Davos hangovers, the US withdrawal from WHO and the quiet unravelling of global health

By the time the private jets lift off from Davos, the world usually discovers what really happened while everyone was distracted by panels, platitudes and performative handshakes. This year is no different.

As the alpine snow settles and elites return home, congratulating themselves for “hard conversations”, a quiet decision landed with far more serious consequences: the US formally withdrew from the World Health Organization (WHO), alongside a broader retreat from 61 United Nations agencies.

It is hard to keep up with the pace of disruption. This week we saw alliances wobble and the global order lurch from one outrageous move to another. But amid the noise, the US’ exit from the WHO demands more than a passing headline. It deserves sustained attention, because this is not a symbolic withdrawal. It is a structural one, with profound implications for poor communities and global health security.

For decades, the WHO has been one of the most consequential institutions in the modern world. Its work rarely trends on social media, but its impact is etched into life expectancy charts and mortality rates across the Global South. Think of the eradication of smallpox and the near-elimination of polio. That’s what we are talking about here.

Add the coordinated vaccination campaigns that reach rural clinics long after cameras leave. Disease surveillance systems that catch outbreaks before they metastasise into global crises. Maternal health guidelines that quietly reduce deaths in childbirth. Pandemic preparedness frameworks built not for profit, but for survival. This is the work of the WHO!

One of the big themes that emerged after Covid-19 is health systems transformation. I have spent a considerable amount of time moderating high-level WHO convenings on building resilient national health systems. It was evident from the outbreak of the pandemic that across parts of Africa, South Asia, Latin America, fragile states suffer disproportionately.

Capacitating domestic health systems and empowering healthcare workers has been a priority for the WHO. For many citizens all over the world, the WHO is not an abstract bureaucracy in Geneva but a collective of technical expertise, supply chains, laboratories, data and credibility. It is the difference between early detection and mass graves.

So, why does Donald Trump have the WHO in his crosshairs?

The answer lies less in policy and more in politics. From his first term, Trump framed the WHO as a convenient antagonist – too multilateral, too deferential to China, too constraining of American sovereignty. During Covid-19 the organisation became an external villain and a scapegoat for domestic failure. So withdrawal was sold as strength.

It is worth remembering that the WHO is not a foreign imposition on the US; it is an institution that the US helped shape, fund and intellectually anchor. American epidemiologists, scientists, public health scholars and pharmaceutical researchers have long been embedded in WHO processes. US universities, laboratories and private firms benefited directly from WHO-coordinated research, data access and global trials. The flow of knowledge was never one-way charity; it was reciprocal power.

In funding the WHO, the US bought goodwill, exercised leadership and shaped norms, while also benefiting from the expertise and lived realities of the professionals who power the WHO from every corner of the globe.

Walking away from the WHO does not punish bureaucrats in Geneva. It punishes immunisation programmes in refugee camps. It weakens outbreak surveillance in countries where the next pandemic is most likely to emerge. And crucially, it makes Americans less safe. Viruses do not respect borders, slogans or electoral cycles. Global health security is indivisible, whether Washington likes it or not.

The irony is stark: the US has nothing tangible to gain from this withdrawal. There will be no fiscal windfalls, strategic advantage or improved health outcomes at home. What it loses, however, is immense credibility, leadership and the moral authority to convene in moments of crisis.

And the vacuum will not remain empty.

Other actors are already positioning themselves to fill the gap. China has steadily increased its engagement with WHO-linked health initiatives, particularly in Africa. The European Union, philanthropic foundations and emerging middle-income countries are stepping in where they can.

The broader retreat from UN agencies follows the same logic and the same mistake. Multilateral institutions are flawed, slow and often frustrating. But they are also the scaffolding of global cooperation. Walking away does not dismantle the world’s problems; it simply removes the tools designed to manage them.

As we shake off our Davos fatigue and scroll past glossy commitments to “global resilience”, this moment demands honesty. The US withdrawal from the WHO is not a bold reassertion of sovereignty. It is a self-inflicted strategic wound. The world will adapt. It always does. New coalitions will form. New funders will emerge. But the cost will be paid first by the poorest and eventually by everyone else. DM

Redi Tlhabi is a South African journalist, producer, author and former radio presenter.