Changing Course at the WHO on Day One
A Trump administration decision to withdraw from WHO might be based on any number of considerations.
Just before Christmas, the Financial Times published a report, citing unnamed sources around the Trump transition, that the new White House team will move to withdraw the United States from the World Health Organization (WHO) on “day one” of the new term.
The move would not be much of a surprise, given the fact that the first Trump team began the process of leaving WHO in the summer of 2020. That decision was promptly reversed by Joe Biden in 2021 in one of his first acts as president, citing the United Nations (U.N.) agency’s lead role in “public health” issues internationally. Biden also used the occasion to name Dr. Anthony Fauci as the U.S. representative to WHO’s executive committee.
WHO, then as now under the leadership of Director-General Tedros Adhanom Ghebreyesus, has embodied the spirit of most multilateral ventures in health policy in the modern era. It has relied on massive contributions from the United States and taken reliably progressive positions on everything from gender identity to abortion, where its stance can be fairly characterized as promotion of legal abortion without limit. Although his biography at the WHO website describes him as a “diplomat” as well as a physician, Tedros has repeatedly spoken out against the protection of prenatal human life in the land of WHO’s main benefactor, the United States. In 2022, after the U.S. Supreme Court rendered its ruling restoring the ability of federal and state legislators to adopt limits on abortion, Tedros issued a statement scorning the decision as a “setback” that would cost lives, by which he meant the lives of mothers and not the unborn.
The U.S. contribution to WHO has been enormous over the years. According to a WHO fact sheet, the United States “is the top donor and partner to WHO,” having given $1.284 billion in taxpayer dollars to the agency in the 2022-23 biennium alone. These funds support a wide range of projects conducted on a multilateral and bilateral basis. The Biden-Harris administration released its detailed guide for support of these projects in April 2024, generally targeting conditions whose eradication would be a boon to mankind. The guide makes no mention of abortion, but the topic has been very much on the mind of WHO and the Biden administration.
WHO’s abortion policy is explicit and, befitting the move toward abortion by pill, decidedly nonmedical for this putatively health-based organization. WHO documents make clear that the involvement of health care workers in abortion is peripheral. “In addition to non-specialist and specialist doctors,” WHO writes, “a wide range of health worker cadres — such as auxiliary nurses, auxiliary nurse midwives, nurses, midwives, associate/advanced associate clinicians, pharmacists and doctors of complementary medicine — can provide various aspects of medical abortion services.”
WHO aligns itself as well with do-it-yourself (DIY) abortions, at one time the very plague in-clinic abortions were said to be the answer to. “When using the combination mifepristone and misoprostol regimen,” WHO says, “the medical abortion process can be self-managed for pregnancies up to 12 weeks of gestation, including the ability to take the medications at home, without direct supervision of a health-care provider.” WHO pays no attention at all to the sanitation conditions that exist “at home” in much of the world, the lack of access to emergency rooms where disproportionate numbers of women harmed by abortion drugs must go, and the lower limit on gestational age recommended or required in various countries, including the United States.
In response to the question of whether a woman should have an ultrasound to confirm pregnancy location (in order to rule out an ectopic pregnancy) prior to consuming the abortion pill, WHO casually remarks, “Ultrasound scanning is not routinely required for the provision of abortion. A physical examination to assess uterine size, determine the last menstrual period and identify symptoms of pregnancy are usually adequate.” “Usually … adequate” hardly seems an appropriate phrase for a global agency putatively focused on maternal and child well-being. But such phrasemaking serves a different, and forceful, agenda when it comes to abortion policy. As it prepares its exit, the Biden administration has been reportedly pressuring the government of Sierra Leone, whose laws bar abortion, to decriminalize the practice or forfeit hundreds of millions in foreign aid. Administration officials have denied the accusation or declined to respond.
A Trump administration decision to withdraw from WHO might be based on any number of considerations: a need to reduce the U.S. annual deficit in the range of $1.8 trillion, WHO’s history of silence about China’s population control policy of mandatory birth control and abortion (WHO today celebrates how it and China have brought “people-centered care to the fore” in a campaign for universal health care), or its decidedly radical position on gender ideology, where it has taken no note at all of the studies, like the Cass Review, in European countries that show the harm of gender ideologies, especially with respect to adolescents.
One thing the Trump administration can be sure of is that any decision to withdraw from WHO will be strongly supported by the American people, particularly under current fiscal conditions. A Marist-Knights of Columbus national survey in January 2021 found that more than three-fourths of Americans, including a majority who describe themselves as “pro-choice,” want significant limits on abortion. Seventy-seven percent either oppose or strongly oppose using U.S. tax dollars to support international abortion, including 64% of those who describe themselves as “pro-choice.”
The incoming Trump administration is signaling its willingness to restore anti-abortion-funding provisions like those governing the domestic Title X program and what has been called Global Mexico City policy. This policy amplifies a landmark achievement of the Reagan administration under which the United States declared it would no longer support bilateral aid projects that included abortion funding or advocacy, and that, in turn, it would embrace policies that were sensitive to the family and cultural values that characterized each recipient nation. The first Trump administration expanded the policy to cover some $7.3 billion in funding in fiscal year 2020, including the PEPFAR program to combat Acquired Immune Deficiency Syndrome (AIDS), maternal health, nutrition, and other programs. Withdrawal of the United States from the multilateral WHO program could further expand the scope of this policy.
Some make the good faith argument that the United States should remain in WHO to retain its influence in the agency and advance pro-life policy. But the main U.S. influence lies with our expansive funding commitments, many of which serve policies that damage the U.S. reputation across the globe as a nation that does not respect religious traditions, the family, human life, and other human rights. Bilateral programs that serve valid and universally shared health goals like combating infectious disease, maternity care, and disaster relief can continue with U.S. funds following objectives, including fiscal responsibility, that the American people favor. Initiatives like the Geneva Consensus Declaration, a statement of support for maternal health initiatives that exclude abortion, now signed by 39 countries, can be imparted new momentum.
For decades the United States has been the dog wagged by its tail, as U.N. bodies hosted on our shores and dominated by national elites that do not share most of our values, receive gifts from U.S. taxpayers, and turn a blind eye to God-given human rights. It is time for a change of course and a true heading.
Chuck Donovan served in the Reagan White House as a senior writer and as Deputy Director of Presidential Correspondence until early 1989. He was executive vice president of Family Research Council, a senior fellow at The Heritage Foundation, and founder/president of Charlotte Lozier Institute from 2011 to 2024. He has written and spoken extensively on issues in life and family policy.
