The health leadership opportunity for India

The public health ecosystem in the country will benefit if New Delhi ups its engagement with WHO in light of the US withdrawing from the global body

- Ramanan Laxminarayan

United States (US) President Donald Trump's executive order on the inaugural day of his second term, withdrawing the US from the World Health Organization (WHO), was not unexpected. But the proposed speed at which this will be implemented, without the normal one-year transition period, is alarming. The US is, by far, the single-largest contributor to WHO, paying nearly a fifth of WHO's expenses. In comparison, India's contribution is only a tenth of the US contribution, much of it going to traditional medicine and digital health.

Beyond the financial implications, curtailing the flow of trained US experts, who are critical to many of WHO's programmes, will harm global health. American expertise has been at the forefront of many global initiatives, including smallpox and polio eradication efforts, childhood immunization, newborn and maternal survival, and pandemic preparedness, and this will be difficult to replace quickly. Since the US typically pays in arrears, WHO could be hard-pressed to pay its salaries and expenses in the short-term, which would create extreme chaos at a time when global health challenges like drug-resistant infections and pandemic threats, compounded by the human-induced climate crisis, are on the rise.