Domestic Returns to Predictable US Participation in the World Health Organization: Health Security and Cost

This analysis assesses the domestic health security, economic, and governance implications of prospective US withdrawal or sustained retrenchment from the World Health Organization (WHO) and identifies policy-relevant options for continued engagement. WHO provides irreplaceable global public goods, including international surveillance networks and emergency convening. Evidence indicates that episodic or unpredictable funding of WHO is associated with coordination failures, delayed threat detection, supply chain disruptions, and higher emergency response costs. Reduced US participation may increase import risks, reduce visibility into emerging threats, and diminish leverage over governance reforms. Sustained US participation in core WHO functions strengthens domestic health security and represents a fiscally prudent risk management strategy. US policy should prioritize multiyear funding for core WHO capacities globally. (Am J Public Health. 2026;116(9): 1409-1415. https://doi.org/10.2105/AJPH.2026.308463).