USA Exits WHO: What is the process and implication for the USA?

Introduction

The WHO is the global health flagship agency coordinating collaborative responses to public health emergencies, guiding health policies, and working towards universal healthcare for all. The WHO was established in the aftermath of World War II, which was a significant step toward global cooperation that emphasized the principle that health transcends national boundaries and is a fundamental human right.

The operations of WHO are based on a solid universal membership and cooperation. However, the framework through which countries affiliate with WHO does not seem entirely immune to trouble. While many member states enjoy cooperative relations, tensions have on occasion resulted in withdrawal threats and funding rows, as demonstrated by the attempt by the United States to pull out of WHO in 2020. The occurrence of these events raises urgent questions about the stability and the governance of the WHO in the increasingly politicized global landscape.

WHO Membership: The Legal Perspective

It is almost a simple act for any state to become a member of WHO as it adopts an all-embracing purpose in pursuit of the equity factor of health within the global setup. Article 3 of WHO's Constitution clearly stipulates that membership should be available for all states based on acceptance of the provisions as contained therein. 

Those that belonged to the UN when WHO came into existence acquired membership by a simple act. Non-member states also become members if a two-thirds majority vote accepts the membership request in the WHA.
With ratification, the country automatically becomes a signatory to participate in the WHO's efforts and contribute to the organization's budget. Additionally, it adheres to the decisions made by WHO, its regulations, especially International Health Regulations. Such regulations are used for ensuring international health safety in cases of infectious disease outbreak and health emergencies.

Membership in the WHO is not just a symbolic gesture; it offers substantive benefits and responsibilities. The member states will have access to the technical expertise of the WHO, funding for health programs, and an international cooperation platform. 

For instance, during the COVID-19 pandemic, member states of the WHO received benefits from the coordination of the distribution of vaccines through the COVAX initiative and its role in disseminating critical health information.
Membership comes with significant responsibilities. Countries will be required to share health information, follow guidelines issued by the WHO, and financially contribute to the organization. This reflects a state of interdependence of global health and collective action on issues that bind it together.

WHO Withdrawal: Processes and Needs

The WHO Constitution outlines a formal legal framework for withdrawal, requiring orderly transitions that will not disrupt world health activities. Article 7 regulates the process of withdrawal by providing that a member state must furnish a written notice to the WHO Director-General. This notice should specify the reasons for the withdrawal and trigger a obligatory waiting period of one year before the decision is effective.

Within this one-year window, the withdrawing state must meet all of its financial commitments to the WHO. These commitments are assessed contributions, voluntary contributions, and outstanding membership fees. This provision makes guarantee that an early member withdrawal won't put the organisation at financial peril.

The waiting period is justified by the need to give people time to think things through and change their minds. Since emergencies can happen at any time and international health is a dynamic field, ongoing international collaboration is essential.

The waiting period is also meant to enable the WHO to realign its programs and budget to reflect the loss of contributions from the exiting member.

Even with these precautions, withdrawal is not without difficulties. Exit from a country can have profound consequences, especially if the country is a significant donor or an influential actor in international health governance. The effect of such withdrawals is further examined in the case of the attempted USA exit from the WHO.

WHO's Sources of Funding and Country Contributions

The WHO has a two-tiered funding arrangement based on assessed contributions and voluntary contributions. This funding model resonates with the hybrid governance model, using mandatory commitments along with discretionary contributions to achieve goals for global health.

Assessed Contributions

Assessed contributions are compulsory contributions that are required by member states to be submitted each year. Assessed contributions are therefore calculated based on the size of every country's population and its gross domestic product. Assessed contributions cover the WHO's core activities, which comprise technical assistance, emergency preparedness, and the application of the International Health Regulations.

While crucial, the assessed contributions of the WHO only account for a small portion of the budget of the organization, usually below 20%. This is a risk for the organization's funding model since it increases dependence on outside donors and de-emphasizes financial predictability.

Voluntary Contributions

Voluntary donations account for most of the WHO's budget and are contributed by member states, international agencies, foundations, and corporate contributors. Such funds frequently are designated for a particular program or initiative, including polio eradication, HIV/AIDS prevention, or pandemic response.

While voluntary contributions offer room for maneuver in responding to newly emerging health issues, they also raise issues of equity and accountability. Richer countries and private contributors have a powerful say over funding priorities, and this can lead to resource allocation which disproportionately benefits some regions or causes. For instance, well-publicized health emergencies in wealthier nations tend to secure greater resources than long-term health issues in poorer countries.

Effects of the USA's Effort to Retract

The Trump Administration announced in 2020 that it would withdraw from the WHO; this was making history in the annals of global health governance because the United States was the only single largest contributor to the WHO funding and activities, and its action was precipitated by allegations of bungling the COVID-19 pandemic response and being excessively deferential towards China in handling the early responses to the pandemic.

