The World Health Organization Bolsters Health Security, Helping Keep Americans Safe
Backgrounder: WHO Bolsters Health Security (PDF)
On Jan. 20, 2025, President Donald Trump issued an executive order announcing his intent to withdraw the United States from the World Health Organization (WHO)—a process that takes one year. The order effectively cuts ties with WHO, suspending funding and other support and recalling U.S. government personnel assigned to work with WHO.
WHO provides an essential mechanism for coordination and collaboration to address health threats. The U.S. engages with WHO across several programs that tackle diseases and keep Americans safe.
WHO facilitates rapid response to health threats.
WHO’s global coordination helps ensure that disease outbreaks are stopped at their source. In 2024 alone, WHO and partners provided support to more than 45 health emergencies in 87 countries—including in response to outbreaks that, if left unchecked, could impact the U.S.
Within 48 hours of an emergency event, WHO assesses the level of risk, releases funds, and activates response networks to protect populations from outbreaks. One such network is the Global Outbreak Alert and Response Network (GOARN), of which the U.S. Centers for Disease Control and Prevention (CDC) is a foundational member. The network ensures that appropriate expertise and resources are available to aid in emergency response efforts.
WHO coordinates critical global surveillance efforts.
WHO manages and supports several surveillance networks to facilitate the sharing of robust information among countries to track threats including flu, measles, and polio, and monitor resistance to medications like antibiotics.
Influenza Surveillance and Response
WHO coordinates the Global Influenza Surveillance and Response System (GISRS), a network that tracks flu viruses year-round. The GISRS network spans labs in 130 countries that detect circulating flu viruses and share data and thousands of viral samples each year. This system informs the annual updates to seasonal flu vaccines and serves as a global alert mechanism for the emergence of flu viruses that could cause pandemics.
- Seasonal flu: Vaccination is the primary method to lower the risk of harm from flu. The CDC estimates that last flu season, vaccination prevented 9.8 million flu-related illnesses and 7,900 deaths in the U.S. U.S. participation in the GISRS network ensures flu vaccines produced and used in the U.S. are effective, available in a timely manner, and available in sufficient quantities. Twice a year, WHO convenes experts from around the world, including representatives from the U.S. CDC and U.S. Food and Drug Administration (FDA), to review information generated by GISRS on circulating flu viruses and to recommend which viruses to target in vaccines for the upcoming flu season. National regulatory authorities, including the U.S. FDA, use the WHO recommendations as a guide in producing their own recommendations. Manufacturers that supply the U.S. market rely on information and materials developed by GISRS to make seasonal flu vaccines.
- Pandemic flu: Similarly to seasonal flu vaccines, WHO-led vaccine composition meetings make recommendations on candidate vaccine viruses for pandemic preparedness. GISRS surveillance informs the recommendations and GISRS members, including the U.S. CDC, produce and make available candidate vaccine viruses—these can be used to help build stockpiles of key materials to shave months off the timeline to produce vaccines deployed as part of an early pandemic response. The U.S. has a stockpile of pre-pandemic flu vaccine “building blocks” that, if well-matched to an emerging virus, can be filled into vials and deployed within weeks. U.S. participation in GISRS ensures that the U.S. and other countries are prepared to respond quickly to novel or pandemic flu viruses.
Read Public Citizen’s report on WHO’s flu surveillance network and on the critical questions that U.S. disengagement raises about our ability to effectively combat flu.
Measles Surveillance and Response
The Global Measles and Rubella Laboratory Network (GMRLN) consists of over 700 labs across 164 countries monitoring measles and rubella cases, as well as cases of other vaccine-preventable diseases. The U.S. has provided about $8 million annually to the network, a modest cost in comparison to the significant benefits it provides, as well as consequential technical support and testing supplies through the CDC. This investment by the U.S. has been crucial in maintaining the network’s capabilities. However, the U.S.’s withdrawal of funding and other support has left the network under threat of collapse, an outcome that would weaken critical capacity to detect measles and mitigate outbreaks. Ongoing lack of support will result in more measles cases and deaths, according to WHO.
Measles is among the most contagious diseases. Increased cases of measles around the world are a direct threat to Americans because those who are unvaccinated can get measles abroad and easily spread it to others upon returning to the U.S. Newborns and young children are at particular risk for severe complications or death from measles because vaccination in the U.S. only begins after the first year of life.
Just last year, the Measles & Rubella Partnership (of which the U.S. CDC and WHO are founding members) reported that since 2000, an estimated 60.3 million measles deaths were averted by measles vaccination. However, progress is backsliding—57 countries experienced large or disruptive measles outbreaks in 2023, a sharp increase from 36 in the prior year. Lower vaccination rates are fueling this resurgence, leading to rising cases globally and in the U.S. These trends underscore the urgent need to strengthen surveillance and immunization efforts.
