The Trump administration’s withdrawal of the United States from the World Health Organisation (WHO) is a decision that reverberates across global health and diplomacy, marking a significant juncture in the intersection of health and politics. For some, this move may appear to be the pinnacle of political interference in global health.

The measured and conciliatory tone of the WHO’s response to the US withdrawal warrants critical reflection. The organisation’s eagerness to dialogue and accommodate contrasts sharply with how a similar move might have been received if it had come from a smaller or less influential nation. This highlights a stark reality: the dynamics of global health governance are deeply intertwined with geopolitical power structures.

As the WHO’s largest single contributor, the United States provided 15.59% of its 2022–2023 biennium budget, amounting to $1.284 billion—significantly outpacing Germany’s $856 million and the $830 million from the Bill and Melinda Gates Foundation.

Notably, China, with a population above 1.4 billion, contributed a meagre 0.4%, while Nigeria, often cited as a struggling health system, contributed 0.44%. The US withdrawal leaves a massive funding vacuum that will not be quickly filled, underscoring the US’s critical role in sustaining global health initiatives.

This move, however, is less about health and more about reasserting US dominance on the global stage. Official statements suggest that the decision was driven by dissatisfaction with the WHO’s handling of the COVID-19 pandemic and its perceived alignment with China. Though not entirely unfounded, such criticisms are steeped in ideological posturing and political theatre—a recurring theme in Trump’s approach to international institutions.

The cyclical politicisation of global health is both alarming and disheartening. In 2020, at the height of the COVID-19 pandemic, the Trump administration withdrew, only for President Biden to reverse the decision upon assuming office.

The implications for the WHO are profound. The organisation must navigate this crisis carefully, balancing its commitment to global health equity with the realities of power dynamics. How far will the WHO accommodate US demands and secure a potential re-engagement? The risk of compromising its principles to appease a hegemonic power is real, and the consequences for low- and middle-income countries could be dire.

This moment also serves as a wake-up call for sovereign states to take greater ownership of their health systems. Over-reliance on external funding and interventions is unsustainable but calls for self-reliance must be tempered with realism. Achieving health independence is not as simple as turning inward or reviving traditional practices. While countries like China and India have leveraged traditional medicine, they have done so atop robust technological and industrial infrastructure.

In contrast, Nigeria and many other African nations lack the technological and manufacturing capacity to support a modern health system independently. The Abuja Declaration of 2001, which saw African leaders pledge to allocate at least 15% of their national budgets to health, remains a haunting reminder of unfulfilled promises. Nigeria, the host of that declaration, has never come close to achieving half of this target. Instead, the country’s health sector still relies on foreign aid, even as inefficiencies and frivolous allocations plague national and state budgets.

This is not a time for empty rhetoric or symbolic gestures. Addressing health funding and governance gaps requires actionable policies, efficient resource allocation, and a commitment to strengthening domestic health systems. It is time for countries like Nigeria to assume urgency over their health challenges—but doing so demands more than mere words.

Global health is not a zero-sum game. It thrives on collaboration, mutual respect, and shared responsibility. Now firmly in power, the Trump administration must transcend post-election theatrics and focus on governance. Public health is not a tool for political grandstanding; it is a universal right that must be safeguarded from the whims of power.

Let this withdrawal serve as a catalyst for innovation, resilience, and unity among nations. Above all, let it remind us that health is a collective endeavour that transcends borders, ideologies, and political agendas. In this era of unprecedented global challenges, the world must rally together to uphold the principles of equity and cooperation that form the cornerstone of global health. The stakes are too high to allow politics to undermine what should be a shared commitment to humanity.

 

Kingsley Oladayo Ogunne, PhD wrote from Ile-Ife

ogunneinfo@gmail.com