The United States' relationship with the World Health Organization has been a goddamn rollercoaster of political grandstanding, financial manipulation, and occasional moments of genuine global health leadership. For fifty years, America has swung between being the WHO's biggest supporter and its biggest pain in the ass, depending largely on which administration is in power and what political points they're trying to score.

In the 1970s, the US actually had its shit together regarding global health. Working closely with the WHO, America played a crucial role in the successful smallpox eradication program, proving what could be accomplished when the world's richest nation decided to act like a grown-up. The US contributed not just money but technical expertise, surveillance systems, and vaccine development capabilities.

Then came the 1980s, and things started getting messy. The Reagan administration, with its hard-on for free-market economics, began pushing back against WHO initiatives that didn't align with American corporate interests. The International Code of Marketing of Breast-milk Substitutes became a particular battleground, with the US being the only nation to vote against it. Because heaven forbid we regulate corporations pushing formula in developing countries.

The Clinton years brought a more balanced approach, but structural problems remained. The US consistently underpaid its WHO dues while demanding outsized influence in the organization's decision-making processes. It's like being that friend who never pays their full share of the dinner bill but always wants to pick the restaurant.

After September 11th, the US started viewing everything, including global health, through a security lens. The WHO became another tool in America's counter-terrorism arsenal, which wasn't entirely bad but definitely skewed priorities. Funding increased for programs that aligned with US security interests, while other crucial health initiatives got the short end of the stick.

The Obama administration tried to repair some damage, particularly during global health emergencies like the 2014 Ebola outbreak. The US showed it could still lead effectively when it wanted to, contributing significant resources and coordination capabilities. But structural tensions remained, particularly around issues of intellectual property rights and pharmaceutical profits.

Then came Trump, and holy fuck did things go off the rails. In the middle of a global pandemic, Trump decided to throw a temper tantrum and announce US withdrawal from the WHO. Here's one of his typical word salads on the subject: "The World Health Organization has failed in its basic duty and it must be held accountable... China has total control over the World Health Organization." This braindead move threatened decades of global health cooperation and demonstrated exactly how one narcissistic asshole could undermine international institutions.

The Biden administration quickly reversed Trump's withdrawal decision, but the damage was done. The US has to rebuild trust while simultaneously pushing for WHO reforms. It's like trying to renovate a house while apologizing for attempting to burn it down.

The US remains the WHO's largest financial contributor, providing about 15% of the organization's budget. But this seemingly generous contribution masks a more complex reality. As the world's richest nation, America actually contributes less as a percentage of GDP than many other developed countries. Plus, much of this funding comes with strings attached that serve US interests.

Despite political drama, the day-to-day technical collaboration between US health agencies and the WHO has remained remarkably productive. The CDC, NIH, and other American institutions continue to work closely with WHO researchers and experts. This scientific cooperation has survived even the worst political tensions, thank fuck.

US involvement has significantly influenced WHO's priority-setting, sometimes for better, sometimes for worse. American support has been crucial for:

However, US influence has also sometimes hindered progress on:

The US-WHO relationship faces several critical challenges moving forward. Climate change, emerging diseases, and global health inequities require unprecedented cooperation. America needs to decide whether it wants to be a genuine partner in addressing these challenges or continue its pattern of self-interested engagement.