The Trump administration is preparing executive orders that would clear the way to drastically reduce the United States’ role in the United Nations and other international organizations, as well as begin a process to review and potentially abrogate certain forms of multilateral treaties. The first of the two draft orders, titled “Auditing and Reducing U.S. Funding of International Organizations” and obtained by The New York Times, calls for terminating funding for any United Nations agency or other international body that meets any one of several criteria.

Those criteria include organizations that give full membership to the Palestinian Authority or Palestine Liberation Organization, or support programs that fund abortion or any activity that circumvents sanctions against Iran or North Korea. The draft order also calls for terminating funding for any organization that “is controlled or substantially influenced by any state that sponsors terrorism” or is blamed for the persecution of marginalized groups or any other systematic violation of human rights.

The order calls for then enacting “at least a 40 percent overall decrease” in remaining United States funding toward international organizations. The order establishes a committee to recommend where those funding cuts should be made. It asks the committee to look specifically at United States funding for peacekeeping operations; the International Criminal Court; development aid to countries that “oppose important United States policies”; and the United Nations Population Fund, which oversees maternal and reproductive health programs.

If President Trump signs the order and its provisions are carried out, the cuts could severely curtail the work of United Nations agencies, which rely on billions of dollars in annual United States contributions for missions that include caring for refugees.

As a general observation in considering this issue, it is worth remembering what proportion of the WHO budget comes from the USA.

WHO’s total approved budget for 2016-2017 was $4,385 million. This comes from two sources: 1) assessed contributions from the member countries (including the USA), which totalled $929 million (or 21.2% of the total) and voluntary contributions from a wide variety of donors, which amounted to $3456 million (or 78.8% of the total). So the overwhelming majority of WHO’s funding comes from voluntary, not government, sources.

The bills before Congress and other US executive decisions can only affect the assessed contributions – the government contribution. In 2016/17, the US is due to provide 21.18% ($227 million) of WHO’s assessed contributions. This is only about 5.2% of WHO’s overall budget.

A President can stop the flow of US government money to the UN system, but probably not – at least not without extreme measures –  other US money. To take the largest example, in 2015 the US-based Gates Foundation contributed more to the WHO budget than the entire US government.

I should stress that this is purely a financial argument. The loss of US government support to WHO (and the rest of the UN system) would be devastating politically and technically. Many government institutions – such as the National Library of Medicine (NLM) and the Centers for Disease Control and Prevention (CDC) – provide crucial technical support to many of WHO’s programmes.Presumably these institutions could be compelled to withdraw their technical support.

So cutting US government contributions to WHO would not be a financial killer. But if the US were to pull out completely, it would still be a disaster for global health.

To get an impression of what Trump can do to national agencies he doesn’t like take a look at

If he applies such strictures to US government organizations like the NLM or CDC, it would seriously impact global health. If he reins in USAID, PEPFAR, and the like, African health would be set back decades…

Cheers, Chris Zielinski

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