow American taxpayer dollars to continue to finance an organisation that, in its present state, is so clearly not serving America’s interests.”

On whether it is possible for the US to simply withdraw from WHO, Adam Kamradt-Scott, senior lecturer in international security studies at the University of Sydney, said the US did reserve the right to withdraw when it joined in 1948. This means it can leave, but it must give one year’s notice and settle any owed payments. As such, he said that with the US presidential election looming, this decision may be reversed.

“The threat from President Trump should be seen for what it is: a blatant attempt to distract the international community and the US’s domestic population from the fact he has fundamentally failed to contain the pandemic in the country he is responsible for. The pandemic in the US has resulted in the deaths of more than 100 000 of his citizens,” he said.

Meanwhile, the former director of the US Centers for Disease Control and Prevention Tom Frieden posted on Twitter,5 “We helped create WHO. We are part of it. It is part of the world. Turning our back on WHO makes us and the world less safe.”

Thomas File, president of the Infectious Diseases Society of America, also put out a statement saying that they are standing “strongly against President Trump’s decision.”


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