Donald Trump unleashes chaos with executive orders, proclamations

Workers unload medical and health supplies to Syria, delivered by the World Health Organization (WHO), at the Istanbul International Airport in Istanbul on December 26, 2024, after the Syrian president was overthrown by Islamist-led rebels. [AFP] The World Health Organization (WHO) has voiced strong concern over newly sworn in President Donald Trump's decision to withdraw the United States of America from the global health services organisation. The move, initiated by Trump before the end of his first term in 2020, has far-reaching implications on global health governance, funding and cooperation in tackling pressing health challenges, particularly in low- and middle-income countries. In a statement released hours after Trump's executive order, WHO expressed regret, while emphasizing its critical role in protecting the health and security of the world's people, including Americans. The health body also noted that U.S'. collaboration has been instrumental in combating pandemics, eradicating diseases and building resilient health systems worldwide. Meanwhile, China, that is emerging to be a keen competitor of the US on the world stage, yesterday seemed to jump at what it is considering an opportunity, quickly pledging to step in and fill the funding gap. As a founding member since 1948, the U.S. has helped in shaping WHO's work and benefitted from its health programmes. The organisation highlighted past achievements, such as eradicating smallpox and bringing polio to the brink of eradication, crediting U.S. support as a key factor. WHO further emphasized that its ongoing reforms are designed to improve accountability, cost-effectiveness and country-level impact; efforts that require sustained global partnerships. "We hope the United States will reconsider and engage in constructive dialogue for the benefit of global health and the well-being of millions of people," WHO urged. The U.S. has historically been the largest donor to WHO, contributing approximately 22 per cent of its annual budget. These funds have been essential for programmes targeting infectious diseases, maternal and child health and emergency response. The withdrawal places the continuation of these programs at risk, especially in regions heavily reliant on international aid. PEPFAR, the President's Emergency Plan for AIDS Relief, which has been instrumental in curbing the HIV epidemic globally, is one such programmes tied to U.S. support. A reduction in U.S. contributions could stall progress in combating diseases that continue to claim millions of lives annually including HIV, tuberculosis and malaria. In Africa, WHO-backed initiatives have played a critical role in managing malaria outbreaks, providing vaccines and offering technical guidance for health systems. Without U.S. funding, programmes such as the Global Polio Eradication Initiative could face serious setbacks, potentially reversing gains made over decades. Experts argue that withdrawing from WHO during a pandemic undermines the global health response. "The COVID-19 pandemic has shown us how interconnected the world's health systems are," says Dr Peter Sands, Executive Director of the Global Fund. "A weakened WHO threatens the ability of nations to collectively combat health emergencies." The withdrawal has profound implications for low- and middle-income countries (LMICs) that depend on WHO's support for health programmes. For example, Kenya relies heavily on WHO's technical expertise and funding to manage disease outbreaks, ensure immunisation and building capacity within its health workforce. WHO's contributions have been pivotal in reducing maternal mortality rates and improving access to essential medicines. Similar challenges face other African nations, where the burden of diseases like HIV/AIDS, tuberculosis and malaria, is disproportionately high. WHO's ability to respond to these challenges may be compromised without U.S. funding, potentially widening health inequities globally. As China steps forward to reaffirm its commitment to WHO and global health cooperation, the ceding of group by Washington has never been so glaring. Guo Jiakun, spokesperson for China's Foreign Ministry, stated, "China will continue to support the WHO and its mission to promote global health equity." However, the shift in global health leadership raises questions about whether China's approach aligns with the needs of vulnerable populations. Critics argue that China's health aid is often tied to its broader geopolitical interests, which may not prioritise long-term health system strengthening. The Lancet has called the U.S. withdrawal 'unlawful,' arguing that it violates international obligations and undermines the very principles of collective action that underpin the WHO's mission. Regional organisations in Africa, such as the African Union's Centres for Disease Control and Prevention (Africa CDC), are also taking steps to enhance self-reliance in health. The establishment of the African Medicines Agency, for instance, aims to improve access to quality medicines and strengthen regulatory capacity across the continent. In a joint statement, several international health organisations, including Gavi, the Vaccine Alliance and the Wellcome Trust, emphasised the importance of collective action. "Global health is a shared responsibility. No country can achieve health security in isolation," the statement read. In an increasingly interconnected world, the health of one nation depends on the health of all. Now more than ever, global cooperation is essential to protect the well-being of current and future generations.

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