Should the U.S. Withdraw from the World Health Organization?

By Stefano Gennarini, J.D. | June 4, 2020

President Trump’s announcement that the U.S. will withdraw from the World Health Organization seems to have caught the entire world off guard. But the surprise and consternation is not justified. Nor are the cries that the U.S. must at all costs stay part of the World Health Organization. The picture is more complex than many commentators are acknowledging.

The President of the United States warned the international health agency over a month ago that the U.S. would withdraw unless the agency showed an earnest commitment to working seriously on reform.

Whether all of the charges in the March letter were entirely justified or not, the international health agency should have immediately taken steps to satisfy all the reasonable conditions its top donor sought. But that did not happen. On the contrary, the agency dug in and defended its actions. That’s a big deal.

The agency can expect many more such warnings to take place in the coming months and years, and not just from the United States. We are living at the dawn of a new age, when relations between Sovereign States and international institutions will be reconfigured. The institutions that will survive and be reformed are the ones most responsive to real needs and that have legitimacy through the backing of authentically sovereign states. A simplistic liberal lens that sees international organizations as inherently and always benevolent is no longer helpful.

Not everything the World Health Organization does is bad or tainted. Without a doubt, there has been good work carried out by the agency, and there is much more good work it could carry out in the future. The problem is that the agency is no longer respecting the sovereignty of its constituent member states.

In the context of the COVID-19 pandemic, by helping China hide the severity of the virus, and serving China’s economic and diplomatic interests first, the World Health organization failed to respect the sovereignty of the whole membership of the organization. Similarly, by using the pandemic as an opportunity to promote abortion as an “essential” health service, the organization has undermined the sovereignty of UN member states who have repeatedly affirmed that abortion is a subject that is the exclusive province of national laws.

The World Health Organization is accountable to its member states. It is a multilateral organization. Member states delegate their sovereignty to the international agency to some degree, even if just to carry out specific functions. The WHO cannot prioritize the interests of any individual state without also violating the sovereignty of the whole membership of the organization. Anything WHO does without authorization by member states, or in disregard of their interests and authority, is a violation of sovereignty.

But the World Health Organization, like many other multilateral institutions, has a complex and intricate bureaucracy governed by an even more complex labyrinth of treaties, resolutions, and diplomatic conventions. It’s not easy to determine what the World Health Organization is authorized to do at any given time. Many UN member states are at the mercy of the agency’s bureaucrats to even understand the agenda of the organization during the meetings of the World Health Assembly, the governing body of the agency, let alone technical legal questions about the scope of the mandate of the agency.

And here is the big problem. More and more the World Health Organization’s bureaucracy, like that of other international institutions, has a life of its own independent of its constituent member states. It is quickly losing “legitimacy” as a result, to use a word from Kissinger’s foreign policy lexicon.

The intricate web of decision-making, political intrigue, and special interests around the World Health Organization is only made worse by the special status afforded by the organization to philanthropists like Bill and Melinda Gates, who contribute over 10% of its budget, or outside groups like the International Planned Parenthood Federation and the population control establishment, who own Tedros Adhanom Ghebreyesus and have groomed him for his current position for the last thirty years.

And then there is the mighty European Union, which virtually controls multilateral fora with its nearly massive coalition of nations and steadily increasing stream of funding, which has already surpassed U.S. contributions in many areas. Unlike U.S. funding, which is always under threat of being cut by Republicans, EU funds to multilateral organizations are only ever increased. And unlike U.S. policy guidance, which changes every 4 to 8 years, depending on whether a Democrat or Republican occupies the White House, EU policy never changes.

It is an open secret that the EU has more influence on UN policy than the United States. When Democrats are in the White House they align themselves with Brussels and follow their lead. When Republicans come into power they are at a loss as to how to improve the organization. The UN bureaucrats are despondent and bide their time waiting for a more favorable climate in Washington D.C. It is no surprise that the most common response Republicans have to UN abuse is to cut funding. It is a response born out of exasperation. It is not a show of power. But even the threat of cutting funds is more and more failing to influence multilateral organizations as the EU, China, and Bill Gates are more than happy to buy more control.

No wonder UN agencies are so despondent with the Trump administration, and on no issue more so than on abortion. Following a letter of Acting Administrator of the U.S. Agency for International Development John Barsa to the UN Secretary-General critical of UN agencies promoting abortion as humanitarian relief, the UN agencies issued a response on May 20, insisting that “sexual and reproductive health and rights are human rights, needed, wanted, essential and lifesaving in every emergency,including “access to safe abortion to the full extent of the law.”

This comes on the heel of three years of very patient diplomacy from the Trump administration asking WHO to refrain from promoting abortion at the World Health Assembly, a diplomatic effort that has been joined by dozens of countries. Unless the U.S. does something dramatic it will give a green light to the entire UN system to continue to ignore and disrespect U.S. officials, federal law, and ultimately U.S. taxpayers, who contribute more than any other people to the functioning of the multilateral system.

In this context, withdrawal is quite possibly a much more effective diplomatic tool than defunding. Defunding international organizations in the present climate actually achieves very little. The U.S. loses more control and influence every time it cuts funds to a multilateral agency. Withdrawal is a much more powerful, even if blunt, tool. What it does is delegitimizes the entire agency. This puts pressure on the agency to engage in authentic reform if it is interested in preserving the integrity of the multilateral system and gain support from the U.S. And it is a tool the U.S. should use now, when it still is the world’s undisputed superpower and still has leverage. As other countries’ influence grows in foreign affairs, and U.S. power wanes relative to the whole, the U.S. will have to take less aggressive positions. But until that power transition has progressed further, the U.S. should avail itself of every tool at its disposal to gain an edge.

Withdrawing from the World Health Organization is not only a powerful way to assert and defend U.S. sovereignty. It is also good for democracy and self-government around the world. In many ways it is a courageous act. The Trump administration is taking political responsibility. Unlike many politicians around the world who have gleefully abdicated their own responsibility to the World Health Organization’s experts to avoid political repercussions for any decisions during the pandemic, the Trump administration is willing to stand on its own two feet. If more political leaders around the world do the same, it bodes well for the multilateral system. Unless the multilateral system is legitimized by sovereign and self-governing states it will never survive.