President Donald Trump’s decision to end U.S. membership in the World Health Organization revives a five-year-old grudge with the WHO’s leader.
Trump has long charged that WHO Director-General Tedros Adhanom Ghebreyesus covered up China’s responsibility for the Covid pandemic, and also aided Democrats who called Trump’s own move to shut the border to Chinese travelers racist.
Tedros, a former Ethiopian health minister who has led the WHO since 2017, did repeat Chinese talking points about Covid’s transmission and praised China’s response to the outbreak when little was known about the virus. And, in line with the WHO’s policies, he did criticize the U.S. border closure. But both the WHO and Tedros reject Trump’s claims that they favored China.
Now, if Tedros can’t heal the rift, hundreds of millions of dollars in annual U.S. contributions to global disease-fighting are at risk.
Even though the U.S. must continue to pay its $130 million dues for a year before withdrawing under rules it previously agreed to, the WHO has already launched a fundraising campaign, frozen most hiring, restricted travel, halted purchases of technology and office equipment and begun renegotiating contracts to make up for the shortfall. Its advocates are urging a detente.
“This is too important to be left to personal grudges,” said Larry Gostin, a Georgetown University professor who directs a center that assists the WHO on legal matters. “They’re going to have to put aside their problems personally with one another and really get down to the business of strengthening WHO and also reforming it significantly.”
Trump told supporters at a rally on Saturday in Las Vegas he might be open to negotiation. Besides combating disease outbreaks in developing countries, the WHO also helps American pharmaceutical companies distribute their products across the globe and coordinates the composition of the annual flu vaccine.
Trump first threatened to withdraw from the WHO in a May 2020 letter to Tedros. Trump indicated his problems with the WHO were more about leadership than the international body itself. Trump took pains to praise one of Tedros’ predecessors, Gro Harlem Brundtland, for her handling of an outbreak of the SARS virus in China in 2003 and said that continued U.S. membership in the organization depended on “reform.”
In a statement posted to X on Jan. 21, Tedros insisted that the WHO had taken that charge to heart.
During the seven years of Tedros’ tenure, the WHO has “implemented the largest set of reforms in its history to transform our accountability, cost-effectiveness, and impact in countries,” the statement said.
The organization is committed to continuing to reform its operations, a WHO spokesperson told POLITICO in an emailed statement.
But Trump, for now, isn’t buying it. His Inauguration Day withdrawal announcement cited the WHO’s “failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.”
The White House didn’t respond to a request for comment.
A former U.S. health official granted anonymity to speak frankly about the relationship with the WHO said Tedros is a strong-willed leader who demands loyalty and is unlikely to give ground. “He is much, much like Trump,” the person said.
A fraught relationship
Three months into the Covid pandemic, Trump wrote a scathing letter to Tedros and laid bare his grievances: Tedros parroted “wildly inaccurate” Chinese claims about the virus’ early spread and engaged in “political gamesmanship” by attacking the U.S. for closing its border to Chinese travelers. The results, Trump charged, were “extremely costly for the world.”
He demanded unspecified reforms as a condition of continued U.S. membership.
Trump still hasn’t spelled out what reforms he has in mind, but it’s clear he wants the WHO to take its cues from the U.S., not China, and to change the way it assesses dues so other countries bear more of the burden. Now, those are based on a country’s gross domestic product.
The U.S. currently pays dues equivalent to about a quarter of the WHO’s core budget, calculated at $130 million for 2025. China’s mandatory dues for this year are $87.6 million, about 15 percent of the core budget.
Additional, voluntary contributions from the U.S. have ranged between $105 million in 2020 and nearly $700 million in 2022, according to health policy think tank KFF. By comparison, China’s voluntary contributions average $14 million a year for 2024 and 2025, according to WHO data.
The U.N. determines how mandatory contributions are calculated, and it and WHO member countries would have to agree to lower America’s contributions.
Trump’s May 2020 missive provides a laundry list of gripes about the WHO’s early pandemic response and suggests Tedros deliberately covered up Chinese missteps.
Two months later, in July, as Covid raged in U.S. cities that had erupted in protest over the murder of George Floyd in Minneapolis, then-Secretary of State Mike Pompeo told members of the U.K. Parliament in a private meeting in London that he had intelligence that Tedros had been bought by the Chinese government.
Tedros called the accusations untrue and unacceptable and said he didn’t want the WHO to be distracted from saving lives.
Pompeo declined a request for an interview on the issue.
The Trump administration, which was taking heavy fire from Democrats for the skyrocketing death toll in America, said Tedros and the WHO were to blame.
Trump pointed out that the organization, made up of U.N. member states, had said the coronavirus wasn’t spreading through transmission among people in mid-January 2020, repeating a Chinese claim at the time.
It had waited till the end of that month, reportedly due to Chinese pressure, to declare an international health emergency. That was three weeks before the devastating outbreak spread to Italy, signaling to the world the virus’ pandemic potential.
Trump was particularly upset with Tedros for praising China’s domestic travel restrictions while opposing Trump’s decision to stop travel to the U.S. from China to curtail the virus, according to Trump’s letter.
“Your political gamesmanship on this issue was deadly, as other governments, relying on your comments, delayed imposing life-saving restrictions on travel to and from China,” Trump wrote.
A WHO spokesperson rejected the accusation of political gamesmanship, saying that’s not something the WHO engages in.
“WHO, its senior leadership, and all staff operate on the basis of impartiality and neutrality, and undertake our work driven by the pursuit of science, evidence and ensuring all people, everywhere, are able to attain the highest possible levels of physical and mental health and wellbeing,” the spokesperson said in an emailed statement.
