WASHINGTON -- The Trump administration has begun the process of withdrawing the United States from the World Health Organization.
The notice of withdrawal, effective July 6, 2021, was sent Monday to United Nations Secretary-General Antonio Guterres. Under the terms of a joint resolution passed by Congress in 1948, the U.S. must give a year's notice and pay its debts to the agency to leave.
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The U.S., which is the agency's largest donor and provides it with more than $450 million per year, currently owes the WHO some $200 million in current and past dues.
Stephane Dujarric, a spokesman for Guterres, said the secretary-general was "verifying with the World Health Organization whether all the conditions for such withdrawal are met."
It is not clear whether the president can pull the U.S. out of the organization and withdraw funding without Congress' approval. When Trump first threatened to withdraw, Democratic lawmakers argued that doing so would be illegal, and they vowed to push back.
House Speaker Nancy Pelosi condemned the move.
"The President's official withdrawal of the U.S. from the World Health Organization is an act of true senselessness," she said in a tweet. "With millions of lives at risk, the president is crippling the international effort to defeat the virus."
Sen. Robert Menendez of New Jersey, the ranking Democrat on the Senate Foreign Relations Committee, tweeted Tuesday that Congress had received notification of the withdrawal, which he said "leaves Americans sick & America alone."
Rep. James Comer of Tennessee, the ranking Republican of the House Oversight Committee, called the withdrawal "the right decision."
"Until the WHO undergoes some serious reforms, it doesn't deserve our money or our membership," he said in a statement.
Joe Biden, the presumptive Democratic nominee for president, said Tuesday that, if elected, he would immediately rejoin the organization and "restore our leadership on the world stage."
"Americans are safer when America is engaged in strengthening global health," he tweeted.
CALL FOR CHANGES
The withdrawal letter comes after months of criticism and threats from the president.
In April, he announced that he was freezing all new funding to the organization. On May 29, less than two weeks after warning the WHO that it had 30 days to change or lose U.S. support, Trump announced that his administration was leaving the organization because of what he said was its inadequate response to the initial outbreak of the coronavirus in China's Wuhan province late last year.
The president said in a White House announcement that Chinese officials "ignored" their reporting obligations to the WHO and pressured the organization to mislead the public about an outbreak that has now killed more than 131,000 Americans.
"We have detailed the reforms that it must make and engaged with them directly, but they have refused to act," Trump said at the time. "Because they have failed to make the requested and greatly needed reforms, we will be today terminating the relationship."
Elements of Trump's critique have resonated beyond the White House. Foreign governments and current WHO advisers have questioned why the WHO amplified false Chinese claims in the early days of the outbreak and repeatedly praised Beijing as the virus spread.
Trump's push to withdraw in the middle of a pandemic has alarmed health specialists and put the United States at odds with traditional allies.
More than 700 experts on global public health and law called on Congress on Tuesday to push back against the plan, warning that "cutting funding to the WHO during a global pandemic would be a dangerous action for global health and U.S. national interests."
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The letter, which was signed by former directors of the Centers for Disease Control and Prevention, the executive director of the American Public Health Association, the president of the National Academy of Medicine, and university presidents and deans, said a U.S. pullout "will likely cost lives, American and foreign."
The United States helped shape the WHO, and U.S. officials still fill key roles there. Pulling American expertise and money will diminish that influence and could hurt ongoing health initiatives, particularly in the developing world.
The U.S. makes mandatory payments to maintain its membership in the WHO in addition to larger voluntary donations. That funding makes up about 15% of the agency's budget.
The mandatory payment, known as the "assessed contribution," may prove difficult for Trump to cut without congressional approval.
At more immediate risk are the "voluntary contributions," money provided to U.S. agencies for health efforts and then given to WHO programs. The largest share of this money goes to polio eradication, with large chunks to fight vaccine-preventable disease, malaria, HIV/AIDS and the provision of basic health care.
The impact may also be felt at home. Without a seat at the table, the U.S. could be cut out of conversations about the coronavirus response, vaccine development or the next emerging threat.
One irony is that the administration has in recent months pushed for Taiwan to gain membership or observer status at the WHO for its safety, noted Mara Pillinger, an associate in global health policy and governance at Georgetown University's O'Neill Institute for National and Global Health Law.
"Now, by withdrawing U.S. membership, they are knowingly, deliberately, jeopardizing the health and safety of the American people," she said.
ALLIES OPPOSED
The U.S. plan to cut ties with the WHO is broadly unpopular among America's allies.
"We have a lot of allies on improving WHO, but we have no allies on abandoning WHO," said Jimmy Kolker, a former U.S. ambassador who served as assistant secretary for global affairs at the Department of Health and Human Services until 2017.
U.N. Foundation President Elizabeth Cousens called the move "short-sighted, unnecessary, and unequivocally dangerous. WHO is the only body capable of leading and coordinating the global response to COVID-19. Terminating the U.S. relationship would undermine the global effort to beat this virus -- putting all of us at risk."
The ONE Campaign, which supports international health projects, called it an "astounding action" that jeopardizes global health.
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"Withdrawing from the World Health Organization amidst an unprecedented global pandemic is an astounding action that puts the safety of all Americans and the world at risk. The U.S. should use its influence to strengthen and reform the WHO, not abandon it at a time when the world needs it most," ONE Campaign president Gayle Smith said.
A State Department spokesperson said Tuesday that the process of scaling down engagement with the WHO is underway but seemed to leave open the possibility of working with the organization in the future.
"The President has been clear that the WHO needs to get its act together," the spokesperson said, speaking on condition of anonymity in line with department rules. "The United States will continue efforts to reform the WHO and other international organizations to ensure they operate with transparency, fulfill their mandates, and hold governments accountable for their commitments under international law."
Information for this article was contributed by Emily Rauhala, Karoun Demirjian, Toluse Olorunnipa and John Hudson of The Washington Post; and by Matthew Lee, Lisa Mascaro and Edith M. Lederer of The Associated Press.