
The 156th Session of the Executive Board at WHO headquarters in Geneva, Switzerland on 3 February 2025. Photo credit: WHO / Christopher Black
By Dr Tedros Adhanom Ghebreyesus*
As you know, two weeks ago, [American] President Donald Trump signed an Executive Order announcing his intention to withdraw the United States from [the World Health Organization] WHO.
We regret the decision, and we hope the US will reconsider. We would welcome constructive dialogue to preserve and strengthen the historic relationship between WHO and the USA that helped bring significant impacts like the eradication of smallpox – I can give you a long list.
The Executive Order gave four reasons for the decision to withdraw from WHO.
First, it says that WHO has “failed to adopt urgently needed reforms”.
Over the past seven years, under the guidance and governance of Member States, WHO has implemented the deepest and most wide-ranging reforms in the Organization’s history. The WHO Transformation has touched every part of our work: our strategy, operating model, processes, partnerships, financing, workforce and culture. We have also taken action on the recommendations of the Agile Member States Task Group; We have implemented 85 of the 97 reforms proposed in the Secretariat Implementation Plan on reform; And we are implementing the recommendations of the Action for Results Group, led by WHO Representatives, to strengthen our country offices. For us, change is a constant, and that’s what our Member States told us when we started the reform, “change is a constant”. We believe in continuous improvement, and we would welcome suggestions from the United States and all Member States for how we can serve you and the people of the world better. So, although we are doing a lot of reform, additional is welcome.
Second, the order says that WHO “demands unfairly onerous payments from the US, out of proportion with what other countries contribute”.
Member States understand how assessed contributions are calculated, and you know that some countries choose to make higher voluntary contributions than others. Addressing the imbalance between assessed and voluntary contributions, and reducing WHO’s over-reliance on a handful of traditional donors, has been one of the major areas of our Transformation. When we started the Transformation, the reliance on a few traditional donors was identified as a risk. And we have decided then, seven years ago, to broaden the donor base. Last week the PBAC recommended the next 20% increase in assessed contributions, and we ask this Board to endorse that recommendation. This is a critical element of our long-term plan to broaden our donor base, and will over the long term reduce the burden of financing for traditional donors, including the U.S. We therefore continue to seek the support and engagement of all Member States, including the U.S., for our shared vision to put WHO on a more sustainable financial footing.
Third, the order refers to WHO’s alleged “mishandling of the COVID-19 pandemic and other global health crises”.
Last week marked five years since I declared a public health emergency of international concern, on the 30th of January 2020. At the time, outside of China there were fewer than 100 reported cases, and no reported deaths. On New Year’s Eve 2019 and New Year’s Day 2020, when much of the world was on holiday, WHO was not. From the moment we picked up the first signals of “viral pneumonia” in Wuhan, we asked for more information, activated our emergency incident management system, alerted the world, convened global experts, and published comprehensive guidance for countries on how to protect their populations and health systems – all before the first death from this new disease was reported in China on the 11th of January 2020.
Of course, there would be challenges and weaknesses, and there have been multiple independent reviews of the global response to COVID-19, with more than 300 recommendations to address the challenges or the weaknesses. In response to those recommendations, WHO and our Member States have taken many steps to strengthen global health security: the Pandemic Fund; the WHO Hub for Pandemic and Epidemic Intelligence; the mRNA Technology Transfer Hub; the Global Training Hub for Biomanufacturing; the Global Health Emergency Corps; the interim Medical Countermeasures Network, and more. So, all of this has been established based on the lessons learned. Member States have committed to concluding negotiations on the Pandemic Agreement in time for this year’s World Health Assembly.
Finally, the Executive Order says WHO has an “inability to demonstrate independence from the inappropriate political influence” of our Member States.
As a UN agency, WHO is impartial and exists to serve all countries and all people. Our Member States ask us for many things, and we always try to help as much as we can. But when what they ask is not supported by scientific evidence, or is contrary to our mission to support global health, we say no, politely. And you have seen me doing that many times. As Member States know, that is what we have done on several occasions to countries of all income levels, in all regions.
Even before the US announcement, WHO was facing a shortfall due to the economic difficulties that many countries are facing. For many months, the Regional Directors and I, with the support of senior management, had been working with twin strategic goals: to mobilize new resources, and to tighten our belts.
The U.S. announcement has made the situation more acute, and we have announced a set of measures with immediate effect to protect our work and workforce to the greatest extent possible: We are conducting a strategic alignment of resources with activities; We are freezing recruitment, except in the most critical areas; We are significantly reducing travel expenditure; And we are looking to renegotiate major procurement contracts and reduce capital investments.
More measures will be announced in due course. Our main objective is to protect our most important asset: our people – the dedicated, talented professionals who today are working around the world to help the people we serve to breathe cleaner air, eat healthier diets, drink safer water and use safer roads; They are working to help people get the safe, quality health services and products they need, where and when they need them, without worrying about what it will cost; And they are working to stop outbreaks and deliver lifesaving care in the most difficult and dangerous situations. In short, they are committed to promoting, providing and protecting health. I am proud to call them my colleagues. And together, we remain committed to the vision that you, our Member States had almost 77 years ago:
The highest attainable standard of health – not as a luxury for some, but a right for all.
*Excerpted from WHO Director-General’s opening remarks at the 156th session of the Executive Board in Geneva today.