U.S. retreat from WHO harms global health and the HIV response

Epidemics know no borders; the role of institutions like the World Health Organization is critical.

Mitchell Warren, the executive director of the AIDS Vaccine Advocacy Coalition (AVAC), describes the damage that the Trump administration is causing by withdrawing the United States from the World Health Organization (WHO). This commentary was first published on the AVAC website.

COMMENTARY

On January 22, 2026, the United States took another giant step away from its role as a global leader, betraying American citizens and the rest of the world by withdrawing from the World Health Organization (WHO). Since 1948, WHO has been the United Nations agency tasked with directing global public health standards and guidelines and responding to health emergencies. 

The U.S. was a founding member of WHO and for over 75 years has both benefited from membership and contributed to its impact. By withdrawing from WHO now, this U.S. president has made Americans less safe, further damaged diplomatic relationships that the country relies on and will ultimately make us less healthy.

As one of the largest donors to the WHO, the U.S. has contributed significantly to many global health achievements, including important progress against HIV, TB and STIs and to advance pandemic preparedness and global health security. As former CDC official Dr. Demetre Daskalakis noted, the U.S. withdrawal will make it harder for the WHO to conduct disease surveillance, inform global research and the norms that guide it, coordinate pandemic responses and sustain hard-won progress on intractable health challenges. 

Epidemics know no borders and the role of institutions like WHO is critical. As Duke University’s Gavin Yamey told the public health news outlet Healthbeat, “There’s no other body that has the same global reach, representation, legitimacy and ability to convene experts and determine best scientific practice. [WHO’s] activities are the bedrock of global health. By weakening the WHO, the U.S. has made the world less safe—which in turn makes the U.S. less safe.”

WHO gathers data, sets scientific and medical standards and allows countries to benefit from shared information and health guidance. In HIV, WHO’s information, recommendations and technical guidance have allowed countries to track and follow which treatment, prevention and diagnostic options have been proven effective, are approved by stringent regulatory authorities, and have implementation guidance available alongside them. This work has been essential for both PEPFAR and the Global Fund to deliver on their missions. The U.S. withdrawal has also been devastating for WHO’s STI response, decimating funding that supports the team responsible for this work.

To end health challenges like HIV, TB and STIs and to prepare for future pandemics in the U.S., we must address them everywhere. For 30 years, AVAC has worked with partners to accelerate ethical development and equitable delivery of prevention tools as part of an integrated response to the epidemic. Our resources have helped guide the WHO response to HIV and planning for prevention and treatment trials in response to new health threats. Our global partnerships have helped ensure that civil society and community perspectives inform WHO’s research agenda and policy decisions, and, working with WHO, we have raised awareness of public health challenges. Over time, these partnerships have strengthened networks of advocates and provided channels through which civil society organizations and populations most affected have their voices heard and reflected in WHO processes, including the design and practice of clinical trials. 

We are now in a moment when global cooperation is more important than ever. Fragmenting access to information and dismantling shared global health governance will harm decision-making, divert research and program implementation and leave behind the coordinated systems that have helped accelerate introduction and access to treatment and prevention. 

The story of lenacapavir (LEN) for HIV prevention is a stark illustration of the deep cruelty in the U.S. decision to withdraw from WHO: LEN, a twice-yearly injectable pre-exposure prophylaxis (PrEP) option, has demonstrated near-perfect efficacy in preventing HIV infection in diverse populations and moved with unprecedented speed from clinical trials to regulatory approval and guidance. Its rapid adoption by WHO, which prequalified the drug and issued new guidelines recommending its use in record time, highlights the remarkable potential of science and political will to shift the course of this epidemic. 

WHO’s support for LEN exemplifies why sustained global cooperation matters. By offering guidance on how countries can adopt it for national HIV prevention programs—a U.S. State Department priority in its new “America First” Global Health Strategy—and working with partners to streamline regulatory pathways, WHO’s actions should help countries reach populations most at risk. But without U.S. support and funding for WHO leadership on this issue, countries may interpret evidence, plan for implementation and define access inconsistently, ultimately harming the global response. 

The cruelest irony is that lenacapavir’s promise to protect people with just two shots a year can only be realized if the global systems that enable access, equity and community-driven delivery remain strong. Cutting ties with WHO, scaling back global funding and sidelining civil society in decision-making does not protect health, it jeopardizes the infrastructure that gives life-saving innovations like LEN a chance to bend HIV epidemic’s trajectory and build a strong global health foundation to make the U.S. and the world safer, stronger and more prosperous.