Perspectives
US exit from the World Health Organization marks a new era in global health policy – here’s what the US, and world, will lose
This article by Jordan Miller of the Arizona State University explains the consequences of the U.S. officially leaving the World Health Organization in January 2026, detailing how the withdrawal will weaken global disease surveillance, reduce American influence in international health policy, and hinder the country’s own ability to prepare for health threats like the annual flu.
Jordan Miller, Arizona State University
The U.S. departure from the World Health Organization became official in late January 2026, according to the Trump administration – a year after President Donald Trump signed an executive order on inauguration day of his second term declaring that he was doing so. He first stated his intention to do so during his first term in 2020, early in the COVID-19 pandemic.
The U.S. severing its ties with the WHO will cause ripple effects that linger for years to come, with widespread implications for public health. The Conversation asked Jordan Miller, a public health professor at Arizona State University, to explain what the U.S. departure means in the short and long term.
Why is the US leaving the WHO?
The Trump administration says it’s unfair that the U.S. contributes more than other nations and cites this as the main reason for leaving. The White House’s official announcement gives the example of China, which – despite having a population three times the size of the U.S. – contributes 90% less than the U.S. does to the WHO.
The Trump administration has also claimed that the WHO’s response to the COVID-19 pandemic was botched and that it lacked accountability and transparency.
The WHO has pushed back on these claims, defending its pandemic response, which recommended masking and physical distancing.
The U.S. does provide a disproportionate amount of funding to the WHO. In 2023, for example, U.S. contributions almost tripled that of the European Commission’s and were roughly 50% more than the second highest donor, Germany. But health experts point out that preventing and responding quickly to public health challenges is far less expensive than dealing with those problems once they’ve taken root and spread.
However, the withdrawal process is complicated, despite the U.S. assertion that it is final. Most countries do not have the ability to withdraw, as that is the way the original agreement to join the WHO was designed. But the U.S. inserted a clause into its agreement with the WHO when it agreed to join, stipulating that the U.S. would have the ability to withdraw, as long as it provided a one-year notice and paid all remaining dues. Though the U.S. gave its notice when Trump took office a year ago, it still owes the WHO about US$260 million in fees for 2024-25. There are complicated questions of international law that remain. https://www.youtube.com/embed/uacD-03S28E?wmode=transparent&start=0 The U.S. has been a dominant force in the WHO, and its absence will have direct and lasting impacts on health systems in the U.S. and other countries.
What does US withdrawal from the WHO mean in the short term?
In short, the U.S. withdrawal weakens public health abroad and at home. The WHO’s priorities include stopping the spread of infectious diseases, stemming antimicrobial resistance, mitigating natural disasters, providing medication and health services to those who need it, and even preventing chronic diseases. Some public health challenges, such as infectious diseases, have to be approached at scale because experience shows that coordination across borders is important for success.
The U.S. has been the largest single funder of the WHO, with contributions in the hundreds of millions of dollars annually over the past decade, so its withdrawal will have immediate operational impacts, limiting the WHO’s ability to continue established programs.
As a result of losing such a significant share of its funding, the WHO announced in a recent memo to staff that it plans to cut roughly 2,300 jobs – a quarter of its workforce – by summer 2026. It also plans to downsize 10 of its divisions to four.
In addition to a long history of funding, U.S. experts have worked closely with the WHO to address public health challenges. Successes stemming from this partnership include effectively responding to several Ebola outbreaks, addressing mpox around the world and the Marburg virus outbreak in Rwanda and Ethiopia. Both the Marburg and Ebola viruses have a 50% fatality rate, on average, so containing these diseases before they reached pandemic-level spread was critically important.
The Infectious Diseases Society of America issued a statement in January 2026 describing the move as “a shortsighted and misguided abandonment of our global health commitments,” noting that “global cooperation and communication are critical to keep our own citizens protected because germs do not respect borders.”
What are the longer-term impacts of US withdrawal?
By withdrawing from the WHO, the U.S. will no longer participate in the organization’s Global Influenza Surveillance and Response System, which has been in operation since 1952. This will seriously compromise the U.S.’s ability to plan and manufacture vaccines to match the predicted flu strains for each coming year.
Annual flu vaccines for the U.S. and globally are developed a year in advance using data that is collected around the world and then analyzed by an international team of experts to predict which strains are likely to be most widespread in the next year. The WHO convenes expert panels twice per year and then makes recommendations on which flu strains to include in each year’s vaccine manufacturing formulation.
