The United States has supported the World Health Organization (WHO) since its inception, playing a central role in its 1948 creation because it ultimately served American interests, despite the entity’s well-known flaws. Heavily influenced by the post-war notion that universalism was the best corrective to yet another devastating global conflict, 20th century leaders in the U.S. understood that improving global health and containing emergencies were desirable outcomes in and of themselves and would directly reduce health threats to Americans. At the time, the U.S. also recognized that building and maintaining an effective global health infrastructure was beyond its lone capacity. Because no one could predict where new infections would emerge, the world required a truly global surveillance and response system. Through WHO, the U.S. leveraged funding sources far beyond its own substantial monetary contributions and granted U.S. experts access to countries otherwise hostile to American initiatives. U.S. withdrawal from the organization on 22 January 2026 and from other international health partnerships, such as Gavi, the Vaccine Alliance—which I led from 2011 to 2023—makes achieving America’s interests more difficult, especially as the current administration dismantles much of the country’s other public health infrastructure.
