The federal agencies with primary responsibility for helping Americans stay in good health are the U.S. Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS). The CDC monitors outbreaks of disease and offers advice that — if followed — should help Americans improve or maintain their health. The CMS administers the Medicare and Medicaid insurance programs that pay healthcare providers who treat seniors and low-income individuals.

Other countries have similar agencies that focus on local healthcare issues. Most countries also belong to the World Health Organization (WHO). The WHO was created by the United Nations in 1948 and funded by 194 of the UN’s member nations.

The United States helped found the WHO and immediately became a member nation. Near the end of his first presidency, Donald Trump suspended American funding of WHO and initiated a process to end US membership in the organization. The Biden administration reversed those actions in 2021.

Donald Trump is president again and has again announced that the United States will withdraw from WHO and end its financial support of the organization. Whether the proposed withdrawal is consistent with international law and with presidential authority remains an open question.

American healthcare experts have sounded an alarm about the consequences that withdrawing from WHO might have on the health of Americans. Older adults may be among those who feel the harshest impact of the withdrawal.

What Is the WHO?

As the United States learned during the pandemic, diseases have no respect for borders. Air travel makes it possible, and perhaps inevitable, that highly contagious diseases will spread from country to country. It simply isn’t realistic to isolate the United States from the transnational movement of diseases.

The WHO provides a safeguard against the spread of infectious diseases by monitoring outbreaks around the globe, devising strategies to contain them, and declaring global health emergencies when they threaten to become epidemics or pandemics. When the severe acute respiratory syndrome (SARS) became a global threat in 2003, the WHO coordinated an international effort that contained the disease within four months. Health experts recognize that WHO’s “management of the global SARS response involved intense daily coordination in the areas of etiology and laboratory diagnosis, surveillance and epidemiology, clinical issues, animal sources, and field operations.”

The WHO also championed child vaccination programs that contributed to the eradication of smallpox in 1979 and reduced polio infections by 99% in recent decades. Advice WHO gave to member nations helped curb the spread of the swine flu epidemic and contributed to the containment of Ebola and Zika virus outbreaks.

Less dramatically, the WHO establishes standards of medical care so that doctors around the world will follow the best practices when they treat their patients. The WHO also creates and maintains diagnostic and treatment codes that allow insurance companies to identify the medical care for which they are being billed. The WHO assigns generic names to medications (thus assuring that doctors in every member nation will be on the same page when they write prescriptions) and makes recommendations designed to reduce medication harm.

In addition, American pharmaceutical companies depend on the assistance of WHO to distribute their medications around the world. The WHO also coordinates member nations as they determine the composition of each year’s flu vaccine. And the WHO monitors the effectiveness of antibiotics as overprescription causes populations to resist their benefits.

Why Does the Trump Administration Oppose US Support of WHO?

The WHO is far from perfect. It has been criticized for its “cumbersome, decentralized, and bureaucratic governance structure.” Many public health experts agree that WHO acted too slowly when it responded to the COVID-19 pandemic. The WHO only belatedly acknowledged that the coronavirus was airborne and that it could spread even in the absence of symptoms.

President Trump has echoed those criticisms while faulting WHO for praising China’s response to the coronavirus outbreak. President Trump has also made inaccurate statements about the relative financial contributions that member nations make to the WHO.

While it is fair to argue that the WHO did not recognize the spread of COVID-19 as quickly as it should have, it can hardly be WHO’s fault that Americans had a far higher death rate from COVID-19 than other wealthy nations. Health experts generally agree that the American public’s resistance to COVID-19 vaccinations and mask wearing explains the disproportionate death rate in the United States.

How Does WHO Benefit the United States?

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, suggests that Americans “don’t experience many of the infectious diseases we see around the world in large part because they are stopped in these countries, oftentimes through the support and coordination of the WHO.” Withdrawing support from WHO may impair the organization’s effectiveness in stopping the spread of diseases before they reach the United States.

Public health experts are also concerned that Americans will suffer if the CDC does not have immediate access to information about disease outbreaks in other parts of the world, leaving doctors unprepared if those diseases travel to the United States. The Trump administration has directed the CDC not to communicate in any way with WHO, including email conversations with WHO staff. That directive may rob America’s public health authorities of information they need to prepare for emerging epidemics.

How Does WHO Help Older Americans?

Protecting people who are most vulnerable to disease — including older adults — has long been a priority of WHO. The organization has made healthy aging a priority and has worked to align healthcare systems with the medical needs of older adults.

The WHO promotes social and technological innovation to support healthy aging. It adopted the term “active aging” in the 1990s to make clear that society should not be satisfied with the treatment of diseases suffered by older adults but should also assure that they age with dignity, maximize their independence and social participation, and have opportunities for self-fulfillment that enhance the quality of their lives. The WHO has also been one of the world’s leading proponent of policies that combat ageism.

Because the WHO is a clearinghouse for data, the CDC’s loss of easy access to that data may hamper [the agency’s ability to formulate responses to health threats that imperil older Americans. As UC-Berkeley Professor Stefano Bertozzi notes, “there is no way that you can isolate yourself from the world and be safe from the many health threats that don’t respect borders—infectious diseases being just one of those.”

It is difficult to see how vulnerable Americans, including older adults, will benefit from a decision to stop collaborating with other countries to stop global health threats before they cross the nation’s borders. Whether the Trump administration will carry out the president’s stated intent to withdraw from WHO remains to be seen, particularly if courts decide that withdrawal requires congressional action. Older adults may want to remind their elected officials that their access to quality care will likely be impaired if the president’s promise is fulfilled.