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.
Commentary
A Borderless Insurgency, a Divided Response: The ECOWAS–AES Security Dilemma
In this article, researcher Joseph McCarthy analyzes the security dilemma created by the withdrawal of Mali, Burkina Faso, and Niger from ECOWAS to form the Alliance of Sahel States (AES). As the jihadist insurgency led by groups like JNIM becomes increasingly transnational and expands toward coastal nations like Ghana, Benin, and Togo, the regional mechanisms for combating it are fracturing. The author argues that the AES’s shift toward Russian security guarantees (via the Africa Corps) fails to address the core challenge of cross-border intelligence sharing and pursuit, substituting firepower for regional trust. This growing divide makes the borderlands more porous for militants and brings the threat directly to the doorsteps of West African coastal states.
A Borderless Insurgency, a Divided Response: The ECOWAS–AES Security Dilemma
By Joseph McCarthy
Mali, Burkina Faso and Niger’s withdrawal from ECOWAS, and their construction of a rival security framework under the Alliance of Sahel States (AES), has produced a troubling paradox just as the insurgency’s geography expands toward the coast. The three juntas have compounded that paradox by turning to Russia and its mercenary formations, first Wagner and now the state-run Africa Corps, as their principal security guarantor, trading regional partnership for a patron with no border in West Africa, no seat at ECOWAS and no proven record of containing the threat. For Jama’at Nusrat al-Islam wal-Muslimin (JNIM) and allied groups, there is no AES border and no ECOWAS border.
There is only territory to penetrate and communities to influence. As the threat becomes more regional, the mechanisms for confronting it are becoming more divided, and Moscow’s growing footprint is deepening rather than resolving that divide, a fact that should concern Accra as much as Abuja or Niamey.
Jihadists move through a cross-border environment rather than within a single state. ACLED research shows JNIM expanding into northern Benin, particularly around the W-Arly-Pendjari complex spanning Benin, Burkina Faso and Niger. The terrain and thin state presence make the area hard to hold. A border difficult for a military to cross is often easier for an insurgent network to slip through, because a state must respect sovereignty and a militant need not. Burkina Faso’s forces may pursue militants to their own frontier, but cannot follow them into Benin without authorisation.
The Burkina Faso–Benin–Togo borderlands also contain trading and kinship networks predating the modern state. A herder crossing to trade livestock attracts no attention, but a militant moving through the same channels can exploit that familiarity. The border becomes a social network as much as a physical one, a gap that widens when relations between neighbouring capitals sour.
This is no longer a purely Sahelian story. JNIM’s push has already reached Benin and Togo, and Ghanaian security officials have repeatedly flagged militant reconnaissance and recruitment activity along the northern frontier with Burkina Faso. The Africa Center for Strategic Studies records militant Islamist-linked fatalities in north-western Nigeria rising from zero in 2024 to 136 in 2025 and 506 in 2026, a 268 per cent jump in a single year, as JNIM and Islamic State Sahel Province appear to collaborate with Boko Haram’s Sadiku faction, Ansaru, Lakurawa and assorted criminal groups. That is the transition from a Sahelian insurgency to a West African one, and coastal states from Ghana to Togo sit directly in its path. It is a spread that Russian-backed forces, thinly deployed and focused on holding capitals rather than contesting rural borderlands, are poorly positioned to check.
The deeper issue is coordination across political, military and intelligence systems, and ECOWAS has acknowledged as much. Its July 2026 communiqué described the regional security situation as deteriorating and directed leadership to engage AES states on a “pragmatic security cooperation mechanism.” Containing terrorism depends on knowing where militants are, who commands them and where attacks are being planned, information that must move quickly across borders.
But the AES breakaway complicates that. Niger and Nigeria share a long, vital border yet sit in different blocs; intelligence sharing now leans more on bilateral goodwill than on a common regional mechanism. A 2026 Institute for Security Studies analysis argues the ECOWAS–AES fragmentation weakens collective security and recommends restoring direct contact between the two blocs’ general staffs. Russia is no substitute for that channel. Moscow sits outside every regional early-warning system ECOWAS has built, including the frameworks Ghana, Togo and Benin actually rely on, so intelligence gathered by AES-aligned forces has no automatic route into them.
