The World Health Organization chief asked global leaders to lean on Washington to reverse President Donald Trump’s decision to withdraw from the UN health agency, insisting in a closed-door meeting with diplomats last week that the US will miss out on critical information about global disease outbreaks.
But countries also pressed WHO at a key budget meeting last Wednesday about how it might cope with the exit of its biggest donor, according to internal meeting materials obtained by The Associated Press. A German envoy, Bjorn Kummel, warned: “The roof is on fire, and we need to stop the fire as soon as possible.”
For 2024-2025, the US is WHO’s biggest donor by far, putting in an estimated $988 million, roughly 14% of WHO’s $6.9 billion budget.
A budget document presented at the meeting showed WHO’s health emergencies program has a “heavy reliance” on American cash. “Readiness functions” in WHO’s Europe office were more than 80% reliant on the $154 million the US contributes.
The document said US funding “provides the backbone of many of WHO's large-scale emergency operations,” covering up to 40%. It said responses in the Middle East, Ukraine and Sudan were at risk, in addition to hundreds of millions of dollars lost by polio-eradication and HIV programs.
The US also covers 95% of WHO's tuberculosis work in Europe and more than 60% of TB efforts in Africa, the Western Pacific and at the agency headquarters in Geneva, the document said.
At a separate private meeting on the impact of the US exit last Wednesday, WHO finance director George Kyriacou said if the agency spends at its current rate, the organization would “be very much in a hand-to-mouth type situation when it comes to our cash flows” in the first half of 2026. He added the current rate of spending is “something we're not going to do,” according to a recording obtained by the AP.
Since Trump’s executive order, WHO has attempted to withdraw funds from the US for past expenses, Kyriacou said, but most of those “have not been accepted.”
The US also has yet to settle its owed contributions to WHO for 2024, pushing the agency into a deficit, he added.
WHO's executive board, made up of 34 high-level envoys including many national health ministers, was expected to discuss budget matters during its latest session, which opens Monday and is set to run through Feb. 11.
WHO's leader wants to bring back the US
Last week, officials at the US Centers for Disease Control and Prevention were instructed to stop working with WHO immediately.
WHO Director-General Tedros Adhanom Ghebreyesus told the attendees at the budget meeting that the agency is still providing US scientists with some data — though it isn't known what data.
“We continue to give them information because they need it,” Tedros said, urging member countries to contact US officials. “We would appreciate it if you continue to push and reach out to them to reconsider.”
Among other health crises, WHO is currently working to stop outbreaks of Marburg virus in Tanzania, Ebola in Uganda and mpox in Congo.
Tedros rebutted Trump’s three stated reasons for leaving the agency in the executive order signed on Jan. 20 — Trump's first day back in office. In the order, the president said WHO mishandled the COVID-19 pandemic that began in China, failed to adopt needed reforms and that US membership required “unfairly onerous payments."
Tedros said WHO alerted the world in January 2020 about the potential dangers of the coronavirus and has made dozens of reforms since — including efforts to expand its donor base.
Tedros also said he believed the US departure was “not about the money” but more about the “void” in outbreak details and other critical health information that the United States would face in the future.
“Bringing the US back will be very important,” he told meeting attendees. “And on that, I think all of you can play a role.”
Kummel, a senior advisor on global health in Germany's health ministry, described the US exit as “the most extensive crisis WHO has been facing in the past decades.”
He also asked: “What concrete functions of WHO will collapse if the funding of the US is not existent anymore?”
Officials from countries including Bangladesh and France asked what specific plans WHO had to deal with the loss of US funding and wondered which health programs would be cut as a result.
The AP obtained a document shared among some WHO senior managers that laid out several options, including a proposal that each major department or office might be slashed in half by the end of the year.
WHO declined to comment on whether Tedros had privately asked countries to lobby on the agency's behalf.
Experts say US benefits from WHO
Some experts said that while the departure of the US was a major crisis, it might also serve as an opportunity to reshape global public health.
Less than 1% of the US health budget goes to WHO, said Matthew Kavanagh, director of Georgetown University’s Center for Global Health Policy and Politics. In exchange, the US gets “a wide variety of benefits to Americans that matter quite a bit,” he said. That includes intelligence about disease epidemics globally and virus samples for vaccines.
Kavanagh also said the WHO is “massively underfunded,” describing the contributions from rich countries as “peanuts.”
WHO emergencies chief Dr. Michael Ryan said at the meeting on the impact of the US withdrawal last week that losing the US was “terrible,” but member states had “tremendous capacity to fill in those gaps.”
Ryan told WHO member countries: “The US is leaving a community of nations. It’s essentially breaking up with you.”
Kavanagh doubted the US would be able to match WHO's ability to gather details about emerging health threats globally, and said its exit from the agency “will absolutely lead to worse health outcomes for Americans.”
“How much worse remains to be seen,” Kavanagh said.
