The World Health Organization (WHO) has launched an appeal for $1.5 billion to address global health emergencies, as the agency faces potential financial instability due to uncertainty over U.S. funding under incoming President Donald Trump. The appeal, unveiled on January 16, aims to assist over 300 million people in 42 critical zones, including Gaza and Afghanistan, where health crises are intensifying.

Funding Gaps and the Role of the U.S.

The WHO’s Director-General Tedros Adhanom Ghebreyesus highlighted the dire consequences of insufficient funding, emphasizing that without adequate resources, the agency will face difficult decisions about who can receive essential care. Historically, the U.S. has been a significant contributor to the WHO’s emergency and overall budgets. For the 2024-2025 period, the U.S. provided 34% of the funding for health emergencies and roughly 20% of the agency’s total $6.8 billion budget.

However, Trump’s previous actions during his first term, including cutting funds to the WHO and announcing the U.S. withdrawal from the agency, have raised concerns about future support. A source close to Trump’s transition team hinted at a similar approach, saying, “The same WHO that we left in the first administration? It seems like we wouldn’t much care what they have to say.”

WHO’s Financial Vulnerability

The WHO relies on a mix of mandatory member state fees, voluntary contributions, and investment rounds to fund its operations. Documents released ahead of the agency’s executive board meeting in February underscore the risks of losing any major donor, particularly the U.S., which alone represents a substantial portion of its voluntary funding. For some programs, five top donors, including the U.S., account for two-thirds of the budget.

The WHO document warns that losing a major donor would create a significant funding gap that would be challenging to fill. Public health experts have called on the WHO to demonstrate accountability and strengthen its relationship with the U.S. to secure continued support.

Uncertainty Under Trump’s Leadership

While the WHO is optimistic about maintaining its partnership with the U.S., past tensions have cast a shadow on the relationship. Trump’s criticism of the WHO’s handling of the COVID-19 pandemic and perceived ties to China led to strained relations during his first term. Experts, including Ashish Jha of Brown University, have urged the WHO to be proactive in addressing criticism and improving its operations to bolster trust with donors like the U.S.

Preparing for the Worst

Although the WHO remains hopeful, public health advocates stress the need to prepare for the possibility of reduced U.S. funding. Tedros and other officials have vowed to work with the incoming administration to preserve the partnership. As the U.S. prepares for a leadership transition, the WHO faces mounting pressure to secure sustainable funding while addressing the growing needs of vulnerable populations worldwide.

This critical juncture underscores the fragile state of global health funding and the potential repercussions of losing a key contributor like the U.S., highlighting the need for robust international cooperation to address pressing health emergencies.