Early warning depends on information moving fast: a tip from northern Burkina Faso could prevent an attack in Benin, just as intelligence from Niger could help Nigeria anticipate militant movement. But when JNIM fighters flee a Burkinabè operation toward Benin, pursuit cannot simply continue across the line. The militants gain a tactical advantage at the border itself, an advantage that hot-pursuit and cross-border agreements could close, but that a Moscow-oriented security architecture, answerable to Russia rather than any regional body, has no mandate to broker.
Beyond the military mechanics lies a diplomatic obstacle. The AES accuses ECOWAS of interfering in domestic affairs and using sanctions as pressure; ECOWAS defends constitutional governance as non-negotiable. Terrorism is indifferent to which narrative prevails, and the mistrust that pushed the AES from ECOWAS also makes cooperation against militancy harder.
This is where dependence on Russia turns autonomy into isolation. Since Wagner’s dissolution after Prigozhin’s 2023 death, Russian deployments in Mali, Burkina Faso and Niger have been absorbed into the Ministry of Defence’s Africa Corps, a leaner but by most independent accounts no more effective force. West Point’s Combating Terrorism Center and other analysts find little evidence the transition improved outcomes, and JNIM inflicted some of the juntas’ heaviest losses around the handover. Africa Corps garrisons in Niger and Burkina Faso number only in the low hundreds, a fraction of what securing that territory demands, while allegations of atrocities against civilians, including proceedings before the African Court on Human and Peoples’ Rights, continue to mount. A security partnership built on a discredited mercenary outfit’s state-run successor does not project regional legitimacy; it substitutes firepower for trust, at the exact moment trust is what a transnational campaign most requires.
The AES’s search for autonomy has grown more costly as the threat it faces has grown more transnational, and dependence on Moscow does not offset that isolation so much as formalise it. Militants are becoming more regionally integrated precisely as the states fighting them, and the external patrons they have chosen, grow more divided. For Ghana and its coastal neighbours, that divide is no longer a distant Sahelian concern. It is arriving at their own borders.
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. joecarthy30@gmail.com
Commentary
‘The Sahel Juntas and the Crisis of Legitimacy’ by Joseph McCarthy
Between 2020 and 2023, military juntas seized power across Mali, Burkina Faso and Niger, promising to defeat jihadist insurgencies that civilian governments had failed to contain. Years later, the security situation has deteriorated rather than improved, with insurgents breaching heavily fortified installations and expanding territorial control. Meanwhile, elections have been indefinitely postponed under the pretext of insecurity, and military rulers have deepened their alignment with Russia to escape external pressure for democratic transitions. This analysis examines the legitimacy crisis facing the Sahel’s juntas, arguing that governments which justify their rule solely through security outcomes cannot survive when those outcomes fail to materialize. This article explores the fragility of military authority in the absence of electoral mandate, the geopolitical calculations driving alignment with Moscow, and the consequences for millions of citizens living with displacement, closed schools and expanding insurgent control.
The Sahel Juntas and the Crisis of Legitimacy
By Joseph McCarthy
When soldiers seized power across the Sahel between 2020 and 2023, they offered strikingly similar justifications. Civilian governments, they argued, had failed to protect their citizens from the advancing threat of Jama’at Nusrat al-Islam wal-Muslimin (JNIM) and the Islamic State Sahel Province (ISSP), despite years of support from France, the United Nations, the European Union and the United States. Military rule, the argument went, would succeed where democratic politics had not: it would restore state authority, defeat the insurgents and, only then, return power to civilians. Years later, the region’s security landscape raises an uncomfortable question. Has military rule delivered on that promise, and what happens to a government’s legitimacy when it has not?
The pattern of coups was remarkably consistent. In Mali, Assimi Goïta removed President Ibrahim Boubacar Keïta in August 2020, citing the army’s inability to control large parts of the north and centre. In Burkina Faso, Paul-Henri Sandaogo Damiba overthrew President Roch Marc Christian Kaboré in January 2022 on similar grounds, only to be removed himself eight months later by Ibrahim Traoré, who argued that Damiba’s own counterterrorism record was too slow. In Niger, Abdourahamane Tiani deposed President Mohamed Bazoum in July 2023, insisting that a new approach to security was needed despite Bazoum having achieved relative gains against jihadist groups. In each case, the message was the same: only military leadership could act with the speed and decisiveness that civilian rule could not.