While manufacturers will likely still be able to obtain information regarding the WHO’s conclusions, the U.S. will not contribute data in the same way, and American experts will no longer have a role in the process of data analysis. This could lead to problematic differences between WHO recommendations and those coming from U.S. authorities.
The Centers for Disease Control and Prevention estimates that each year in the U.S. millions of people get the flu, hundreds of thousands of Americans are hospitalized and tens of thousands die as a result of influenza. Diminishing the country’s ability to prepare in advance through flu shots will likely mean more hospitalizations and more deaths as a result of the flu.
This is just one example of many of how the U.S.’s departure will affect the country’s readiness to respond to disease threats.
Additionally, the reputational damage done by the U.S. departure cannot be overstated. The U.S. has developed its position as an international leader in public health over many decades as the largest developer and implementer of global health programs.
I believe surrendering this position will diminish the United States’ ability to influence public health strategies internationally, and that is important because global health affects health in the U.S. It will also make it harder to shape a multinational response in the event of another public health crisis like the COVID-19 pandemic.
Public health and policy experts predict that China will use this opportunity to strengthen its position and its global influence, stepping into the power vacuum the U.S. creates by withdrawing. China has pledged an additional US$500 million in support of the WHO over the next five years.
As a member of the WHO, the United States has had ready access to a vast amount of data collected by the WHO and its members. While most data the WHO obtains is ultimately made available to the public, member nations have greater access to detailed information about collection methods and gain access sooner, as new threats are emerging.
Delays in access to data could hamstring the country’s ability to respond in the event of the next infectious disease outbreak.
Could the US return under a new president?
In short, yes. The WHO has clearly signaled its desire to continue to engage with the U.S., saying it “regrets the U.S. decision to withdraw” and hopes the U.S. will reconsider its decision to leave.
In the meantime, individual states have the opportunity to participate. In late January, California announced it will join the WHO’s Global Outbreak Alert & Response Network, which is open to a broader array of participants than just WHO member nations. California was also a founding member of the West Coast Health Alliance, which now includes 14 U.S. states that have agreed to work together to address public health challenges.
California Gov. Gavin Newsom has also launched an initiative designed to improve public health infrastructure and build trust. He enlisted national public health leaders for this effort, including former Centers for Disease Control and Prevention leaders Susan Monarez and Deb Houry, as well as Katelyn Jetelina, who became well known as Your Local Epidemiologist during the COVID-19 pandemic.
I think we will continue to see innovative efforts like these emerging, as political and public health leaders work to fill the vacuum being created by the Trump administration’s disinvestment in public health.
Jordan Miller, Teaching Professor of Public Health, Arizona State University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
JNIM now strikes at capitals and governs territory, and the bet that Mali, Burkina Faso, and Niger placed on Russia as their sole security guarantor has failed. Analyst and researcher Joseph McCarthy writes that the fire will not stop at the Sahel’s borders, and Ghana stands directly in its path.
The Sahel is Burning, and West Africa Cannot Look Away
By Joseph McCarthy
At dawn on 18 June 2026, fighters stormed Diori Hamani International Airport in Niamey, the most heavily guarded site in Niger’s capital. It is not merely an airport. The complex houses the air force, most of the country’s drones, the headquarters of the Alliance of Sahel States’ joint force, the Russian personnel meant to help crush the insurgency, and even uranium stocks the state hopes to sell. JNIM claimed the assault, which killed eleven soldiers and two civilians. It was the second strike on that complex this year; the Islamic State’s Sahel Province claimed a January raid. Both of the region’s jihadist franchises have now breached the defences of a capital. This was not just another attack. It was a strategic signal.
It was also no act of opportunism. Hitting a fortified installation in a capital demands months of surveillance, intelligence on shift changes, the logistics to move fighters and weapons over long distances, and the ability to slip past layered security. It implies networks operating close to, or inside, the capital itself. As the Armed Conflict Location and Event Data project noted, the Sahel’s insurgents have moved from localised rural fighting to coordinated strikes on vital national infrastructure. The pattern is everywhere. In Mali, JNIM has throttled Bamako with a fuel blockade since September 2025, destroying hundreds of tankers; in April, it overran the garrison town of Kati and killed the defence minister in his own home; it has since placed a bounty of two million euros on the head of Mali’s junta leader, Assimi Goïta.