Polio Surveillance and Response
The Global Polio Laboratory Network (GPLN) spans 146 WHO-accredited polio labs in 92 countries. The WHO-coordinated network bolsters efforts to eradicate polio under the Global Polio Eradication Initiative (GPEI).
According to the CDC, prior to the introduction of the polio vaccine, polio paralyzed over 15,000 people in the U.S. each year. While the U.S. has declared wild poliovirus eliminated, the disease can still spread among unvaccinated people via travelers or through virus variants. Revoking U.S. funding and support for polio response could increase this risk.
The suspension of U.S. funding and support for GPEI threatens progress to eradicate polio. The Trump administration’s orders to cut ties with WHO have already begun to impede program efforts, according to one program lead who described gaps introduced by the sudden cessation of U.S. support:
“curtailing of technical and strategic inputs by CDC in the overall polio eradication programme, withdrawal of CDC personnel from WHO offices, and the inability of the programme to access CDC’s global specialized poliovirus laboratory that serves as the nerve center for poliovirus testing and characterization and detection of polio outbreaks.”
Polio is one of only two active public health emergencies of international concern indicating that coordinated action is needed to protect against international spread. This further underscores the need to maintain support for polio surveillance and control to lower the risk of spread to the U.S.
Tracking Drug Resistance
WHO works with member states to improve surveillance and monitoring of drug resistance to antibiotics, as well as to medicines for HIV, malaria, and tuberculosis.
In the U.S., over 2.8 million antimicrobial-resistant infections occur each year—over 35,000 people die as a result. Globally, antimicrobial resistance causes or contributes to six million deaths every year. Resistance anywhere is a threat everywhere because new forms of resistance can emerge and spread making infections harder to treat.
WHO advances global efforts to enhance surveillance, which can help reduce the development and spread of antimicrobial resistance. Without coordinated action to combat antimicrobial resistance, these medicines will be less effective and drug-resistant infections will be hard, or impossible, to treat. In this scenario, the resulting costs to the global economy would be at least $1 trillion annually after 2030, according to the World Bank.
WHO led the effort to eradicate smallpox and continues to support smallpox biosafety, biosecurity, and preparedness.
WHO spearheaded the global effort to eliminate smallpox, an infectious disease that killed 3-in-10 people it infected and disfigured many more before it was declared eradicated in 1980. U.S. funding and expertise advanced the eradication effort. In addition to eliminating the negative health impacts of smallpox, the U.S. has recouped its financial investment in smallpox eradication many times over in costs saved from domestic vaccination alone.
WHO coordination also helps address the ongoing threat of smallpox. WHO reduces the risk posed by smallpox virus stored for research purposes in the U.S. and Russia by inspecting remaining virus stores and ensuring that research is conducted safely and is publicly reported. Experts assert that this helps to mitigate the risk of an inadvertent smallpox outbreak and lower suspicions of smallpox research being performed in secret.
WHO also has capacity and expertise to respond to a potential smallpox outbreak. This includes an emergency reserve of smallpox vaccines. About 70% of this reserve is pledged by the U.S. In announcing the U.S.’s commitment, the Department of Health and Human Services secretary at the time said of the pledge: “[t]he United States is proud to make a significant contribution to a global stockpile that will serve as a critical line of defense in the event of a smallpox attack anywhere in the world … This is an important step toward ensuring the health and safety of the American people.”
WHO’s role in smallpox safety and preparedness remains important because an accidental or deliberate smallpox outbreak poses a substantial threat to the U.S. population, the majority of which has not been vaccinated against the disease.
WHO helps get medicines to the places where they are needed to address health threats.
WHO’s prequalification program assesses the quality, safety, and efficacy of medical products. The program facilitates procurement from international agencies that supply medicines to developing countries. It can also inform national regulatory and procurement decisions. The U.S. FDA serves as a reference regulatory authority for the prequalification program. Collaboration between the FDA and WHO aids prequalification, ensuring countries can access quality-assured products.
Prequalification, as well as WHO’s procedure for certifying medicines for use during emergencies, accelerates access to medical tools to combat outbreaks, including those that could threaten Americans. For example, in 2019, based on regulatory evaluation by the U.S. FDA and the European Medicines Agency, WHO expedited prequalification of the first vaccine against Ebola—a severe, often fatal disease. Prequalification has also enabled procurement for a global Ebola vaccine stockpile that helps contain outbreaks at their source.