The U.S. has finalized its withdrawal from the World Health Organization, one year after President Donald Trump announced America was ending its 78-year-old commitment, federal officials said Thursday.

But it’s hardly a clean break.

The U.S. owes more than $130 million to the global health agency, according to WHO. And Trump administration officials acknowledge that they haven’t finished working out some issues, such as lost access to data from other countries that could give America an early warning of a new pandemic.

The withdrawal will hurt the global response to new outbreaks and will hobble the ability of U.S. scientists and pharmaceutical companies to develop vaccines and medicines against new threats, said Lawrence Gostin, a public health law expert at Georgetown University.

“In my opinion, it’s the most ruinous presidential decision in my lifetime,” he said.

The WHO is the United Nations’ specialized health agency and is mandated to coordinate the response to global health threats, such as outbreaks of mpox, Ebola and polio. It also provides technical assistance to poorer countries; helps distribute scarce vaccines, supplies and treatments; and sets guidelines for hundreds of health conditions, including mental health and cancer.

Nearly every country in the world is a member.

The U.S. has finalized its withdrawal from the World Health Organization, one year after President Donald Trump announced America was ending its 78-year-old commitment, federal officials said Thursday.

But it’s hardly a clean break.

The U.S. owes more than $130 million to the global health agency, according to WHO. And Trump administration officials acknowledge that they haven’t finished working out some issues, such as lost access to data from other countries that could give America an early warning of a new pandemic.

The withdrawal will hurt the global response to new outbreaks and will hobble the ability of U.S. scientists and pharmaceutical companies to develop vaccines and medicines against new threats, said Lawrence Gostin, a public health law expert at Georgetown University.

“In my opinion, it’s the most ruinous presidential decision in my lifetime,” he said.

The WHO is the United Nations’ specialized health agency and is mandated to coordinate the response to global health threats, such as outbreaks of mpox, Ebola and polio. It also provides technical assistance to poorer countries; helps distribute scarce vaccines, supplies and treatments; and sets guidelines for hundreds of health conditions, including mental health and cancer.

Nearly every country in the world is a member.

Gostin, an expert on international public health treaties and collaborations, said it’s unlikely the U.S. will reach agreements with more than a couple dozen countries.

Many emerging viruses are first spotted in China, but “is China going to sign a contract with the United States?” Gostin said. “Are countries in Africa going to do it? Are the countries Trump has slapped with a huge tariff going to send us their data? The claim is almost laughable.”

Gostin also believes Trump overstepped his authority in pulling out of WHO. The U.S. joined the organization through an act of Congress and it is supposed to take an act of Congress to withdraw, he argued.

US still owes money, WHO says

The U.S. is legally required to give notice one year in advance of withdrawal — which it did — but also to pay any outstanding financial obligations.

The U.S. has not paid any of its dues for 2024 and 2025. leaving a balance of more than $133 million, according to WHO.

An administration official denied that requirement Thursday, saying the U.S. had no obligation to pay prior to withdrawing as a member.

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