More troubling than the firepower is the governance. A Reuters investigation found that JNIM now arbitrates land disputes, collects taxes, enforces rules and imposes a rough order in territories the state has vacated. Forged from the merger of four groups, it increasingly presents itself not as a militia but as an alternative authority, building legitimacy among populations long neglected by distant governments. History is unkind here: from Afghanistan to Somalia, insurgencies that learn to govern outlast those that only fight. The contest is no longer simply about defeating armed men. It is about whether the state, rather than an armed movement, remains the most credible source of authority, justice and security.
Against all this, the juntas made a bet. Mali, Burkina Faso and Niger expelled Western forces, walked out of ECOWAS, and rebuilt their security around a single guarantor: Russia, first through the Wagner Group, then the Africa Corps. On 26 June, Burkina Faso severed diplomatic relations with France entirely, accusing Paris of backing the very terrorists it claims to fight, an allegation offered without evidence and flatly rejected. Niger’s government, for its part, blamed the Niamey attack on mercenaries funded by President Macron, again without proof. The promise was straightforward: sovereignty restored, foreign influence reduced, terrorism defeated. Judged by the junta’s own promise, the bet has failed. The violence has not receded. It has spread.
This should not be read as a uniquely Russian failure. It exposes the limits of any strategy built around a single external guarantor. No partner, whether Russia, France or the United States, can resolve a conflict rooted in governance failure, economic exclusion, local grievance and hollow institutions. Force can kill fighters. It cannot rebuild public trust, settle a quarrel between communities, open a clinic or create a job for an idle young man, and those are the very conditions the insurgents harvest for recruits. Russia carries constraints of its own: bogged down in Ukraine, its resources finite, it was outfought alongside Malian troops at Kidal even after reportedly receiving a warning of the assault. A security architecture resting on a single distracted partner does not reduce risk; it concentrates it, and when that partner underdelivers, there is no second line. The 2026 Global Terrorism Index now names the Sahel the global epicentre of terrorism, the source of more than half the world’s terrorism deaths and one in five of its attacks.
None of this stays in the Sahel. Ghana shares roughly 550 kilometres of frontier with Burkina Faso, much of it porous and threaded with informal crossings used daily by traders and herders. Southward expansion rarely begins with a spectacular attack. It begins quietly: a recruiter, a supply route, a financing cell, fighters embedding in border communities long before a shot is fired. That is precisely how the contagion crossed from Mali into Burkina Faso and Niger, and how it has already reached Benin and Togo, with Côte d’Ivoire and northern Ghana plainly exposed. Alongside the fighters’ travels, something almost as corrosive: a flood of assault rifles, explosives and military hardware that does not stop at extremist hands but arms robbers, traffickers and illegal mining syndicates, hollowing out a country’s security long before any jihadist banner appears.
The wider world has its own reasons to watch. Niger holds some of the planet’s richest uranium. A jihadist proto-state straddling West Africa would command migration routes toward the coast and the Mediterranean, strain fragile coastal economies, disrupt trade corridors and rattle investor confidence. At the same time, every successful strike on a capital broadcasts a template to armed groups from Nigeria to Mozambique. What looks today like a regional security crisis could become an international one. A region generating one in five of the world’s militant attacks is not a distant problem. It is a lit fuse.
Africa has paid before for believing that outside powers can guarantee its security. They cannot. Partners can offer intelligence, training and equipment; they cannot substitute for legitimate governance and functioning institutions. This crisis will be settled not only on the battlefield but in courtrooms, classrooms, local councils and marketplaces, where citizens decide whether the state or an armed movement better delivers justice and opportunity. For Ghana, the task is preventive, not reactive: intelligence cooperation, stronger borders, regional collaboration, community resilience and investment in local governance, all of it far cheaper than containment once the violence has taken root. And for the Sahel’s rulers, there is a harder truth.
Sovereignty that trades several partners for total dependence on one distant and overstretched power is not sovereignty; it is a fresh vulnerability dressed in the language of liberation. The question is no longer whether the crisis will spread beyond Mali, Burkina Faso and Niger. It already has. The only question left is whether West Africa acts before the Sahel becomes the world’s next strategic emergency.
