As U.S. prepares to exit WHO, it is stiffing the agency on a large bill

Hundreds of millions are owed, but no one expects Trump administration to pay

https://www.statnews.com/2026/01/21/trump-withdrawal-world-health-organization-leaves-unpaid-bills-behind/

By Helen Branswell

Jan. 21, 2026

When the United States’ withdrawal from the World Health Organization goes into effect Thursday, the world’s largest economy will be leaving the global health agency with a hefty unpaid bill.

The U.S. has not made good on its assessed contributions for the past two years — including the final year of the Biden administration — effectively stiffing the WHO on a bill of roughly $278 million. In addition, several hundred million dollars in promised voluntary contributions for 2025 — and to a lesser extent for 2024 — have also not been delivered. Voluntary contributions are earmarked funds a country provides the WHO to support work that is of particular interest to that country.

Under the provisions of a congressional resolution that allowed the country to join the nascent global health agency in 1948, the U.S. is supposed to pay at least some of that outstanding bill before leaving the organization. And in a WHO press conference last week, the agency’s principal legal officer, Steven Solomon, suggested its member states will study the issue to determine if the U.S. has met the requirements for leaving.

But President Trump’s disdain for the WHO — and his record of sometimes not paying bills — has left little doubt in the minds of global health observers that this condition of the 1948 joint resolution will go unmet.

“There’s no chance that the U.S. is going to pay before it leaves,” said Lawrence Gostin, a professor at Georgetown University and director of the WHO Collaborating Center on National and Global Health Law.

Tom Bollyky, director of the global health program at the Council on Foreign Relations, said if anybody could block the United States’ withdrawal for failing to meet the conditions of the joint resolution, it would be Congress, not the member states of the WHO.

Bollyky told STAT it was understandable that the WHO might study the issue of the unpaid bill to determine its options. “But that doesn’t seem like a winning argument to me,” he said.

With little support for the WHO among Republicans — who control both the House and the Senate — there has been no push from Congress to hold the country to the provision set out by their forerunners.

Monies for the assessed contributions — effectively a country’s WHO dues — traditionally have been paid by the State Department’s international agencies bureau. A department spokesperson said the U.S. has no intention of settling this outstanding debt.

“The United States will not be making any payments to the WHO before our withdrawal on January 22, 2026. The cost [borne] by the U.S. taxpayer and U.S. economy after the WHO’s failure during the Covid pandemic — and since — has been too high as it is,” the spokesperson said in an emailed statement. “We will ensure that no more U.S. funds are routed to this organization.”

The U.S. had committed to providing the WHO with $490 million in voluntary contributions for 2024 and 2025. (The agency draws up budgets on a biennial basis.) The funding was to support work such as the WHO’s health emergency program, tuberculosis control, and the polio eradication effort.

Two U.S. sources who spoke on condition of anonymity told STAT some of the 2024 voluntary contributions were paid, but they could not provide an estimate of the amount.

The WHO did not respond to queries about details of what the U.S. owes the agency, and declined STAT’s requests for interviews about its departure from the agency.

The WHO’s constitution deliberately does not include an exit clause. When it was approving the U.S.’s entry into the new international agency, Congress reserved the right to leave at some point in the future if it so wished. The joint resolution said the country would need to provide a year’s notice of its intention to withdraw, and pay in full its financial obligations for the organization’s current fiscal year. The joint resolution does not stipulate if that applies to both assessed and voluntary contributions, though Gostin believes it refers only to assessed contributions. It also did not appear to anticipate the possibility a withdrawal might occur at a time when the U.S. was several years in arrears on its bills.

The WHO’s executive board, which is made up of a rotating membership of 34 countries, has been asked to report on the withdrawal of the United States and Argentina to the World Health Assembly, the annual general meeting of the WHO’s member states, which occurs in May. (Argentina served notice last year that it would be withdrawing on March 17 of this year.)

At last week’s press conference, Director-General Tedros Adhanom Ghebreyesus called the U.S. withdrawal from the WHO a “lose-lose situation.”

“It’s a lose for the U.S., and it’s also a lose for the rest of the world,” Tedros said, suggesting global health security will suffer further without this key partnership. “I hope they will reconsider.”

Gostin, who was involved in efforts to try to get the administration to reconsider, sees no chance of this happening at this point.

“I think Trump’s view is that he withdrew on Day 1 and it becomes official on January 22,” he told STAT.

It is unsurprising that the Trump administration has not submitted payment for U.S. assessed or voluntary contributions to the WHO since taking office. In his first term, Trump served notice the U.S. was withdrawing from the agency, a move the Biden administration rescinded on its first day in office in 2021. The wording of the executive order Trump signed on his first day back in office last January stated that the transfer of all funds would be halted.

What is surprising, however, is that the Biden administration left office without having settled up its bill for 2024, knowing the incoming administration would likely renew its efforts to take the country out of the WHO. The outstanding amount for 2024 has been estimated at roughly $130 million — about 22% of the funding the WHO had expected to receive in assessed contributions for the year. (Voluntary contributions from countries and philanthropic organizations such as the Gates Foundation make up more than half of the agency’s annual budget.)

Multiple sources confirmed that the U.S. had a long history of paying its WHO bills late. Though assessed contributions are due on Jan. 1 of each year, the U.S. routinely sent payment for a previous year sometime in the early part of the next one.

And a number of people who worked in the Biden administration said it was known — with discussions reaching the level of the White House — that the WHO assessed contribution hadn’t yet been paid as the clock ticked down towards Trump’s second inauguration.

“There was no individual justification or to my knowledge [no] decision actually made not to pay. I think it was negligence and a kind of dragging feet, dragging feet until the new administration came in,” said one person who was pushing for payment of the bill. This individual, as well as several others, spoke on condition that their names and their positions in the administration not be identified. Several others suggested there wasn’t enough money in the pot administered by the State Department’s international agencies bureau to cover all the dues owed to the various organizations to which the U.S. belonged.

“I understand that there were folks at [Health and Human Services] and elsewhere who wanted very badly to make the payments. And I understand there were folks at [the National Security Council] who also wanted to make the payments. But I also understand there were folks at State that did not,” said one official familiar with the discussions. “I think they prevailed in that interagency debate.”