Donald Trump’s announcement on Friday that the US would break its ties with the World Health Organization was characteristically blunt. But it left diplomats and legal experts wondering how the president’s pledge would be put into practice.
Mr Trump said on Friday: “[The US] will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent global public health needs.”
But he did not say exactly how, when or on what terms the US would extricate itself from an organisation of which it has been a member since 1948, let alone what the consequences might be for either side.
“It’s a classic Trump move,” said Richard Gowan, UN director at the International Crisis Group. “This man is not a connoisseur of international treaty law. He frequently makes this sort of statement and then it’s left to his officials to work out what it means in reality.”
What is behind the move by Mr Trump?
On May 19, the president warned he would reconsider US membership of the WHO unless it made “major substantive improvements” within 30 days. Ten days later, he announced he would carry out his threat.
Mr Trump has accused the organisation of helping Beijing hide the truth about coronavirus, which originated in the Chinese province of Wuhan, calling it a “puppet of China”.
Many health experts agree that the WHO was slow to label the disease as a pandemic, and say the organisation has been particularly florid in its praise for China’s policy response.
But others say Mr Trump made some incorrect accusations — such as claiming Taiwan had warned about human-to-human transmission on December 31 — that suggest the president is using the row as a way to stoke anti-China feeling in the US.
Can the US withdraw?
One question posed by Mr Trump’s statement is exactly what he meant by “terminating”. Did he intend a full withdrawal, or something less drastic, such as a halt in funding and co-operation, which might be easier to achieve legally?
“We are mindful of the language that was used,” said Kate Dodson, vice-president for global health at the UN Foundation. “He did not use the word withdraw.”
If Mr Trump does want to withdraw unilaterally, he probably can, say legal scholars. When the US joined the organisation in 1948, Congress passed a resolution asserting that the country could unilaterally depart with a year’s notice, which was then accepted by the WHO itself.
This leaves the president with legal grounds to pull the US out without a vote in Congress. But under the terms of the resolution, he would have to wait a year and, more importantly, pay outstanding dues of just under $100m.
If the president decides he does not want to pay the money, he could argue that the terms of the 1948 resolution are unconstitutional in their limits on presidential power.
“It’s likely that the president will argue that measures such as this are unconstitutional,” said Thomas Bollyky, director of global health at the Council on Foreign Relations. “I don’t think that money is going to get paid.”
What would it mean for the US?
The US is by far the biggest funder of the WHO, and would be able to reclaim the roughly $400m it pays the organisation annually.
Critics — including members of the president’s own party — say the money would be best spent in tandem with other countries to avoid replicating each others’ work, especially during a pandemic.
Lamar Alexander, the Republican chair of the Senate health committee, said withdrawing from the WHO could “interfere with clinical trials that are essential to the development of vaccines”.
Last month, Mike Pompeo, secretary of state, reportedly argued that funding should be maintained for WHO programmes in seven countries where other organisations do not have the necessary contacts with local governments. They included several countries of strategic importance to the US, such as Pakistan, Afghanistan, Syria and Venezuela.
What would it mean for the WHO?
The WHO did not comment on Mr Trump’s announcement on Friday, but Tedros Adhanom Ghebreyesus, its director-general, said last month the organisation would work to fill any financial gaps it faced as a result of the temporary suspension of US funding.
Several donors, including the UK and the Bill & Melinda Gates Foundation, have said they would boost funding in the wake of Mr Trump’s earlier threats, but experts do not think they will be able to fill the void completely.
It is not just the money that makes the US an important WHO member. The country hosts 82 joint research institutes, 21 of which are based at the Centers for Disease Control and Prevention, the US public health organisation that has been at the forefront of the coronavirus response.
The WHO’s supporters say without the US, it will be far less able to handle future outbreaks, making the US less safe.
“There’s always a sense of political theatre about pulling out of these organisations,” said Mr Gowan, the UN director at the International Crisis Group. “But this feels like a more drastic move and I’m much more worried about what this will do to global health.”