Joseph McCarthy is an analyst and researcher specialising in governance, security, and political transitions in the Sahel. He writes on geopolitics, development, and African diplomacy. Email: joecarthy30@gmail.com
Perspectives
From Crossroads to Counter‑Offensive | Colonel Festus Aboagye (Retired) Discusses Ghana’s Anti-Narcotics Posture
Ghana’s 2026 World Drug Day commemoration marks a decisive turning point in the nation’s long struggle against narcotics trafficking, signaling a shift from reactive interdiction to an assertive, intelligence‑led posture that is already yielding tangible results. Yet, as a new policy brief by Colonel Festus Aboagye (Retired) makes clear, the strategic contest over governance integrity remains unresolved.
Twelve months after the Crossroads Republic paper rated Ghana’s narco‑state risk at 2.7 out of 5 — moderate but escalating — the country has made measurable progress. The Narcotics Control Commission (NACOC) has expanded from fewer than 10 district commands to 77 across all 16 regions; arrests, prosecutions and seizures are up sharply; and a special narcotics court and enhanced prosecutorial powers — both recommendations from 2025 — are now in place. But the threat has evolved in parallel: methamphetamine concealed in charcoal shipments, synthetic and new psychoactive substances, cyber‑enabled trafficking, a 7% drug‑test failure rate among security‑service applicants, and localised consumption hotspots (73.5% lifetime use in Madina) all point to a challenge that is far from contained.
The reform most central to averting state capture — political‑party‑campaign‑finance transparency — has gone unaddressed. Though Ghana may be winning tactical battles, the strategic contest over the integrity of governance remains open.
Read the full 20‑page policy brief, “From Crossroads to Counter‑Offensive”, by Colonel Festus Aboagye (Retired):
Share, discuss, and join the conversation on sustaining Ghana’s resilience against the evolving narcotics threat.
#WorldDrugDay #PolicyBrief #Governance #Resilience #Ghana #NarcoTrafficking #StateCapture
Commentary
Reflections on Ghana And the Future it Deserves | By Simone Giger, Swiss Ambassador to Ghana
As her diplomatic tenure in West Africa draws to a close, Swiss Ambassador Simone Giger pens a reflective and heartfelt tribute to Ghana’s enduring national character. Having traveled extensively across the country—from Paga to Keta and Wa to Goaso—she offers an intimate, human-centered assessment of a nation defined by its resilient democratic culture, youthful ambition, and an infectious “vibe” that fosters cohesion. In this candid farewell, Ambassador Giger explores the complex challenges threatening Ghana’s ecological treasures and argues that sustained institutional reform, rather than outside invention, is the key to unlocking the prosperous future the country so clearly deserves.
Travelling through northern Ghana, this author once stopped in a small community after a long journey. Despite the day’s heat and the demands of daily life, residents welcomed visitors with warm smiles, easy laughter and an eagerness to share stories about their hopes for the future.
It was a simple encounter, yet it captured something profoundly Ghanaian: an enduring optimism that persists even in difficult circumstances.
In diplomacy, countries are often assessed through official meetings, economic indicators and policy documents. Yet to truly understand a nation, one must travel through it, listen to its people, appreciate its strengths, observe its contradictions and understand the aspirations that shape everyday life.
As the end of a diplomatic assignment in Ghana approaches, this author finds reason to reflect deeply on a country that has left a lasting impression, not only professionally but personally.
Over the past four years, extensive travels across Ghana—from Paga to Keta, Damongo to Donkokrom, and Wa to Goaso—have revealed a country of extraordinary diversity, complexity, creativity and resilience.
Every journey has unveiled a different dimension of Ghana. Yet one common thread consistently emerges: a nation brimming with potential.
There is something profoundly remarkable about Ghana and its national character, what many Ghanaians simply describe as the country’s “vibe”.
It is evident in the warmth extended to strangers, the humour with which difficulties are confronted and the optimism that endures even during periods of uncertainty.
Even in challenging moments, there is often a joke, a proverb or a story that helps place events in perspective.
In this author’s view, that national character has become one of the essential ingredients behind Ghana’s democratic success.
At a time when democratic systems around the world are facing increasing pressure, polarisation and distrust, Ghana continues to distinguish itself through its commitment to dialogue, constitutional order and peaceful coexistence.
Democracy here is not perfect. No democracy truly is, including Switzerland’s.
What matters is that it remains alive, active and deeply valued by citizens.
Over the years, Ghana has established itself as an important democratic reference point in West Africa.
