The Unraveling of Public Health: How Policy Shifts Exacerbate Preventable Diseases
The United States’ formal departure from the World Health Organization (WHO) in late January 2026 marks a significant and concerning juncture for global and domestic public health. This decision, initiated by the previous administration and finalized after a year of intent signaling, has been accompanied by a notable redirection of policy priorities within the nation’s public health apparatus. A key element of this shift has been the reduction of scientific oversight and the dismissal of the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP). This action has effectively weakened the country’s adherence to established international health standards, creating a more conducive environment for the resurgence of preventable infectious diseases.
The consequences of these policy choices are increasingly evident across a spectrum of infectious illnesses. The United States is currently experiencing its twelfth major wave of COVID-19, characterized by largely unchecked transmission rates. Recent estimates from the Pandemic Mitigation Collaborative (PMC) suggest that approximately 260 million SARS-CoV-2 infections have occurred in the U.S. during 2025, impacting roughly 76 percent of the population. This widespread transmission has resulted in an estimated 13 to 52 million new cases of long COVID and a level of excess mortality comparable to the nation’s leading causes of death.
Modeling conducted by the PMC indicates that COVID-19 is estimated to have caused between 81,000 and 175,000 excess deaths in 2025 alone. Even at the lower end of this range, the death toll rivals or exceeds the annual mortality burdens of chronic kidney disease, influenza, pneumonia, and diabetes. This places COVID-19 as the seventh or eighth leading cause of death in the United States.
Alarmingly, the immense scale of COVID-19-related mortality is largely obscured from public view. While the 2025-26 influenza season has garnered significant media attention, the U.S.'s withdrawal from the WHO has diminished its ability to participate in crucial global health initiatives. As a result, the country faces challenges in coordinating international responses to infectious disease threats. The WHO’s role in coordinating global health efforts, including disease surveillance and vaccine development, is significantly compromised by the U.S. absence.
The U.S. has historically been a major financial contributor to the WHO, with annual contributions reaching hundreds of millions of dollars. This funding has supported critical programs aimed at preventing and responding to infectious diseases, including efforts to combat Ebola, mpox, and the Marburg virus. The withdrawal has prompted the WHO to announce significant budget cuts, including the planned reduction of approximately 2,300 jobs and the downsizing of ten of its divisions.
The long-term impacts of the U.S. withdrawal extend beyond the immediate operational challenges for the WHO. The U.S. will no longer participate in the Global Influenza Surveillance and Response System, a vital network for monitoring influenza strains and developing corresponding vaccines. This absence could lead to mismatches between WHO recommendations and U.S. public health strategies, potentially increasing the burden of influenza-related illness and mortality within the country.
Furthermore, the U.S.’s diminished role in global health leadership could have reputational consequences, potentially hindering its ability to influence international health policy and coordinate multinational responses to future public health crises. Other nations, particularly China, may seek to fill the leadership vacuum created by the U.S. withdrawal, potentially shifting the balance of global health influence.
Despite the significant challenges posed by the withdrawal, there is potential for the U.S. to re-engage with the WHO in the future. The WHO has expressed a desire for the U.S. to reconsider its decision. In the interim, individual states, such as California, are exploring alternative avenues for participation in global health networks. Initiatives at the state level, often led by former public health leaders, aim to bolster domestic public health infrastructure and foster collaboration.
The U.S. withdrawal from the WHO represents a setback for global public health. It weakens international cooperation in addressing infectious disease threats and creates vulnerabilities within the United States. While the long-term consequences remain uncertain, the decision underscores the importance of sustained investment in public health and international health partnerships to effectively prevent and respond to the ever-evolving challenges to human health.
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