Previously, the US had taken a leadership role in combating Covid-19 and strengthening global health security, as reflected in Executive Order 13987, which aimed to provide a unified government response to the pandemic. However, with the removal of the directorate, the administration has shifted its focus away from global health security frameworks.

One of the most consequential actions came on January 20, 2025, when President Trump officially withdrew the US from the World Health Organization (WHO). This move halted US funding, support, and resources to the WHO, and recalled all US government personnel or contractors working with the organisation. Trump justified the decision by citing the WHO's alleged mishandling of the Covid-19 pandemic, particularly its response in Wuhan, China, and its perceived failure to adopt necessary reforms and maintain independence from political influence, especially from China.

Trump also criticised the financial burden on the US, arguing that the country contributed disproportionately to the WHO compared to other member states. He highlighted that China, with a population significantly larger than that of the US, contributed nearly 90% less to the organisation. Given that the US previously provided 16-18% of WHO's total funding, amounting to $2.4 billion, this withdrawal represents a substantial shift in global health engagement and is expected to have significant repercussions for global health initiatives.

With a renewed focus on domestic health priorities, President Trump issued an executive order in February 2025 establishing the Make America Healthy Again Commission. This commission is tasked with investigating the root causes of escalating health issues in the US, initially focusing on childhood chronic diseases.

Further, the administration imposed a 90-day pause on foreign development assistance, leading USAID to issue a stop-work order on January 24, 2025. This temporary freeze affected foreign military financing for Israel and Egypt, emergency food assistance, and administrative spending, including foreign travel by US officials. In a move to downsize operations, USAID implemented a Reduction-in-Force strategy, cutting 1,600 personnel both domestically and overseas. Following a six-week review, secretary of state, Marco Rubio announced on March 10 that 83% of USAID programmes (5,200 contracts) had been cancelled, drastically reducing US emergency assistance, efforts to combat infectious diseases, and long-term global health development initiatives.

President Trump also reinstated and expanded the Mexico City Policy, restricting US funding to international organisations that provide or promote abortion services. This policy has significantly affected family planning services, particularly in Asia, Africa, and Latin America. Additionally, it has disrupted HIV prevention programmes that were integrated with reproductive health services. In line with this policy stance, the administration renewed its commitment to the Geneva Consensus Declaration on Promoting Women’s Health and Strengthening the Family, which rejects the notion of an international right to abortion.

Beyond the WHO, the US has withdrawn from other multilateral global health engagements. The administration announced that it would cease participation and funding for the United Nations Human Rights Council (UNHRC) and the United Nations Relief and Works Agency for Palestine Refugees (UNRWA). Additionally, a memorandum was issued to stop funding global health NGOs that are deemed to undermine national interests and administration priorities. Given that 62% of US global health funding flows through NGOs—with 45% allocated to US-based NGOs and 17% to foreign-based NGOs—this decision is expected to have widespread implications for global health initiatives.

The administration has also curtailed US participation in humanitarian aid and development efforts in the Global South. Significant reductions in USAID funding and the withdrawal from multilateral development initiatives have impacted critical infrastructure projects, food security programs, and health initiatives in developing nations. The policy shift has led to concerns over long-term economic stability and health outcomes in vulnerable regions that have historically relied on US aid.

Countries particularly affected include Ethiopia, where US cuts to humanitarian aid have exacerbated food insecurity and slowed efforts to combat famine and malnutrition in vulnerable populations. In Haiti, the reduction in USAID funding has hindered health and education programs, further destabilising an already fragile State. Bangladesh has also suffered due to funding cuts that have negatively impacted Rohingya refugee assistance programmes, affecting shelter, food, and healthcare provisions. Kenya has faced setbacks in family planning and HIV prevention programmes, previously funded by US assistance, due to the reinstated Mexico City Policy. In Yemen, humanitarian relief efforts, including emergency food assistance and health services, have been significantly reduced, worsening the humanitarian crisis in the war-torn country.

President Trump’s executive actions mark a fundamental shift in US global health policy The withdrawal from WHO and other multilateral engagements, coupled with the restructuring of USAID and restrictions on foreign assistance, have redefined America’s role in global health and humanitarian aid. While these policies align with the administration’s ‘America First’ agenda, they also raise concerns about the long-term impact on global health security, international cooperation, and the ability to respond effectively to future health crises.

This article is authored by Mehdi Hussain, research associate, Indian Council of World Affairs, New Delhi.