Trump's executive order on WHO, explained

U.S. President Donald Trump’s executive order to withdraw the United States from the World Health Organization has raised concerns about its impact on global health. Beyond the health consequences, the order has also raised a lot of questions about its legal and practical implications. The questions include whether Trump has the authority to withdraw from WHO. The U.S. Congress adopted a joint resolution in 1948 that allows the president to accept WHO membership and states that the U.S. reserves the right to withdraw from WHO. The resolution is unclear on whether the president can withdraw from the agency without congressional approval. Other questions include whether the process will run for one year or six months and whether the executive order effectively removes the U.S. from the amendments to the International Health Regulations, the legally binding instrument that lists countries’ and WHO’s obligations in a health emergency. In an interview with Devex, Lawrence Gostin, founding O'Neill chair in global health law at Georgetown University and a renowned expert on global health law, helped break down the executive order’s legalese and the ambiguities that surround it. Gostin said he plans to launch a legal challenge against Trump’s actions. “I believe, and my legal team believes, that this is too monumental a decision to be left to the whim or even the grudge of a president and that it needs congressional approval. And that's the basis upon which we're considering legal challenges to Trump's actions,” he said. This conversation has been edited for length and clarity. President Donald Trump announced the U.S. intention to withdraw from WHO again by revoking former President Joseph Biden’s retraction of the first withdrawal. What does that mean in terms of processes? Are we looking at the continuation of what Trump initially did back in 2020 or is this a new withdrawal with a 12-month notice period? I've just had a legal strategy team with some of the best lawyers in the country to try to plan a litigation against this. And we discussed this a lot. I think the executive order has a lot of intentional ambiguity, but it's clear to me that it makes a mockery of the joint resolution of Congress, and is a gross violation of the law for a number of reasons. But let's begin with the fact that he doesn't appear to be giving one year's notice of the intention to withdraw. I think the most likely reading of it is that he thinks that the one-year clock began to toll when he first sent the letter to [United Nations] Secretary-General [António] Guterres, then he rescinded Biden's order. So since about six months lapse before Biden reversed this, he seems to be saying that he can withdraw within six months. And of course, I think that's a gross violation of an act of Congress, and also makes a mockery of the one-year notice rule. And how has Congress responded to this current executive order? With a great big yawn. I think the Republican Party [is] in such lockstep with Trump that it's almost impossible for me to believe that Congress would repudiate or revoke what Trump has done. On the other hand, my argument is that we got into WHO through an act of Congress, and Congress needs to approve any withdrawal. I don't believe that Trump could ever get Congress to actually pass a law approving or authorizing him to do it. Basically, my view is that Congress is silent. It won't act one way or the other, and that I think in Trump's mind gives him a bright green light to proceed. And I think he has every intention of carrying out his plan to withdraw from WHO in six months. When he did this back in 2020, was there any pushback from Congress? There was from Democrats and some Republicans that value institutions. But this is a completely different Congress now, and most of the Republicans, if not all, who would stand up to Trump, are no longer there. Adding to the ambiguity, is it accurate that the resolution Congress passed to join WHO states that the U.S. has the right to withdraw from the agency but does not clarify who is supposed to issue a withdrawal? Yes, exactly right. Basically, Congress said the United States can withdraw by giving one year's notice and by paying back its financial obligations, but it never said who acts for the United States. Trump believes that he can do this unilaterally, without regard to the Congress or the courts, and with no accountability or checks and balances. I believe, and my legal team believes, that this is too monumental a decision to be left to the whim or even the grudge of a president and that it needs congressional approval. And that's the basis upon which we're considering legal challenges to Trump's actions. What would that legal challenge entail, and could it reverse this decision? It would be three things. The one that's most likely to succeed if it goes forward is the idea of not getting one year's notice — that seems to be such a blatant violation of Congress that even a conservative court would say, ‘No, hold on. No, you can't just simply rescind the past president's order and then shortcut the exit from WHO.’ That's the first. The second is the idea that the Supreme Court itself has said many years ago, which is that when the president acts unilaterally, he's at the lowest end of his authority. And so the second thing would be to say, even if he gives one year notice, he can't do it on his own. He needs Congress to authorize it. And then thirdly, Trump has frozen U.S. funding for WHO. I think that's blatantly unlawful too, because under the terms of Congress, we have to pay back all of our financial obligations, and we've not paid our assessed dues. Another part of the EO directs the secretary of state and the director of the Office of Management and Budget to “recall and reassign” U.S. government personnel or contractors working with WHO. What’s the impact of this recall? It's happening now. And I think it's very alarming. What this suggests to me [is that] … Trump might be saying, ‘Well, I'm going to give notice of our intention to withdraw.’ But for all intents and purposes, he has withdrawn. He's basically rescinded adoption of the IHR amendments, pulled us out of pandemic agreement negotiations, froze all of U.S. funding, and recalled U.S. staff. That sounds to me like he's withdrawn already. So essentially Trump wants all of this to happen as soon as possible. Does this mean there won’t be any U.S. negotiators at the next meeting of the Intergovernmental Negotiating Body on the pandemic agreement? They will not. “The United States has no blueprint anymore for dealing with future pandemics and future health emergencies.” --— Lawrence Gostin, founding O'Neill chair in global health law, Georgetown University In terms of legal procedure, does the U.S. need to take any further actions to rescind U.S. participation in the IHR amendments? This is tricky, because the IHR is adopted under the World Health Organization constitution, and the constitution is a treaty of which the United States is a member and has adopted that treaty. And so by rule, if there are any amendments to the IHR, the U.S. or any country is allowed to issue a reservation or even to opt out within a certain period of time, but that would take an extra step. The executive order itself purports to pull the U.S. out. But I think legally they can't without taking that extra step. And of course, I think it would be extraordinarily dangerous to withdraw from the IHR or the IHR amendments. Dangerous to the United States [and] dangerous to the world. Because what makes the IHR so powerful is that they’re universal. It's the most widely adopted treaty in the world. And even more member states than WHO itself. So I think it would be a grave strategic mistake to do this. But he [Trump] appears to think he's done it in the executive order. There's a deep irony there because the United States … were the driving force behind the amendments … So with the U.S. having really been single-handedly almost responsible for the amendments, that we would then bow out is unforgivable. He also ordered the establishment of directorates and coordinating mechanisms within the National Security Council “to safeguard public health and fortify biosecurity.” What does that mean? He's done a few things. First of all, he's rescinded the Biden administration's various global health security strategies. So basically, the United States has no blueprint anymore for dealing with future pandemics and future health emergencies. But I think this also signals that he's going to concentrate power over global health and public health in the White House and outside of scientific agencies like CDC, NIH, and FDA, which I also think is dangerous. If you take all of his actions as a whole, I've never seen a time of greater peril for global solidarity around health than I do see now.