The United States has formally completed its withdrawal from the World Health Organisation (WHO), marking a major shift in its global health policy. The decision comes a year after President Donald Trump ordered the exit, and it ends all US involvement in the United Nations health agency. However, the move has also left behind an unpaid debt of around $260 million, according to reports by Bloomberg and Reuters.

The US Department of Health and Human Services (HHS) confirmed that all funding to the WHO has been terminated. It also announced that US personnel have been recalled from the organisation’s headquarters and offices across the world. In addition, the United States has ended its participation in WHO-sponsored leadership bodies, technical committees, and working groups.

The withdrawal follows an executive order signed by President Trump on his first day in office during his second term. The order cited the WHO’s “mishandling of the Covid pandemic, failure to adopt reforms and a lack of independence from inappropriate political influence” as the main reasons for the decision.

An administration official denied that the United States is obligated to settle its outstanding dues before leaving the WHO. The official stated that there is no legal requirement to pay the debt prior to withdrawal.

A senior HHS official told reporters that there is no statutory requirement for the US to clear unpaid dues before exiting the agency, even though a 1948 Congressional resolution calls for one year’s notice and payment of any outstanding contributions.

Despite the formal exit, the United States has not paid its dues for 2024 and 2025. According to the WHO, the US owed about $260 million as of January 2025. However, an Associated Press report quoted a WHO official who said the debt amount was more than $130 million.

The US withdrawal has significant financial implications for the WHO, as the country has been its largest contributor. According to Bloomberg, between 2022 and 2023, the United States contributed nearly $1.3 billion to the organisation.

Commenting on the situation, Lawrence Gostin, director of the WHO Collaborating Centre on National and Global Health Law at Georgetown University, described the situation as “It’s a very messy divorce.”

Gostin also warned about the broader impact of the decision, saying, “The withdrawal will hurt the global response to new outbreaks and will hobble the ability of US scientists and pharmaceutical companies to develop vaccines and medicines against new threats. In my opinion, it’s the most ruinous presidential decision in my lifetime.”

The WHO plays a central role in global health. It coordinates responses to international health emergencies, provides technical support to poorer nations, distributes vaccines and treatments, and sets global health guidelines. Nearly every country in the world is a member of the organisation.

Experts believe that the US withdrawal could weaken several global health initiatives. These include programs related to polio eradication, maternal and child health, and research on emerging viruses.

Dr Ronald Nahass, president of the Infectious Diseases Society of America, strongly criticised the decision. He called the move “shortsighted and misguided” and described it as “scientifically reckless.”

By ending its participation in WHO committees and technical groups, the United States has also lost access to global influenza data. This data is crucial for making vaccine decisions and for enabling countries to respond quickly during outbreaks. The loss of such access could affect how the US prepares for future health emergencies.

The decision to withdraw from the WHO has sparked debate among experts and officials, with many warning that it could weaken global cooperation in health and reduce the ability to respond effectively to future pandemics and outbreaks.