The United States’ withdrawal from the World Health Organization is set to take effect on Thursday, leaving the global health agency with a significant unpaid bill. The U.S. has not fulfilled its assessed contributions for the past two years, amounting to around $278 million. Additionally, promised voluntary contributions for 2024 and 2025 have also not been delivered. Voluntary contributions are funds provided by a country to support specific initiatives of the WHO.
According to a congressional resolution dating back to 1948, the U.S. is required to pay part of the outstanding bill before exiting the organization. However, it is unlikely that this condition will be met given President Trump’s negative stance towards the WHO and his history of delayed payments. Lawrence Gostin, a professor at Georgetown University, expressed skepticism about the U.S. meeting this requirement.
Tom Bollyky from the Council on Foreign Relations suggested that Congress, rather than the WHO member states, could potentially block the U.S. withdrawal for failing to fulfill the conditions of the joint resolution. However, due to the lack of support for the WHO among Republicans in Congress, there has been no effort to hold the country accountable.
The State Department’s international agencies bureau traditionally handles payments for assessed contributions to the WHO. A spokesperson stated that the U.S. has no intention of settling the outstanding debt, citing the high cost to the U.S. taxpayer and economy due to the WHO’s response during the Covid-19 pandemic.
The U.S. had committed to providing $490 million in voluntary contributions for 2024 and 2025 to support various WHO initiatives. While some of the 2024 contributions were reportedly paid, the exact amount remains unknown. The WHO did not provide details on what the U.S. owes the agency and declined to comment on the situation.
The WHO’s constitution does not include an exit clause, and when the U.S. joined the organization in 1948, Congress reserved the right to withdraw in the future. The joint resolution stipulates that the country should provide a year’s notice and pay its financial obligations for the current fiscal year before leaving. The WHO’s executive board has been asked to report on the withdrawals of the U.S. and Argentina to the World Health Assembly in May.
Director-General Tedros Adhanom Ghebreyesus called the U.S. withdrawal a “lose-lose situation,” emphasizing the negative impact on global health security. Despite efforts to encourage the U.S. to reconsider, it appears unlikely that the withdrawal will be reversed. The Trump administration’s decision to withdraw from the WHO and halt payments was continued by the Biden administration, which left office without settling its financial obligations for 2024. The World Health Organization (WHO) is facing a significant financial shortfall in 2024, with an outstanding amount of approximately $130 million. This amount represents about 22% of the funding that the organization had expected to receive in assessed contributions for the year. It is important to note that voluntary contributions from countries and philanthropic organizations, such as the Gates Foundation, make up more than half of the WHO’s annual budget.
One key contributor to this financial shortfall is the United States, which has a history of paying its WHO bills late. Assessed contributions are supposed to be paid on January 1 of each year, but the U.S. typically sends payment for the previous year sometime in the early part of the next year. As the clock ticked down towards the end of the Trump administration, it was known that the WHO assessed contribution had not yet been paid.
Multiple sources have indicated that there was no specific decision not to pay the dues, but rather a combination of negligence and procrastination until the new administration took office. Some individuals within the Biden administration were pushing for the payment to be made, but there were challenges related to the availability of funds within the State Department’s international agencies bureau.
While there were officials at Health and Human Services and the National Security Council who were in favor of making the payment, there were also individuals at the State Department who did not support it. Ultimately, it seems that those opposing the payment prevailed in the interagency debate.
The financial shortfall facing the WHO in 2024 highlights the importance of timely payments from member states to support the organization’s critical work in global health. It is essential for countries to fulfill their financial obligations to ensure that the WHO can effectively respond to health crises and provide vital services to populations around the world.

