On the first day of his second administration, President Trump signed an executive order to “withdraw the US from the World Health Organisation (WHO)”.
This won’t be the first time for the United States of America to leave a United Nations entity. Quite the contrary. It has been out but then back like a yoyo, leaving no lasting mark on relevant organisations. Will this time be different?
The recent history of the US and specific multilateral entities belonging to the UN system is quite tumultuous. Like the complexity of human relationships, it features dissatisfactions, fallouts, threats, divorces and re-marriages. These chapters correspond to changes of American administrations. With Trump’s second term, the withdrawal from the WHO was not unexpected, based on his previous positions during the COVID-19 crisis.
The US is undoubtedly a heavyweight in the UN system, thanks to its important financial contributions, economic power, overseas aid distributed through domestic institutions and bilateral channels, and of course, its population size and Americans’ genuine desire to make the rest of the world better. It contributes an impressive 22% of the UN regular budget. In addition, since the creation of the UN, it is also the top voluntary contributor to keep the system afloat. It is also the top direct contributor to the WHO’s 2024-25 budget, at 15% ($500 million per year). China pays just 0.35%.
The US has also made its diplomatic displeasures heard multiple times in international arenas in the past, reflecting its current stated intent to withdraw from WHO. Most notably, these have been evident in its relations with the UN Human Rights Council (HRC) and the UN Educational, Scientific and Cultural Organisation (UNESCO).
Withdrawal from and return to the HRC
In 2006, the HRC was created as a subsidiary body of the United Nations General Assembly (UNGA) to replace the Human Rights Commission. Headquartered at the UN Office at Geneva (Switzerland), it is composed of 47 members elected for three-year terms by the 193 Member States of the UNGA. One third of the members are renewed each year, and countries can serve a maximum of two consecutive terms. Hence, roughly, one third of UN Member States are in the HRC at any time. Election is by regional groupings and extremely prone to politicisation. This has undoubtedly compromised its mandate of protecting and promoting human rights.
The HRC works through cycles of Universal Periodic Review where all UN Members States are periodically assessed, appoints the Special Procedures (independent human rights experts for specific countries or themes), authorises commissions of inquiry and fact-finding missions on war crimes and crimes against humanity, and hold crisis meetings in emergencies. Resolutions or decisions require a simple majority, and membership can be suspended by a two-thirds majority (as happened with Libya in 2011 and currently with Russia).
The relationship between the US and the HRC has long been difficult. The US (together with Israel, Palau and Marshall Islands) voted against the original UNGA resolution creating the HRC. Nevertheless, the US joined 2009 under the Obama administration, reflecting a change in position as it had preferred to be an observer to the now-defunct Human Rights Commission during the George W. Bush administration.
The US continued to voice its criticisms regarding HRC’s alleged politicisation on many issues, notably related to a high number of resolutions adopted against Israel. For instance, in February 2011, at the 16th session of the HRC, Secretary of State Hillary Clinton pointed at “the structural bias against Israel – including a standing agenda item for Israel”, which “undermined” the HRC’s work.
In October 2011, Palestine was admitted as a full member by UNESCO. A year later, the UN General Assembly (UNGA) adopted Resolution 67/19 on the “Status of Palestine in the United Nations” by 138 approved votes, three abstentions, five absences and nine rejections (including the US). Palestine thus became a non-member observer State to the UNGA – a similar status conferred to the Vatican. This was widely seen as a formalisation of the statehood of Palestine. Successive HRC resolutions (A/HRC/RES/16/30 of March 25th 2011, A/HRC/RES/19/15 of March 22nd 2012, etc.) on the Palestine-Israel issue have repeatedly called for “the two-state solution”, while the US has unsuccessfully stood, either alone or with few allies, against all other HRC members.
In March 2018, a further resolution, A/HRC/RES/37/75, condemned Israel’s past and present actions against Palestinians. On June 19th, the Trump administration decided to exit. Secretary of State Mike Pompeo laid out several reasons, such as: i) HRC members included authoritarian governments with unambiguous and abhorrent human rights records, and ii) HRC’s continued and well-documented bias against Israel. The US Ambassador to the UN, Nikki Haley, added that “for too long, the Human Rights Council has been a protector of human rights abusers and a cesspool of political bias”. Haley further stated that she had led the US efforts to try to reform the HRC for a year; however such efforts had failed due to resistance of many countries but also allies’ reticence to challenge the status quo.
The exit was swiftly reversed by the Biden administration. On February 8th 2021, Secretary of State Anthony Blinken announced that the US would reengage “immediately and robustly” with the HRC. A few weeks later, at the 46th Session of the HRC on February 24th 2021, Blinken requested peers’ support for the US to return and seek election for the HRC 2022-24 term. The country was subsequently elected and back on the Council.
US withdrawals and returns to UNESCO
Although the US was a founding member of UNESCO, the relationship has been bumpy. The Ronald Reagan administration left UNESCO in 1984 officially “because of a growing disparity between US foreign policy and UNESCO goals”. The UK’s Thatcher administration also left UNESCO in 1985.
The UK returmed in 1997 and the US in 2003 under the George W. Bush administration. Singapore also left in 1985 to return 22 years later.
