Before Trump took office, his team had considered reforming the World Health Organization, including appointing an American as the head to ensure that the US remained a member of the WHO.
According to Reuters, before Trump took office, his team commissioned an external policy expert to write a proposal. The proposal suggested that the US swiftly announce its withdrawal from the WHO and adopt a “radical new approach” to deal with the organization, including pushing for an American official to become the Director-General when Tedros Adhanom’s term ends in 2027.
The proposal argued that the WHO had failed to implement reforms proposed over the past 20 years, leading to a deterioration in management and scientific expertise.
While acknowledging that withdrawing from the WHO would harm US interests, the proposal believed that staying in the organization under current circumstances without reform would also be detrimental.
On his first day in office, Trump signed an executive order announcing the US’s withdrawal from the WHO. This would result in the WHO losing its largest funder in January 2026. The executive order accused the WHO of mishandling the COVID-19 pandemic and being influenced by “improper political influences” from other countries. The WHO denied these allegations.
Trump later hinted that if the WHO “cleaned up,” the US might rejoin, but did not provide specific details on requirements.
While this reform proposal had been under discussion before Trump took office, two sources told Reuters that it was unclear whether the Trump administration would adopt other suggestions.
White House spokesman Kush Desai stated in a release that the Trump administration “will continue to review current processes and healthcare institutions to implement necessary reforms.” He did not comment on the content of the proposal.
Søren Brostrøm, WHO’s Transformation Director, denied the critique of the WHO in the proposal during an interview with Reuters, stating that the organization had undergone the most fundamental reform under Tedros’s leadership.
He said, “We have changed everything and we know we are still progressing.” The reform measures, he explained, included increasing independence by reforming funding models, granting more autonomy to directors outside the headquarters in various countries, and providing more expenditure transparency.
He added that the work of the WHO might be more complex than other UN agencies due to its broad responsibilities but emphasized that its response to health crises was not chaotic.
“If member states have additional reform demands, we will strive to meet them,” he said.
The proposal called for the appointment of a US envoy in 2025 to report to Trump and the White House, overseeing negotiations on potential reforms with the WHO before the US exits next year.
Currently, coordination with the WHO is carried out by the US Department of State and the Department of Health and Human Services. This envoy would advocate for the first time for a US official to assume a leadership position in the WHO.
The proposal stated, “While no formal explanation was given for this situation, the lack of leadership by the US at the senior levels of the WHO is a key factor in waste of US funds and decreased efficiency of the organization.”
The US is the largest financial supporter of the WHO. The WHO receives 18% of its funding annually from the US, including $400 million in voluntary contributions and $130 million in assessed contributions based on member country economic size.
The WHO has warned that unless other donors fill the funding gap left by the US, the organization will face the risk of budget cuts.
Regarding the proposal for an American to serve as the Director-General of the WHO, Brostrøm stated that any member country could nominate a Director-General candidate and advocate for their candidate. The Executive Board of the WHO would select a final list of candidates, and a candidate who receives at least two-thirds support from member countries would be elected.
The US has ceased cooperation with the WHO, including halting communication with the Centers for Disease Control and Prevention in the US. The CDC has been a long-term partner of the WHO in identifying and containing global disease outbreaks.
However, Brostrøm stated that US representatives would attend the WHO’s Executive Board meeting in Geneva from February 3 to 11. The meeting aims to determine the WHO’s future budget and priorities.
(This article was based on reports from Reuters)