After the inauguration of the 47th president of the United States, Donald Trump, a controversial decision was made to withdraw the U.S. from the World Health Organization (WHO). This move sparked widespread condemnation from various sectors, both within the U.S. and globally. Despite the uproar caused by Trump’s decision, this is not the first instance where the U.S. has flexed its political muscle and financial influence over the WHO.
An American concept from its inception, the WHO was part of the U.S.’s vision for a post-World War II world order. With significant financial contributions and strategic placements of American allies within the organization, the U.S. maintained a dominant position within the WHO. This influence extended to regional preferences and the promotion of specific health initiatives, such as the Malaria Eradication Program, driven by Cold War strategies.
The U.S.’s aggressive tactics led to the withdrawal of the Soviet Union and its allies from the WHO in 1949. However, the organization saw a resurgence in the late 1950s with the initiation of a smallpox eradication program, a success story that showcased the potential of international cooperation in public health.
During the 1970s, the political landscape within the WHO began to shift with the emergence of developing nations demanding equitable access to health services and essential medicines. This shift was met with resistance from developed nations, particularly the U.S., leading to the creation of alternative health care models and the diminishing influence of the WHO.
The 1980s marked a turning point with the World Bank’s increasing involvement in global health initiatives, surpassing the WHO in financial commitments and program implementations. New alliances and entities, such as Roll Back Malaria, GAVI, and the Global Fund, further marginalized the WHO’s role in international health governance.
The U.S.’s interventions, notably through initiatives like PEPFAR, undermined the WHO’s priorities and autonomy in addressing critical health issues like HIV/AIDS prevention and treatment. These interventions reflected a broader trend of U.S. influence reshaping the global health landscape to align with its foreign policy objectives.
The U.S.’s emphasis on emerging infectious diseases in the 1990s pressured the WHO to revamp its International Health Regulations, limiting the organization’s authority in responding to epidemics and pandemics. This legal constraint, championed by U.S. interests, laid the groundwork for Trump’s drastic actions against the WHO during the COVID-19 pandemic.
In light of these historical precedents, the current U.S. administration’s efforts to dismantle the WHO signal a departure from past strategies of reshaping the organization to meet American interests. The implications of this move could irreversibly alter the course of the WHO’s future and its ability to fulfill its founding principles.
Theodore M. Brown, Ph.D., a distinguished historian and public health expert, sheds light on the implications of U.S. interventions in the WHO’s history. As a professor emeritus at the University of Rochester, Brown’s insights offer a critical perspective on the evolving dynamics between the U.S. and the WHO, shaping the trajectory of global health governance.
