The U.S. Is Out of the WHO—But Global Health Isn’t Done with America

Late last month, the United States made its break-up with the World Health Organization (WHO) official. The nation’s withdrawal from the collaborative framework of 194 member states marked a historic moment in global health, and is a move experts say will cost lives and harm human health. The U.S. provides the bulk of the money—and much of the scientific expertise—to this collaboration. Public health leaders, doctors, and scientific organizations have decried the decision and warned it will do irreparable harm and will pose a national security threat for the U.S.  

While this decision is done, public health work—and disease threats continue.

The late epidemiologist Bill Foege felt that “global coalitions are essential,” and elevated it as one of nine core lessons to learn from his work to eradicate smallpox through his Becoming Better Ancestors project.

Why? Because public health problems, like viruses, know no boundaries. To effectively prevent and manage outbreaks, countries have to share information in an organized way, and in partnership with one another. Since 1948, the WHO has served that purpose.  For Americans, this isn’t an abstract policy debate — it affects pandemic preparedness, vaccine development, and national security at home.

How American Public Health Workers Can Still Promote Global Health 

“It will be essential for U.S.-based nongovernmental organizations, professional societies, academic institutions, and philanthropic foundations that operate independently of government to formally engage with, and contribute to, WHO processes as non-state actors (NSA),” says Ken Castro, MD, emeritus professor of global health at the Rollins School of Public Health.

He continues, “NSAs can contribute subject matter expertise during technical consultations convened by WHO and to deliberations during meetings of the World Health Assembly. In the future, we must proactively seek and secure participation in WHO deliberations that could benefit from our academic expertise, real-world experience, and perspective.”

Two states are already taking immediate action and continuing direct engagement with the WHO by joining WHO’s Global Outbreak Alert and Response Network.

What Happens During WHO Meetings?

The reason why U.S. presence is critical for American health, is having U.S. expertise in the room advising and learning from other nations, being involved with decision-making, and having input in conversations that affect the world. For instance, the following topics are ones that regularly come up during WHO meetings:

• Emergency preparedness and response
• Vaccine development, particularly for the yearly flu formulation
• Leadership changes
• Setting global standards for issues impacting health

For nearly 80 years, the United States has worked hand-in-hand with the WHO to tackle all aspects of WHO activities. Castro says this includes, “a successful campaign to eradicate smallpox and ongoing efforts to eradicate polio and tackle HIV, hepatitis, vaccine preventable diseases, malaria, TB, other infectious foodborne and respiratory diseases, and noncommunicable diseases."

Advice for Global Health MPH Students

Global health education is still critical—if not more so. Castro says that current or prospective students interested in contributing to global health should focus on scholarly and rigorous scientific work, such as documenting the country-specific burden, distribution, and risk factors associated with diseases. 

He also recommends that students implement research that helps inform: 

• effective interventions to mitigate, control, prevent, and eventually eliminate diseases, and
• the formulation of evidence-based guidelines and policies for improved health outcomes.

Castro recently wrote that American involvement in global health is not only the right thing to do, but that our actions and contributions reflect enlightened self-interest. “Because many global health problems directly impact U.S. citizens and residents, the departure by the United States as one of WHO member states comes at our own peril.”