Interview/ Lawrence Gostin, director, World Health Organization Collaborating Center on Public Health Law & Human Rights at Georgetown University
With the United States officially leaving the World Health Organization, concerns are mounting over what this could mean for global health cooperation, and for countries like India that rely on WHO for disease surveillance, technical guidance and emergency coordination.
The US has historically been one of WHO’s largest funders and most influential political actors, and its exit comes at a time when the world remains vulnerable to pandemics and emerging infections.
Lawrence Gostin, director, World Health Organization Collaborating Center on Public Health Law & Human Rights at Georgetown University, tells THE WEEK how the US withdrawal weakens WHO’s capacities, why densely populated countries such as India should be concerned, and why this moment could also open the door for India to step into a larger leadership role in global health.
Does the US withdrawal weaken WHO’s authority, or primarily its financial and political leverage?
The US withdrawal primarily weakens WHO’s financial position. Stopping US funding has resulted in about a 20 per cent reduction in WHO staffing and capacities. It means that the WHO has to cut back on vital programmes such as pandemic preparedness and response, including surveillance in key areas like influenza and measles. Technically, the US withdrawal should not weaken WHO's authority because it gains its authority through the WHO constitution and World Health Assembly, which won't change. But politically it will make it much harder for the WHO to leverage its influence if the United States is not on board, or worse, if the US is actively opposing WHO initiatives.
How could this decision affect countries like India?
WHO will be in a weaker position to offer technical and scientific assistance and guidance to middle-income countries like India. WHO is losing scientific and other experts and is stretched thin without US funding and participation. The absence of scientific expertise from the US Centers for Disease Control and Prevention is especially concerning.
Is there a risk that global disease surveillance and early-warning systems could be weakened? What would that mean for densely populated countries such as India?
Much of the reductions in financing and capacities will occur in the areas of disease surveillance and outbreak detection and response. For a densely populated country like India, this is of grave concern, as there are heightened vulnerabilities to infectious diseases.
Does the US withdrawal set a concerning precedent for other countries to disengage from multilateral health institutions?
As a matter of law, the US is the only country that is permitted to withdraw under the WHO constitution. This is due to a joint resolution of the US Congress that grants the US the power to withdraw but only if it pays its existing dues. President Donald Trump has not paid his current financial obligations.
How might this reshape global health governance going forward?
The US has been highly influential in global health governance and diplomacy. The US withdrawal will certainly weaken overall governance and international negotiations.
What could this shift mean for India’s role and influence within the organisation?
I would make a plea for India to see the US withdrawal as an opportunity to assert its influence in global health policy. India should significantly increase its funding of WHO and become reenergised in WHO policy and governance. This is a unique opportunity for India to take leadership in global health. It makes sense as India is one of the world's most accomplished scientific powers, including in the manufacturing of vaccines and medicines. I would rather see India leading on science, health and equity at WHO than China.