The potential financial impact of the United States withdrawal was astronomical. In 2019, the United States gave approximately $893 million to the WHO, which represented about 15% of its budget. This was placed in a wide range of activities including emergency response efforts, vaccine work, and maternal health programs.

The withdrawal effort also had profound geopolitical consequences. The United States' move to decouple from the WHO created an opening that other powers, and in this case, China, were eager to fill. This power transfer underscored the larger challenge of preserving neutrality and equity in global health governance.

In the end, the Biden Administration reaffirmed the United States' commitment to the WHO and revoked the pullout decision. However, the episode drew attention to how susceptible the organization's governance and financial structure was to political forces.

Broader Geopolitical and Public Health Implications of Withdrawals

Withdrawals by member states, especially powerful ones, have far-reaching implications for global health governance. The loss of financial and technical contributions erodes the WHO's capacity to coordinate international responses to health emergencies. It also upsets long-term programs that require sustained funding and collaboration.

Beyond the fiscal bottom line, a series of exits also points to a retrenchment on multilateralism at a time when collective action is more called for than ever. The pandemic caused by the COVID-19 virus shows how global health is an intrinsically connected issue. One country's choices can send ripples around the world. Fragmentation of a global health system would weaken the preparedness and capacity of nations to face further crises, pandemics, climate-related health effects, and the spread of antimicrobial resistance.

Structural problems in WHO and the need for change.

The challenges that member withdrawals and funding imbalances pose underscore the need for reform by WHO. In this respect, WHO needs to address its overdependence on voluntary contributions, which make its budget vulnerable to the priorities of the few powerful donors. The suggested increase in the proportion of assessed contributions will help stabilize the WHO's finances and make the programs not donor-driven but driven by a concern for global health needs.

The WHO needs governance reforms that enhance the transparency and accountability in the organization. Some of the essential steps for strengthening oversight in funding allocations, enhancing the decision-making processes of the World Health Assembly, and the introduction of sound mechanisms for the evaluation of programs.
Consequences of Politicization in Global Health Governance

This makes the politicization of global health governance a risk to the effective functioning of the WHO. Often, member states leverage their financial input to the organization to push it in a particular direction that benefits them most. This situation made the United States' withdrawal attempt a vivid case of national interest versus collective responsibility.

Further, non-state actors like private donors and multinational corporations increasingly have a role to play in the governance landscape. While such involvement brings significant resource and technical assistance, the challenge is on ensuring accountability and equity in decision-making. Thus, how to maintain a balance of interest among the diversified stakeholders to maintain the focus on health equity by the WHO requires some lessons from the USA's attempt to leave it.

This experience, though unfortunate, has lessons to be learned by the United States for the future of global health governance. For instance, this action highlights the importance of financial sustainability in terms of the resilience of the organization against political disruption. Diversification of funding sources and reduced dependence on voluntary contributions can lessen the impact of member withdrawals.

The second aspect is that the episode requires stronger legal safeguards to prevent abrupt exits that jeopardize ongoing health initiatives. Clearer guidelines for withdrawal and financial accountability can protect the WHO from similar challenges in the future.

Finally, the attempt at withdrawal reminds one of the interdependence of global health. The COVID-19 pandemic demonstrated that no nation can handle health emergencies alone. To guarantee the security of global health, international collaboration must be reinforced and the collective action tenets must be reiterated.

Conclusion

Coordinating worldwide efforts to fight illnesses, advance health equity, and handle medical crises, the WHO continues to be the cornerstone of global health governance. However, the level of collaboration and dedication from its member nations determines how effective it is.

The challenges highlighted by the United States' attempted withdrawal call for the implementation of reforms aimed at strengthening the financial stability of the WHO, making the process of governance more transparent, and legal provisions for the exit of members. Such reform efforts could allow the WHO to once again be a blueprint for international solidarity and a continued power to meet emerging challenges related to health in an increasingly interconnected world.

FAQs

1. What is the process for a country to join the WHO?
Membership is open to all sovereign states that accept the WHO Constitution. Countries must ratify the Constitution through their national legal systems to become members.

2. How does the WHO fund its operations?
The WHO relies on assessed contributions from member states, calculated based on their GDP and population, as well as voluntary contributions from states, private donors, and international organizations.

3. Can a country withdraw from the WHO at any time?
Under Article 7 of the WHO Constitution, a country can withdraw by submitting formal written notice to the Director-General. The withdrawal takes effect after a one-year waiting period, during which the country must fulfill its financial obligations.

4. What was the impact of the USA’s withdrawal attempt?
The attempted withdrawal in 2020 highlighted the financial and geopolitical risks associated with member exits. It jeopardized critical health programs and underscored the need for reforms to strengthen the WHO’s resilience.

5. What reforms are needed to improve the WHO?
Key reforms include increasing assessed contributions, enhancing governance transparency, and clarifying legal provisions for member withdrawals. These changes can strengthen the organization’s ability to address global health challenges.