As of January 22, 2026, the US has formally withdrawn from the World Health Organization (WHO) with the following repercussions:
- All US funding to the WHO has been terminated.
- All personnel and contractors assigned and working within the WHO have been recalled from several WHO headquarters.
- Hundreds of ongoing projects with the WHO and the US have been suspended or discontinued.
- The US is no longer an official participant in any committees, leadership bodies, technical groups, or governance structures within the organization.
The WHO has expressed its disappointment in this decision, citing many of the same concerns we discussed in our 2025 analysis. Last summer, I used Christensen’s Modularity Theory to forecast likely short- and long-term outcomes from the US WHO withdrawal. Theory suggests that the WHO is a deeply interdependent organization in which the US served as a key component.
The US withdrawal has been finalized, and we can already see Modularity Theory at work, particularly in the ongoing Ebola crisis.
Ebola is currently spreading through the Democratic Republic of Congo and Uganda, but this outbreak is different from prior ones. It’s spreading incredibly quickly, and there are no vaccines or drugs that can stop this version of the virus.
The current outbreak is from the Bundibugyo virus (different from the first ever discovered Ebola virus and the one we have a vaccine for, but in the same genus), which causes Ebola disease. There hasn’t been a need for treatment of Bundibugyo because previous outbreaks have been minor.
That all changed this spring.
WHO member nations are now left without US infrastructure and funding to fight the disease. Taking a closer look at how the US and the WHO are living up to the theory’s predictions may help predict the outcomes of this current crisis.
Where are they now? Modularity’s predictions from 2025.
Our predictions included that:
1. The WHO will need to diversify its cash flow and will likely see budget cuts due to significant drops in funding.
True. Following the US withdrawal, the WHO was forced to reduce its anticipated 2026-2027 budget by about 22%. This decision, brought about by President Donald Trump’s executive order back in January 2025, left a budgetary deficit of about $600M in immediate funding for the WHO through the end of 2025. To partially offset this deficit, WHO member states agreed to increase assessed contributions (i.e., membership dues) to the organization by 20%.
This increase means dues now account for 50% of the WHO’s budget, compared to 16% previously. Alone, this dues increase represents a relatively small amount compared to the budget deficit. When paired with the WHO’s budget reduction, this shows an effort by the WHO to create a sustainable, long-term structural fix that is less reliant on a large country like the US. Instead of taking on the impossible task of recouping this loss, the WHO made the difficult decision to implement deep structural cuts. Even so, the WHO is still seeing some lingering funding gaps.
2. Both the WHO and the US will struggle to quickly and effectively respond to global health emergencies.
True. We are seeing this play out in full force now as an Ebola epidemic spreads through Congo and Uganda. There was a four-week detection gap between the first symptomatic case and confirmation of an outbreak, a critical gap in disease response, which drastically worsened the extent of the outbreak. US officials didn’t learn about the outbreak until nine days after the WHO knew. At that time, about 1 month had passed since the first death.
Additionally, without USAID’s support (after it was eliminated), access to personal protective equipment (PPE) was limited at critical points during the outbreak of this epidemic. In its pre-2025 form, USAID could have moved PPE onto the scene within hours. Now, the US and WHO are trying to play catch-up on a disease outbreak with no known vaccine or treatment.
3. Global health communication will falter, and we will see a reduction in disease surveillance capacity.
True. There has been a notable gap in global health communication and surveillance capacity as Ebola spreads. We saw this in the delayed notification to the US after the WHO identified the outbreak. The WHO estimates that the disease was circulating for 2 months prior to the WHO identifying it. Contact tracing, disease surveillance, and testing remain severely limited without the crucial global health partnership between USAID and the WHO.
Historically, USAID has provided significant funding and implementation capacity to supplement the WHO’s technical expertise and disease surveillance. With domestic US funding cuts and the dismantling of USAID, this partnership no longer exists, and these containment measures have become more difficult to implement.
4. Scientific expertise will be limited globally, and access to experts will be insufficient.
True. The New York Times noted that due to recent US funding cuts, there’s been a significant loss of expertise and emergency teams that would have taken charge and helped control the epidemic. This scientific expertise was instrumental in the infamous Ebola outbreak back in 2014. Currently, several key staff positions in Congo and Uganda remain vacant. These roles are critical for effective outbreak response capacity.
As of July 2026, the CDC has deployed about 100 staff members domestically and internationally, with about 30 federal health service workers, including health professionals and engineers, separately preparing to travel to outbreak sites in Africa. The US State Department continues to engage with its global health partners to provide financial and operational support for the regional response.