Tedros’ praise of China’s response to the pandemic in the early days, despite reports that the Chinese government was silencing health care workers, raised eyebrows at the time.
The WHO and Tedros have rejected accusations that they took orders from China or any other member country in their handling of the pandemic.
The WHO spokesperson said the WHO and other organizations like it “tend to engage in a blend of public diplomacy and private meetings” when working with member countries. “WHO cannot compel Member States to take actions,” the spokesperson said.
The global health body has published a timeline of its actions, and over the past few years, Tedros and other WHO officials have called on China to share more information about how the pandemic started — whether from an infected animal that came in contact with people or from a lab leak in Wuhan, the Chinese city where the first Covid cases were reported.
That’s of high interest for congressional Republicans, who have come to the conclusion, which remains unproven, that the pandemic most likely started due to a lab leak. The theory got a boost Saturday when the CIA said that it was leaning toward it, changing its yearslong stance that it couldn’t conclude with certainty how the pandemic started. Many GOP lawmakers are leaning on Trump to withdraw from the WHO because they believe it has covered up the truth about Covid’s origins.
Gostin, who is considering a lawsuit arguing that Congress must approve U.S. withdrawal from the WHO, said the issues Trump cited were diplomatic bungling not corruption. “I worked with WHO for years and I can tell you that the U.S. has had far more influence over WHO than China ever has,” he said.
A few months after sending his letter, Trump announced he was withdrawing the U.S. from the WHO and started the clock for the departure to become effective a year later.
But Joe Biden won the November 2020 election and reversed Trump’s withdrawal decision when he took office in January 2021.
Trump’s executive order on Inauguration Day rescinded Biden’s order.
Tedros’ rise
Ethiopia made dramatic public health advances during Tedros’ tenure as health minister from 2005 to 2012, helping to elevate his candidacy to lead the WHO when member states voted in 2017.
He beat a British doctor and diplomat for the director-general post, becoming the first African to hold it, winning the votes of 133 of 183 countries that cast secret ballots.
Since coming into office, he has pitched himself as a reformer, aiming to make the massive global health bureaucracy more nimble and focused on results, such as delivering health care access for billions of people globally.
The reforms include organizing the WHO’s work and staff to more clearly show its impact and improving transparency and accountability; creating a division for emergency preparedness and fundraising from new donors to make the organization’s funding more sustainable, the WHO spokesperson said.
But the call for an overhaul goes beyond Trump.
Brown University School of Public Health Dean Ashish Jha, who led the U.S. Covid response for Biden, has called for one, arguing in an opinion piece this month for the medical news website Stat that the WHO needs to focus on its core functions. He said that means helping developing countries build their disease-fighting capabilities, responding rapidly to outbreaks, establishing technical standards and convening nations to work together.
He added that the group should change its financing model so countries that make voluntary contributions don’t get to set its agenda and limit the director-general to one term so they don’t need to worry about running for reelection.
Jha said the U.S. should remain a WHO member to push for those changes.
In response, Maria D. Van Kerkhove, WHO interim director of epidemic and pandemic threat management, gave no ground, accusing Jha of “inaccuracies, omissions, and misrepresentations.”
“WHO is what its 194 member states make it, including the U.S.,” she wrote.
The call for a WHO overhaul goes beyond Trump. | Robert Hradil/Getty Images
Tedros, whose second and last term ends in 2027, was controversial when he campaigned to lead the WHO in 2016.
He was a high-ranking member of Ethiopia’s ruling party at the time, the Tigray People’s Liberation Front, which opponents accused of widespread political oppression.
Tedros acknowledged Ethiopia’s imperfections as a democracy while distancing himself from responsibility for his party’s alleged abuses.
By the time he was running for a second term in 2021, the pandemic was raging and a civil war between the Ethiopian region controlled by his party and another party ruling the central government was ravaging the country.
The Ethiopian government didn’t endorse Tedros to run for a second WHO term, accusing him of helping arm his party, which Tedros denied.
France and Germany nominated him for a second term, which he won after running unopposed.
The possibility of U.S. withdrawal is the latest crisis Tedros has faced.
Besides leading the organization in responding to the Covid pandemic, he’s also overseen the WHO response to two outbreaks of the rash-causing virus mpox, one of which spread to the U.S. and Europe, and multiple conflicts and natural emergencies from Ethiopia to Ukraine to Gaza and Pakistan.
The art of the deal
“They wanted us back so badly, so we’ll see what happens,” Trump said on Inauguration Day about the WHO reaction to his first withdrawal attempt.
To some WHO advocates, that’s a sign Trump may be using the withdrawal threat to gain more control over the organization. At a Las Vegas rally on Saturday, Trump suggested he was open to negotiation. “We would have to clean it up a little bit,” he said of the WHO.
Peter Yeo, a senior vice president at the U.N. Foundation, a nonprofit that advocates for the world body in Washington, hopes the year-long delay before the U.S. can stop paying its dues provides a window.
Talks could include discussion about the leadership of the organization, Yeo said, adding that the U.S. could yield more power over organizational changes if it stays in.
Trump’s nominee for U.N. ambassador, Rep. Elise Stefanik (R-N.Y.), told the Senate Foreign Relations Committee during her nomination hearing last week that she recognized the need for the U.S. to retain influence at the U.N. to combat Chinese influence.
Stefanik said she’d review U.S. involvement in U.N. agencies to ensure the U.S. taxpayer gets a good return on investment.
She promised to “deliver reforms and make sure that our dollars are going to programs within the U.N. that work, that have a basis in the rule of law, that have a basis in transparency and accountability and strengthen our national security and our partnerships.”
Politico
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