The record since then complicates that claim. In June 2026, JNIM fighters breached Diori Hamani International Airport in Niamey. This is one of Niger’s most heavily fortified installations, housing the air force, military drones, the headquarters of the Alliance of Sahel States’ joint force, and Russian personnel. In April, coordinated attacks across Mali, including in Kati, revealed an insurgency that has grown more sophisticated rather than less, even as military governments have intensified their campaigns. Large swathes of northern and central Mali, eastern Burkina Faso and western Niger remain outside effective state control. Millions of people are displaced, schools and clinics have shut down across rural areas, and food insecurity continues to rise. Perhaps most tellingly, JNIM has moved beyond pure military operations in parts of the territory it contests, reportedly collecting taxes, mediating local disputes and enforcing its own rules, functions that amount to governance. For juntas that justified their rule by promising to restore the state’s authority, this is a difficult reality to reconcile.
None of this has produced elections. Goïta has repeatedly extended Mali’s transition, arguing that voting while the country remains insecure would undermine its credibility. Traoré has pushed Burkina Faso’s elections back to 2029. Tiani has likewise announced a prolonged transition in Niger, citing the need for stability before any return to civilian rule. In each case, insecurity, the very problem the juntas promised to solve, has become the justification for indefinitely postponing the democratic process that was meant to follow.
This is where the deepening alignment with Moscow matters. Russian foreign policy in the region, delivered first through the Wagner Group and now the Africa Corps, has emphasised sovereignty, executive authority and non-interference rather than electoral timetables. Unlike France and other Western partners, who after the 2020 and 2021 coups pushed for sanctions and rapid transitions back to constitutional rule through ECOWAS, Russia has attached no such conditions to its military assistance. That gives the juntas diplomatic cover and security backing without the external pressure that once accompanied Western partnerships, making prolonged military rule more sustainable in the short term.
But sustainability is not the same as legitimacy. Governments that seize power through force cannot draw on the ballot box or constitutional continuity to justify their authority. Instead, they rely on a narrower and more fragile bargain: deliver security, and the question of legitimacy can wait. That bargain depends entirely on results. It is not clear that the juntas are delivering them.
This is the vulnerability now facing Goïta, Traoré and Tiani. The argument that brought each of them to power, that civilian rule had failed to stop the violence and military leadership would not, is the same argument that can be turned against them if the violence continues to escalate under their watch. A partnership with Russia may insulate these governments from external pressure to hold elections. Still, it cannot insulate them from the judgement of their own citizens, who continue to live with displacement, closed schools and expanding insurgent control. If security remains the sole justification for indefinitely concentrating political power, then the failure to secure it becomes the sole justification for questioning that power. The Sahel’s juntas are not simply fighting insurgents. They are running out of time to prove that their original argument for seizing power still holds.
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. joecarthy30@gmail.com
Commentary
What Ghana’s World Cup ‘juju man’ tells us about sport and spirituality in Africa

Ayodeji Ogunnaike, McGill University
One of the most notable figures of the 2026 FIFA World Cup emerged during Ghana’s first match of the tournament: the “juju man,” Kailani Ibrahim Kpa, who was famously seen blowing white powder into the air during the game.
Another Ghanaian, Nana Kwaku Bonsam, went viral just before the match for claiming to have placed a curse on England’s captain, Harry Kane. Bonsam is a particularly media-savvy Twi traditional priest and one of the most recognizable faces of what is commonly called “witchcraft” or “juju” in African soccer.
Juju quickly became a topic of conversation and fascination for millions of soccer fans around the world, particularly after Kane failed to score and the match ended in a draw.
Although it may seem strange to westerners, soccer and esoteric rituals go hand in hand in Africa. One infamous video from Rwanda that regularly circulates on African group chats shows a striker failing to score, snatching a “charm” from inside the goal and subsequently scoring.
Ghanaians in particular have a long history of leveraging the spiritual side of sports. Former captain André Ayew scattered a ritual powder on the pitch in 2012, and Bonsam himself announced he cursed Portugal’s Cristiano Ronaldo ahead of the 2014 World Cup.
This blending of spirituality and sport can be easy for westerners to misinterpret or dismiss as simple superstition. This is particularly true when spiritual fraudsters try to make money by promising to help teams win and their predictions do not come true.
