A Setback on Global Health and Infection Control With US Withdrawal From WHO: An Infection Preventionist’s Opinion

Shahbaz Salehi, MD, MPH, MSHIA, Infection Control Today Educator of the Year^TM

(Image courtesy of Foothill Medical Center, Tustin, California)

The World Health Organization (WHO) has long been a cornerstone of global efforts to bring together research, resources, and expertise to prevent and control diseases in our interconnected world. For over 70 years, the global community has worked in unison to tackle public health challenges, relying on the WHO as the principal authority in health guidance, research, and interventions. Through the efforts of WHO, significant progress has been made in eradicating and controlling diseases such as smallpox, polio, measles, malaria, HIV/AIDS, and, most recently, the COVID-19 pandemic. These milestones exemplify the power of international collaboration, with WHO at the helm, to address diseases that know no borders.

For instance, the successful eradication of smallpox in 1980 remains one of WHO’s greatest achievements, eliminating a disease that once killed millions.¹ Similarly, the organization’s concerted efforts in reducing the spread of polio have led to a near-global eradication, with only a handful of countries still reporting cases.² WHO's success in curbing the global burden of malaria through initiatives such as the Roll Back Malaria partnership has been instrumental in reducing malaria-related deaths by more than 60% in the past two decades.³ The organization’s role in controlling HIV/AIDS is equally impressive, as it has worked with global partners to reduce new infections by nearly 40% since 2000.⁴ The COVID-19 pandemic, a global crisis unlike any other, has once again highlighted the importance of WHO’s leadership in coordinating worldwide responses and providing timely scientific guidance.

However, on his first day in office, President-elect Donald Trump issued an executive order to withdraw the US from the WHO, a decision that would sever the country’s longstanding relationship with the organization. The US is a founding member of the WHO and has contributed significantly to its budget, playing a vital role in funding global health initiatives. The decision to withdraw from WHO, one of the world’s most influential public health bodies, has sparked heated debates and divided opinions. While some argue that the U.S. should prioritize domestic health issues, the consequences of this withdrawal would have far-reaching implications not only for the US but also for global health and infection control.

The implications of the US pulling out of WHO are multifaceted, and the decision could undermine the progress made in global health over the past few decades. WHO's ability to provide timely guidance on emerging infectious diseases is critical, particularly in an era of increasing globalization and interconnectedness. The COVID-19 pandemic has starkly demonstrated how a virus can quickly travel across the globe, infecting millions within a short period. The interconnectedness of nations through trade, travel, and communication means that an outbreak in one country can easily become a global emergency. In this context, WHO's role in monitoring global health trends and issuing timely alerts has proven indispensable.

In a rapidly globalizing world, public health is no longer a national issue but a shared global responsibility. The pandemic provided a crucial lesson in how diseases can spread quickly from one part of the world to another, often within a matter of hours. This interconnectedness means we are more vulnerable than ever to the spread of infectious diseases. As a result, global collaboration is essential. WHO’s role in facilitating this collaboration through information sharing, research, and coordinated efforts cannot be overstated. The organization provides the framework for countries to work together, using scientific evidence to inform their responses to public health threats.

Moreover, infection preventionists and public health professionals worldwide rely on WHO for guidance, resources, and the latest research. WHO’s leadership in providing technical assistance, training, and tools has enabled countries to implement the best infection prevention and control practices. The organization's collaboration with national public health agencies, the CDC, and regional organizations like the European Centre for Disease Prevention and Control (ECDC) is vital to tracking emerging diseases and providing evidence-based recommendations to mitigate their spread.

Infection control measures are particularly dependent on international cooperation, as diseases do not respect borders. WHO’s role in issuing alerts about disease outbreaks, sharing epidemiological data, and coordinating responses among nations is crucial for preventing widespread outbreaks. For example, WHO’s efforts in coordinating the global response to the Ebola outbreak in West Africa from 2014 to 2016 saved countless lives and helped prevent the virus from spreading to other continents.⁵ Without such coordination, the impact of outbreaks like Ebola, Zika, or even COVID-19 could have been far more devastating.

Based on projections, it could take about 1 to 2 years for the US to fully withdraw from WHO. During this time, WHO would be left without one of its founding members and a major funding source. The financial support provided by the US is critical, especially for low- and middle-income countries that rely on WHO for assistance in combating infectious diseases. If the US were to withdraw its funding, WHO’s ability to support vulnerable countries would be significantly diminished. This decision would also weaken WHO’s ability to respond to future global health emergencies, potentially leaving countries without the necessary resources and guidance to effectively address public health crises.

The withdrawal of the US from WHO would have dire consequences not only for global health but also for the infection control profession. Infection control is an inherently international field, with practitioners relying on global standards and guidelines. WHO’s leadership in establishing protocols, training, and recommendations has helped shape infection control practices worldwide. Infection preventionists depend on WHO’s expertise to respond to new threats and ensure the safety of healthcare workers and patients alike. The absence of US leadership within WHO would send a troubling signal about the importance of global collaboration in addressing public health challenges.

In conclusion, the decision to withdraw from WHO represents a significant setback for global health and infection control. In an era where diseases can spread rapidly across borders, international cooperation is more crucial than ever. The US has long been a key player in supporting global health initiatives, and its withdrawal from WHO would undermine decades of progress in combating infectious diseases. For the sake of public health, infection control, and the global community, it is essential that the US remains engaged with WHO and continues to support its mission to promote health and well-being for all.

References

1. World Health Organization. (2020). Smallpox Eradication. Retrieved from https://www.who.int/health-topics/smallpox#tab=tab_1.
2. Global Polio Eradication Initiative. (2021). Polio Eradication and Endgame Strategic Plan 2019-2023. Retrieved from https://polioeradication.org/.
3. World Health Organization. (2020). World Malaria Report 2020. Retrieved from https://www.who.int/publications/i/item/9789240064895.
4. UNAIDS. (2020). Global AIDS Update 2020: Seizing the Moment—Tackling Entrenched Inequalities to End Epidemics. Retrieved from https://www.unaids.org/en/resources/documents/2020/global-aids-report.
5. World Health Organization. (2016). Ebola Virus Disease – West Africa Outbreak. Retrieved from https://www.who.int/csr/disease/ebola/en/