US President Donald Trump’s decision to withdraw the country from the World Health Organization has sparked widespread concern among NGOs and across the European political spectrum.

The US is currently the WHO’s largest financial backer, accounting for 14% of its budget. The European Commission will now explore how this substantial gap could be filled, urging “all WHO members to address this challenge and to reinforce their commitments,” said health spokesperson Eva Hrnčířová.

Announcing his intention to withdraw via executive order shortly after his inauguration on Monday, Trump wrote that US contribution to the budget was “far out of proportion” with other countries, especially in relation to China, “with a population of 1.4 billion, [China] has 300% of the population of the United States, yet contributes nearly 90% less to the WHO.”

Experts, policymakers and NGOs all cast doubt on the ability of the WHO to meet its vital functions without US backing – and on the US’s ability to meet global health challenges alone.

Global cooperation is “vital in combatting health threats that impact everyone, including Americans,” said Marc Suzman, CEO of the Gates Foundation, the body’s second-largest donor after the US.

The WHO said it regretted the decision and pointed to the decades-long collaboration with US authorities that has eradicated smallpox and nearly eradicated polio.

MEP reactions pour in

The European Parliament’s main political groups were largely unanimous in their condemnation of Trump’s move.

“After appointing a notorious anti-vaxxer as Health Secretary, Trump is doubling down with another populist decision that will have very real catastrophic consequences” for the WHO’s work, said the President of The Left group, Manon Aubry.

While Vlad Voiculescu, an MEP for the centrist Renew Europe group and a former Romanian health minister, said the EU should “step up and support the WHO,” the responsibility to do so will likely fall on the wider international community.

The EU alone is unlikely to have the cash in its coffers to fill such a significant funding gap, particularly given member states have already sought to cut the EU’s own health funding programme for 2025.

Despite the obvious headaches for both the EU and the WHO, a US withdrawal was at least anticipated in much of Brussels – particularly given Trump had once previously notified the body of his intent to withdraw, in 2020.

German MEP Tiemo Wölken of the Socialists and Democrats described the decision as “reckless”, but says it came as no surprise given that the president “disregards facts and science.” Trump has a well-documented history of making misleading and false statements on public health matters, most notably during the Covid-19 pandemic.

Laurent Castillo, a French conservative MEP, instead sees “an opportunity” for the EU – with US agencies and pharmaceutical companies now likely to lack access to key health data needed for development of certain vaccines, such as for seasonal flu.

“This could send a clear message: come innovate in the EU!”

Knock-on effects for global reproductive health

Another executive order “reevaluating and realigning United States foreign aid” also presents deep concerns for global health. The 90-day pause is particularly concerning to those working on sexual and reproductive health.

“The US led the charge in 2022 as the top global donor for Sexual and Reproductive Health (SRH),” said Lisa Goerlitz, Head of the Brussels office at DSW, a global health NGO. Of the total $14.18 billion donor countries provided to promote SRH, the US contributed almost 66% of global funding.

NGOs are concerned by a “global gag rule”, which deems non-US NGOs ineligible for US government global health assistance if they provide, promote, or refer people to abortion services.

If this was reintroduced, there would be a shortfall in SRH services, Goerlitz says, meaning European donors would have to step in and ensure “the vast progress made in improving the lives of women and girls is not lost.”