5. Disease prevalence will increase.
True. Ebola infections are spreading rapidly over hundreds of miles, creating an enormous infectious footprint without the response capacity to stop it. Ebola has infected more than 1,000 people in Congo (a 38% increase in cases in one week), and nearly a fifth of these cases are children.
At this rate, experts say it is possible the outbreak could surpass the Ebola epidemic between 2014 and 2016 that killed over 11,000 people in West Africa.
6. Health care costs will increase.
Somewhat. It’s too early to determine if this has come to fruition yet. But globally, we will likely see increased out-of-pocket costs for lower-income countries as subsidized programs experience massive reductions in US support. The overall financial burden has increased for households, and access to critical health care services has been limited.
Currently, the largest expenses have fallen on WHO member nations as they increase their membership dues to cover the funding deficit. Still, without subsidized health programs typically led by US teams, people in these low- and middle-income countries will likely see increased household health care spending.
What does all of this mean?
As predicted, the US withdrawal from the WHO has significantly damaged the system’s performance and stability, even over a one-year time horizon.
Member nations rely on the strengths of others in order to supplement any weaknesses they may have on their own. Each nation relies on other nations to create a multilateral, functional global health response in crisis. Coordination within the WHO system is necessary to function as intended, but we’ve removed a key player, and we’re seeing performance suffer as a result.
As this analysis highlights, Modularity Theory provides critical insights into our world in real-time. My statements above lend support to the interdependent and highly integrated nature of the WHO.
None of this means that the WHO nor the US will completely crumble, but the next few years will be critical in determining the future for each.
However, there is hope on the horizon as world leaders recently gathered at the World Health Assembly, and governments are coming together to identify a way out of the Ebola crisis.
Current member nations are trying to create a new WHO that is less reliant on significant US funding, allowing them to leverage partial financing to improve disease surveillance and provide necessary PPE for frontline workers. The new financing structure for member nations (increased assessed contributions) lends hope to this vision. Scientists and nonprofit organizations are racing to find vaccines and treatments that will work for this virus.
And, the US State Department has now committed over $500 million (an amount equivalent to or greater than their annual WHO spend, on average) to support regional response efforts to the Ebola outbreak, including disease screening, surveillance, and treatment.
It’s my hope that the US has been reminded of how interdependent our global health system truly is, especially as it balances the recent Hantavirus outbreak, rising measles transmission, and now Ebola at its borders. It seems as though the US’s hand may be forced into a global health response, regardless of any America First ambitions.
What would a new WHO look like?
The WHO is hard at work finding new ways to diversify and strengthen its financial structure.
Over the last few years, the organization has had a limited base budget (from member dues) and expansive voluntary contributions earmarked for specified projects. As a result, diversification was necessary, even before the US left the WHO. In 2024, we saw the creation of the WHO’s Investment Round, similar in some ways to Gavi’s replenishment campaigns, to establish sustainable financing for the base budget. As mentioned, we have seen an increase in assessed contributions from member nations. The gap left by the US withdrawal remains unaddressed.
A new financing structure for the WHO could take many shapes. It could limit voluntary contributions to encourage any donors or member states to pay into an investment round or larger base budget. It could attract private capital, similar to what it’s doing with the WHO Foundation, and incentivize participation through de-risking measures and market guarantees. It could restructure its voting membership base to include a rotating council of major philanthropic and grassroots organizations.
The last one has interesting potential. Currently, non-governmental organizations (NGOs) don’t have voting power (they sit in an advisory capacity), yet the largest WHO donor to date is an NGO: the Gates Foundation. Many of these organizations work hand in hand with the WHO and local governments on the ground, implementing the WHO’s decisions.
While there are significant risks with increasing the decision power of the private and non-profit sectors in the WHO (e.g., prioritization of operational efficiency, focus on a return on investment, etc.), even minorly increasing the decision power of key players could give the WHO market-shaping capabilities and allow it to function more easily in states with instability.
By completely restructuring its composition, the WHO has a unique opportunity to pivot toward a more decentralized, peer-to-peer network that can work closely with community groups to provide basic, localized access to health care. A decentralized platform model could enable the WHO to respond to future outbreaks more quickly, especially without relying on a single member-state donor.
The WHO is at a turning point. It needs to decide whether its future will stick with the status quo or explore the unknown. As it stands, its financing model (or its budget targets) won’t last forever, but there are so many opportunities for the organization to become more agile and innovative, with or without the US.
As Ebola continues to rapidly spread and the US realizes how important global health can be, the WHO is perfectly positioned to bring every player back to the table. Sometimes all it takes is getting a bigger table to build a healthier, safer future for all of us.