However, Africans are not backwards or simple-minded. Foreign academics and even colonial officials with first-hand experience with African spiritual arts have been surprised by how effective they are at achieving their intended results.
Fortunately, we also now have excellent written accounts from Africans about the power and logic behind Indigenous knowledge and ritual systems.
African knowledge systems
Western society has developed in a context that often seeks to define and establish separate religious and secular aspects of life. However, African knowledge systems generally treat what we might call science, religion, medicine and art as parts of a unified whole.
What westerners may call “religion” is often integrated into every aspect of African life, and it is more helpful to reconceptualize its relationship to sport as the reasonable engagement with the physical and metaphysical world toward a desired end.
When I studied with a priest and diviner in Nigeria, I helped him prepare many òògùn (a Yoruba term meaning simultaneously medicine, charm and technology) to heal and prevent injuries and harm.
Because all facets of their lives have a spiritual dimension, many Black and African players and teams regularly pray together before and after matches. Germany’s Jonathan Tah and Felix Nmecha made news by joining Curaçao’s team in prayer after their match.
From this perspective, a priest offering services to a team is just as legitimate as a sports psychologist, nutritionist or physiotherapist. Each draws on a long-standing tradition of experimentation, training and the application of different technologies to support favourable results.
For example, the Senegalese wrestling sport Laamb integrates marabouts (Muslim clerics) and amulets into competitions. The marabouts function much like boxing coaches, just also with power over immaterial forces.
Unlike in Laamb, spiritual intervention in soccer was not initially conceptualized as integral to the game, but it has, sometimes covertly, been integrated into the sport in Africa. https://www.youtube.com/embed/XvNIR0AIrPs?wmode=transparent&start=0 A clip about marabouts and Senegalese Laamb wrestling (Vice Media)
Accessing a nonphysical reality
A fundamental principle of Indigenous African spiritual systems is that all materials also have a nonphysical reality, and they can be used to effect change on that nonphysical level.
Powders, like those scattered by Ayew or Kpa seemed to blow, frequently contain dried, ground or burned natural substances with some characteristic related to the desired outcome.
These substances can be placed on or in a body, or important places such as a door frame or goal, to prevent things from entering. This is why the striker in the Rwandan example I mentioned removed the charm from his opponents’ goal while his opponents desperately tried to get it back.
Other common approaches include reciting incantations or soaking the body in ritual baths. Some also involve using flames to burn away or scatter dark and malevolent forces, like those I saw in a pot on the head of a Ghana fan at the 2010 World Cup.
Mischaracterization and prejudice
Europeans have often mischaracterized African ritual and knowledge systems as “black magic,” “witchcraft,” or “superstition” to justify a sense of religious, cultural and racial superiority over Black people. African religious practices and experts are also still frequently and pejoratively called “fetishism” and “witch doctors.”
The prejudice toward and dismissal of these practices and practitioners has driven many underground, but they are still ubiquitous in African society. Such pejorative attitudes were evident during Bonsam’s recent interviews in western media.
While I worked with the Nigerian diviner, people who might be considered “modern” and operating in secular spheres from a western perspective — such as university students, prominent business people and even politicians — regularly came for spiritual and professional help, which they understood as one and the same.
Athletes are particularly aware that talent and hard work are not always enough to ensure victory. Africans and non-Africans alike generally recognize that there are forces beyond their control at play, even if some might generically conceptualize those forces as “luck.” And even spiritual services are no guarantee of victory if the other side has access to them too.
It is unclear if Kpa’s powder was actually ritual material or simply a demonstration of cultural heritage, like Norway’s Viking row. However, after the goalless Ghana match, Kane did go on to score against Panama once Bonsam said he had “released” the Englishman.
Kpa and Bonsam unsurprisingly captivated African and non-African soccer fans, even if their actions may have been less legible to some. Beyond the World Cup, what may be more interesting is how both men represent an ancestral knowledge tradition that is thousands of years old, and they are merely a visible part of the invisible spiritual dimension of sport in Africa.
Ayodeji Ogunnaike, Assistant Professor of African Religions; Canada Research Chair (Tier 2) in the Globalization of African Religions and Yoruba Mythology, McGill University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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