The country has repeatedly demonstrated that political competition can coexist with stability, that transfers of power can occur peacefully and that national debates can take place within institutional frameworks rather than outside them.
Such achievements should never be taken for granted.
Democracy is not sustained by elections alone.
It requires strong institutions, active citizens, credible public discourse and a continuous willingness to negotiate consensus across political, ethnic, religious and generational lines.
One can observe that Ghana’s diversity presents both opportunities and challenges. Yet this author has often admired the manner in which the country continues to navigate these varied interests while preserving national cohesion.
In many respects, this is where Ghana’s democratic future becomes particularly important.
The country possesses extraordinary human capital.
Wherever this author travelled, young people displayed ambition, intelligence, creativity and determination.
Ghana’s greatest resource is not found beneath the ground.
It resides in its people, their ideas and their aspirations.
Ideas and aspirations, however, require systems that function effectively if they are to translate into meaningful and productive outcomes.
When institutions are transparent, responsive, accountable and trusted, they unlock innovation, investment and opportunity.
When they are weak or inconsistent, they risk frustrating the very energy capable of propelling a nation forward.
This is why governance reforms remain so important to Ghana’s long-term trajectory.
One development that particularly impressed this author during the diplomatic assignment has been Ghana’s constitutional review process.
What stands out is not only the process itself, but also the spirit behind it – a willingness to reflect critically on how democratic governance can evolve to meet contemporary realities and future expectations.
This demonstrates political maturity.
Constitutions should never be viewed as static documents frozen in time.
Strong democracies periodically examine whether their systems remain responsive, inclusive and effective.
Ghana’s consultative approach reflects a country seeking not merely to preserve democracy, but to improve it.
Switzerland is proud to support these home-grown efforts and remains committed to supporting the constitutional reform process until its hoped-for successful conclusion.
History demonstrates that democratic stability does not emerge automatically.
It requires deliberate investment in participation, inclusion and dialogue.
Swiss democracy itself evolved gradually through compromise, negotiation and the understanding that national cohesion is strengthened when citizens feel ownership over public decisions.
One can observe important similarities between Ghana and Switzerland.
Both countries are diverse societies that have chosen coexistence over division.
Both understand that stability is strongest when different voices are heard and accommodated.
Both appreciate the importance of consensus-building in national life.
This shared philosophy has shaped bilateral cooperation over many decades.
Today, the partnership continues to evolve in both breadth and depth.
Switzerland currently supports initiatives focused on democratic governance, parliamentary cooperation, decentralisation, peace and security, cultural exchange, environmental integrity, climate adaptation and economic development.
Switzerland and Ghana may differ in geography, history and scale, yet both countries share a belief in dialogue and cooperation as foundations for national progress.
Despite Ghana’s bright prospects, one cannot ignore the challenges confronting the country.
No nation can fully realise its potential without confronting difficult issues directly.
During the years spent in Ghana, citizens from various walks of life spoke openly about concerns surrounding institutional effectiveness, economic opportunity, environmental degradation and governance accountability.
Such conversations reflected not pessimism, but a desire to see the country fulfil its promise.
Particularly concerning is the destruction caused by illegal mining activities.
Ghana’s rivers, forests and landscapes are among its greatest treasures.
Environmental degradation is not merely an ecological issue.
It is fundamentally a matter of intergenerational responsibility.
Future prosperity depends on preserving the natural foundation upon which communities, livelihoods and national identity are built.
Yet despite these challenges, this author remains deeply optimistic about Ghana’s future.
That optimism stems not from idealism but from observation.
The future of democracy globally will not be shaped only by geopolitical actors or large states.
Medium-sized countries such as Switzerland and Ghana also have important roles to play.
They can demonstrate that democratic resilience, peaceful coexistence and institutional reform remain both possible and necessary.
As this diplomatic assignment draws to a close, there is profound gratitude for the opportunity to have lived and worked in Ghana.
Over the years, this author has come to admire the country not only for its democratic achievements, but also for its humanity – its warmth, creativity, humour and enduring sense of possibility.
The task ahead is not to invent Ghana’s future.
Rather, it is to create the institutional conditions necessary for that future to emerge fully.
From all that has been observed across the country, there is every reason to believe that Ghana can achieve precisely that.
The author, Simone Giger, is the Swiss Ambassador to Ghana, Togo and Benin
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