President-elect Donald Trump’s upcoming inauguration promises to be a glitzy, expensive affair. There will reportedly be fireworks, multiple inaugural balls, and celebrity performances from Carrie Underwood and the Village People.
So far, Trump’s inaugural committee has raised more than $170 million for the event, which — don’t you just love math? — is significantly more than the U.S. annual dues of $130 million to the World Health Organization. The latter sum may not reach the agency if Trump decides to pull the U.S. out of WHO again or freeze its funding. Some experts say it’s premature to say Trump will do so — although he promised on the campaign trail that he would, and he started the process to formally withdraw from WHO during his last term in office, though that was reversed by his successor Joe Biden.
For 2025, Dr. Catharina Boehme, WHO assistant director-general for external relations and governance, tells me that the organization is currently 90% funded — but that assumes U.S. funding will come through. Experts tell me the funding impact of a potential U.S. withdrawal shouldn’t be immediate since the process takes 12 months. But the president also has a lot of discretion on what he wants to do with WHO funding.
The U.S. is WHO’s number one donor, and its contributions go to key programs, such as health preparedness and response, HIV and tuberculosis, and childhood vaccinations. The United Nations health agency has been trying to diversify its funding, and it has done so somewhat successfully in its investment round, which aimed to raise more predictable funding for the next four years. But it only raised $1.7 billion from that effort to date, leaving it with a funding gap of roughly $3.3 billion.
WHO’s other bilateral donors are struggling economically too, or have other priorities. This adds to the challenges in the implementation of its new program of work — which starts this year — and their deliverables, Boehme tells me.
Implementation of WHO’s new program of work also takes place against a backdrop of other challenges, such as an ever-increasing number of outbreaks, zoonotic spillovers, and extreme weather events.
Coincidentally, my colleague Sara Jerving tells me there’s a suspected Marburg outbreak in Tanzania’s Kagera region, which borders Rwanda. At present, there are nine suspected cases and eight deaths across two of Tanzania’s districts. Samples from two patients are being tested to confirm if it’s Marburg.
Read: What’s in store for WHO in 2025?
Outbreak alert: Suspected outbreak of Marburg reported in transit hub in Tanzania
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Deadly cuts
What happens to WHO under Trump isn’t the only talk of the town. There are also concerns that he would again reimpose the global gag rule — which bans U.S. health funding to foreign NGOs if they use their own non-U.S. funds for abortion-related activities — and further expand it, as well as cut funding to the United Nations Population Fund, whose work includes reducing maternal mortality.
In Cox’s Bazar, home to more than 1 million refugees, those cuts would be deadly. Devex contributor Rebecca Root writes that maternal mortality rates are already 44% higher in the camps compared to the general population of Bangladesh, and experts fear that the gap would grow if U.S. funding disappears.
Read: The funding cuts that could endanger Rohingya refugee mothers
What’s at stake for the US?
Much of what we’ve written is how much potential U.S. funding cuts could hurt global health work. But experts note that Americans could lose out too.
Peter Yeo, senior vice president at the United Nations Foundation, tells me that one important issue in 2025 and beyond that should prompt the new U.S. administration to engage with WHO is who will be the next WHO director-general. Current chief Tedros Adhanom Ghebreyesus will see his term end in 2027, so the race to succeed him has likely already begun.
“The question is, how should the U.S. best position itself to influence who the next leader of the World Health Organization is going to be?” Yeo tells me. “Clearly, the U.S. continuing to strongly engage with the WHO, and meeting its financial obligations to WHO, is essential to ensuring that the U.S. has a strong voice and role in selecting the next head [of the agency].”
WHO also plays an essential role in keeping Americans safe, helping in tracking, monitoring, and stopping pandemics and health emergencies before they hit U.S. shores. And it is a major purchaser of American goods and services, which Yeo says amounted to $51 million in 2023.
“[That] basically meant that for every dollar we sent in assessed contributions to [the] World Health Organization, about 46 cents came back to the American economy and American jobs. So that's a pretty good return on investment,” he says.
Let’s not forget
Trump initiated a withdrawal from WHO in the midst of the COVID-19 pandemic, after accusing the U.N. agency of being a “puppet of China.”
That was nearly five years ago. And many have moved on from the COVID-19 nightmare, or at least tried to. But some can’t, even if they want to.
I’m talking about the people who continue to suffer from long COVID, in which a range of symptoms — including fatigue and cognitive dysfunction — continue long after infection with COVID-19 has normally dissipated. In much of the world, doctors still struggle to diagnose the condition, and patients are often dismissed without receiving appropriate care.
But some researchers are working together to unfold the mystery and better understand how to manage and treat it. And in places such as Nigeria and South Africa, there are dedicated, specialized clinics for long COVID patients, reports Devex contributor Paul Adepoju.
Fatigue and fog: Navigating Nigeria’s long COVID crisis
One big number
40%
—If we say Fifth Avenue, you probably think of New York City’s famous luxury shopping street. But in Zimbabwe’s second-largest city, Bulawayo, they have their own Fifth Avenue — filled with vendors selling fresh produce, second-hand shops, and beauty products. Highly in demand there? Skin-lightening creams, some of which promise “bright results within five days of use.”
The craze for such products is real — likely driven by discrimination against darker skin colors. WHO estimates that 40% of African women bleach their skin, and some go as far as taking oral supplements or injectables to achieve lighter tones.
And that has health implications. Some of these tonics contain dangerous ingredients, including mercury, and can be toxic to the liver, kidneys, and nervous system.
Read: Why skin bleaching is a public health concern
What we’re reading
Kenya has run out of essential medical supplies, including HIV medicines. [Nation Africa]
Cholera surges in Sudan, with over 51,000 cases and more than 1,000 deaths. [Sudan Tribune]
A coalition of health professionals and scientists have asked U.S. senators to ‘oppose the nomination’ of RFK Jr. [The New York Times]
About the author
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