The Israeli-Palestinian conflict triggered further disagreements. As mentioned above, UNESCO’s General Assembly voted in October 2011 to welcome the State of Palestine as its 195th member, despite its mere “observer entity” status at UNGA at the time. As a consequence (as feared by UNESCO Director-General Irina Bokova and UN Secretary General Ban Ki-Moon), the Obama administration froze its contributions equivalent to 22% of UNESCO’s regular $1.5 billion budget, and all support for UNESCO’s voluntary programmes. Israel, a member since 1948, left soon after.
The Trump administration then quit altogether in 2019, by which time the US had had accumulated an estimated $600 million in unpaid dues.
The US formally rejoined to UNESCO in 2023 under the Biden administration, celebrated with a flag raising ceremony at UNESCO headquarter in Paris and dinner reception with First Lady Dr Jill Biden at the US Embassy. The return depended on a majority vote of UNESCO members, and the US agreed to pay all arrears totalling $619 million, plus to fund specific voluntary programmes as negotiated with UNESCO (African projects, freedom of journalists, etc.). To this day, Israel remains an outsider despite UNESCO’s invitation to return, perhaps wishing to avoid the apparent humiliation imposed on the US.
US and WHO: a strained relationship at the beginning of COVID-19
The US was one of the founding members of the WHO. On June 14th 1948, Congress adopted the Joint Resolution “providing for membership and participation by the US in the WHO and authorising an appropriation therefor” (80th Congress, Second session, CH, 460 – June 14th 1948) to authorise the President to accept US membership of WHO. It also noted that:
Sec. 4. In adopting this joint resolution the Congress does so with the understanding that, in the absence of any provision in the WHO Constitution, the US reserves its right to withdraw from the organisation on a one-year notice: Provided, however, that the financial obligations of the US to the Organisation shall be met in full for the Organisation’s current fiscal year.
The WHO Constitution does not contain any withdrawal provision, like most of the founding texts of UN entities born immediately after the Second World War. Thus, the US Congress made clear it can withdraw from the WHO, through a formal 12-month notification providing its due contributions are acquitted. These provisions are consistent with practices codified later by the 1969 Vienna Convention on the Law of Treaties which allows parties to leave an international agreement (Articles 54 and 56).
During the first year of COVID-19, on May 29th 2020, President Trump announced that the US would be leaving the WHO. The formal procedure was triggered on July 6th by a diplomatic letter sent to both WHO Geneva headquarters and UN New York offices, citing WHO’s failures in response to COVID-19 and other recent health crises, and its unwillingness to reform. At the time, the US still had an outstanding due of $198 million.
Things did not go as planned. The Biden administration reversed the situation half a year later, not only aborting the withdrawal process triggered by Trump but also increasing US engagement with the WHO. The US then proposed the 2022 amendments to the 2005 International Health Regulations (IHR), reducing the period for new amendments to enter into force from 24 months to 12 months, and the period to make reservations from 18 months to 10 months. It was also the country actively involved in the drafting and negotiations of the 2024 amendments to the IHR that will hobble all countries’ health budgets and resources in order to spend liberally on early detection of future pandemics rather than more rational priorities.
On January 20th 2025, President Trump opened his second term by ordering:
Section 1. Purpose. 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% of the population of the United States, yet contributes nearly 90% less to the WHO.
Sec. 2. Actions. (a) The United States intends to withdraw from the WHO. The Presidential Letter to the Secretary-General of the United Nations signed on January 20th 2021, that retracted the United States’ July 6th 2020 notification of withdrawal is revoked.
Section 2(a) of the Executive Order seems to try to make the six months already passed since the first withdrawal notification (July 6th 2020) still count. It translates Trump’s wish to complete what he had started as soon as possible. It is not clear whether this argument may be accepted, or whether the new notification will re-trigger the withdrawal process again, though Congress could vote to shorten the period required. Regardless, this time, the Trump administration has plenty of time to complete a withdrawal.
But for how long? Who can ensure that the next administration will hold onto this position? Or will history simply repeat itself as in the quick and humiliating returns to the HRC and UNESCO with full backpay for the years of absence and without necessary reforms?
Stay vs quit?
As demonstrated above, it has become habitual that these policies are reversed with little public attention. Leaving arguments on their rightness or wrongness aside, the decisions to step out of the HRC and UNESCO under the Trump 1.0 administration were both quickly dismantled. Each time, the momentum was lost, as was the time, money and posture. Hence, if the Trump 2.0 administration actually leaves WHO this time, the outcome may well be nullified in the near future.
The French people say ‘qui va à la chasse perd sa place‘ (he who goes hunting loses his seat) for a reason. Perhaps it might be better, after all, for the US to use its current position and time to work for real reform, so as not to lose this opportunity. Right now, the Trump administration has many solid arguments and allies to demand serious assessment of WHO actions and inactions during Covid and its poorly evidenced approach to pandemics in general, and to seize the momentum for change. There are real opportunities to re-assess, reform or even replace the organisation with another one, to make changes not easily undone by future administrations. This would provide real and lasting impact for Americans and globally.
Dr Thi Thuy Van Dinh (LLM, PhD) worked on international law in the United Nations Office on Drugs and Crime and the Office of the High Commissioner for Human Rights. Subsequently, she managed multilateral organisation partnerships for Intellectual Ventures Global Good Fund and led environmental health technology development efforts for low-resource settings.
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