Trump Orders U.S. Exit from the World Health Organization (WHO), What Nurses Should Know

President Donald Trump has once again ordered the United States to withdraw from the World Health Organization (WHO). This decision has far-reaching consequences for healthcare professionals worldwide, with nurses facing particularly significant impacts.

What is the World Health Organization?

The World Health Organization (WHO) is a specialized agency of the United Nations dedicated to global public health. Established on April 7, 1948, the WHO aims to achieve the highest possible level of health for all people worldwide.

WHO’s Key Characteristics:

• Headquartered in Geneva, Switzerland
• Six regional offices and 150 field offices globally
• Works with 194 Member States across 6 regions

WHO’s Core Purpose and Functions:

• Promoting health and safety for vulnerable populations
• Providing technical assistance to countries
• Setting international health standards
• Collecting global health data
• Serving as a forum for scientific and policy discussions related to health

WHO’s Key Focus Areas

• Expanding universal health coverage
• Directing global responses to health emergencies, including preventing and eradicating communicable diseases, and health challenges like antimicrobial resistance and climate change
• Promoting healthier lives from pregnancy through old age

Why Does Trump Want to Withdraw from the WHO?

Trump initially attempted to withdraw the United States from the World Health Organization (WHO) in July 2020 during his first term as president. The primary reasons for his first withdrawal attempt were:

• Criticism of the WHO's handling of the COVID-19 pandemic
• Accusations that the organization was "China-centric" and favored China in its guidance during the crisis
• Concerns about the WHO's alleged failure to implement reforms
• Disagreements over the financial contributions expected from the U.S.

Although the Trump administration officially notified the United Nations of its intention to withdraw from the WHO, this withdrawal process was not completed. The incoming Biden administration blocked the executive order and reversed the decision in January 2021.

This time, Trump's withdrawal from the WHO is different in several ways:

• Timing: the new executive order was signed on his first day back in office during his second term (compared to the end of his first term).
• Increased likelihood of implementation: by executing this order on his inaugural day, the chances of a formal departure from the international agency are higher.
• More comprehensive approach: the new executive order calls for:
  • Pausing future transfer of U.S. government funds to the WHO
  • Recalling and reassigning federal personnel and contractors working with the WHO
  • Identifying alternative partners to assume activities previously undertaken by the WHO
• Review of previous strategies: the order mandates a review, rescission, and replacement of the Biden administration's 2024 U.S. Global Health Security Strategy.
• Emphasis on financial contributions: the new order places significant emphasis on what Trump perceives as "unfairly onerous payments" from the U.S. to the WHO, comparing U.S. contributions to those of other countries like China.

While the core reasons for withdrawal remain similar, this second attempt appears more comprehensive and immediate in its approach, reflecting Trump's renewed focus on the issue in his second term.

Disruption of Global Health Collaborations

The U.S. withdrawal from the WHO threatens to disrupt crucial global health initiatives, many of which rely heavily on nursing expertise. Nurses play a vital role in infection control, pandemic preparedness, and response to infectious diseases on a global scale. The loss of U.S. involvement and funding could significantly weaken these international collaborations, potentially leaving nurses with fewer resources and support systems to tackle global health challenges.

The WHO Collaborating Centres for Nursing and Midwifery, some of which are based in the United States, may face operational challenges due to this decision. These centers are instrumental in providing critical training, education, and support for nursing professionals worldwide. The severance of U.S. relations with the WHO could compromise these collaborative efforts, potentially limiting opportunities for nurses to engage in international training programs and knowledge exchange.

Funding Cuts and Resource Limitations

The WHO relies heavily on U.S. funding to support various global health programs, including those focused on disease eradication, vaccine distribution, and public health emergencies. The withdrawal of U.S. financial support could lead to a substantial decrease in resources available for these initiatives.

For nurses, this reduction in funding may translate to fewer opportunities to participate in global health programs and reduced access to resources for managing public health crises. It could also impact the availability of updated guidelines, research findings, and best practices that are often facilitated by WHO-led initiatives.

Impact on Research and Development

The U.S. exit from the WHO could have significant repercussions for research and development in global health. Areas such as antimicrobial resistance and vaccine research, which are critical to nursing practice, may face setbacks due to reduced collaboration and funding.

Nurses involved in research, education, and clinical practice may find themselves with limited access to cutting-edge research findings and innovative healthcare solutions that often emerge from WHO-coordinated efforts. This could potentially slow down advancements in nursing practice and hinder the profession's ability to address emerging health threats effectively.

Challenges in Public Health Surveillance and Data Sharing

One of the WHO's crucial roles is coordinating global health surveillance and facilitating the sharing of public health intelligence. The U.S. withdrawal could limit access to this vital information, potentially leaving nurses and other healthcare professionals less informed about emerging health threats and global best practices in public health.

This reduction in data sharing could hamper nurses' ability to stay ahead of potential outbreaks and respond effectively to public health emergencies. It may also impact their capacity to provide evidence-based care and contribute to global health initiatives.

Domestic Implications for U.S. Nurses

While the focus is often on global implications, the withdrawal from the WHO also has significant domestic impacts for U.S. nurses. Many U.S. institutions, including universities and health organizations, collaborate closely with the WHO on various health issues. The loss of these collaborations could affect U.S. nurses' involvement in international health projects and limit their access to global health expertise and resources.

Furthermore, the reduced interaction with the international health community may lead to a more isolated approach to healthcare in the U.S., potentially limiting the exchange of ideas and best practices that have historically benefited the nursing profession.

Several prominent medical organizations have voiced strong opposition to President Trump's decision to withdraw the U.S. from the WHO, releasing a joint statement calling it a "major setback to science, public health, and global coordination efforts.” They emphasized that the decision "puts the health of our country at grave risk" and urged Congress to reject the withdrawal and maintain the United States' relationship with the WHO.

For nurses, the U.S. withdrawal from the WHO represents more than just a shift in international relations; it underscores a growing need to advocate for the profession’s vital role in global health. The decision challenges nurses to adapt to a rapidly changing landscape, finding innovative ways to access resources, collaborate with international peers, and ensure evidence-based care in the face of diminished global support. Nursing leaders must continue to voice the critical importance of a united approach to health challenges, working to bridge gaps that may arise from this seismic policy change.

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