Science
Leaving the W.H.O. Could Hurt Americans on a Range of Health Matters
President Trump’s decision to withdraw the United States from the World Health Organization could have harsh consequences for countries around the world that rely on the agency to achieve important health goals, including routine immunizations, outbreak control and nutrition programs.
But it could also have unfortunate, unintended repercussions for Americans.
Disengaging from the W.H.O. would rob the United States of crucial information about emerging outbreaks like mpox and resurgent dangers like malaria and measles, public health experts said. It may also give more power to nations like Russia and China in setting a global health agenda, and it could hurt the interests of American pharmaceutical and health technology companies.
The W.H.O.’s work touches American lives in myriad ways. The agency compiles the International Classification of Diseases, the system of diagnostic codes used by doctors and insurance companies. It assigns generic names to medicines that are recognizable worldwide. Its extensive flu surveillance network helps select the seasonal flu vaccine each year.
The agency also closely tracks resistance to antibiotics and other drugs, keeps American travelers apprised of health threats, and studies a wide range of issues such as teen mental health, substance use and aging, which may then inform policies in the United States.
“There’s a reason why there was a W.H.O.,” said Loyce Pace, who served as an assistant secretary of health and human services under former President Joseph R. Biden Jr. “It’s because we saw value, even as a superpower, in the wake of the world war to come together as a global community on global problems.”
“America, no matter how great we are, cannot do this work alone,” she said.
Though it will take a year for the withdrawal to take effect — and it is not entirely clear that it can happen without congressional approval — Mr. Trump’s announcement has already prompted drastic cost-cutting measures at the W.H.O.
In a memo to employees, the director general, Dr. Tedros Adhanom Ghebreyesus, announced a hiring freeze and limited renegotiation of major contracts, adding that more measures would follow. He also said all meetings without prior approval should be fully virtual from now on and “missions to provide technical support to countries should be limited to the most essential.”
Late Sunday night, employees of the U.S. Centers for Disease Control and Prevention were instructed, effective immediately, to stop engaging with the W.H.O. in any way. The employees were later told not to participate in meetings or even email conversations that included W.H.O. staff.
The W.H.O. is often criticized as a lumbering bureaucracy, too conservative in its approach and too slow to action. Mr. Trump cited the organization’s “mishandling of the Covid-19 pandemic” as one of the main reasons the United States is pulling out.
Many public health experts have for decades called for reforms of the agency, noting that it is too timid in calling out its members’ missteps, holds a rigid view of what constitutes medical evidence and has too many areas of focus. The criticisms escalated during the pandemic, when the W.H.O. was months late in acknowledging that the coronavirus was airborne and that the virus could spread in the absence of symptoms.
Yet there is no other organization that can match the W.H.O.’s reach or influence in the world, said Dr. Thomas Frieden, who has worked with the W.H.O. for decades, including as a former C.D.C. director.
“Are there lots of things they could be better at? Of course,” he said. But, he added, “are they indispensable? Yes.”
For all its scope, the W.H.O. has a relatively modest budget, totaling about $6.8 billion for 2024 and 2025. For comparison, the health department of the tiny state of Rhode Island spent just over $6 billion in 2024 alone.
The United States is the W.H.O.’s largest donor, accounting for nearly 15 percent of its planned budget.
In the executive order, Mr. Trump complained that the W.H.O. “continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments,” adding that China contributes nearly 90 percent less.
Both of those assertions are inaccurate.
The obligatory fees are calculated according to each country’s population and income, using a formula approved by member states. For the two-year 2024-25 budget, that amount was $264 million for the United States and $181 million for China, a difference of about 31 percent.
Mr. Trump’s claim that China pays much less may have been based on voluntary contributions, which are usually motivated by specific interests such as polio eradication: The United States has so far provided $442 million in voluntary contributions for 2024-25, while China has given only $2.5 million. Even so, China’s total contribution is about 74 percent less than the United States’, not 90 percent.
Mr. Trump’s decision was “not based on sound, factual ground,” said Helen Clark, a former prime minister of New Zealand and former administrator of the United Nations Development Program.
On Monday, the Trump administration halted the distribution of H.I.V. drugs purchased with U.S. aid. Abruptly ending treatment will jeopardize the health of people living with H.I.V. and lead to more infections and may drive resistance to available medications, health experts warned.
The W.H.O.’s programs monitor drug resistance worldwide to antibiotics and medications for H.I.V., malaria and other diseases.
“These are not invincible drugs, and having that ability to know when resistance occurs and why we need to change strategies can be very important,” said Dr. Meg Doherty, who directs W.H.O. programs on H.I.V. and sexually transmitted infections.
“They are things that people in the United States should be aware of and should be concerned could come to them in the future,” she said.
If the United States loses access to the W.H.O.’s information and data sharing, online reports and informal communications may fill some of the void, but they may be muffled, filtered or marred by misinformation. And the W.H.O. and other countries are not obligated to share information, such as genetic sequences, with the United States, let alone heed its advice, if the country is not a member.
“If we’re not there, we don’t get to have a voice at all,” Dr. Frieden said.
The W.H.O. began in 1948 as a branch of the United Nations focused on global health. Over the decades, it led the eradication of smallpox, nearly vanquished polio and has helped control use of tobacco and trans fats.
Countries that do not have the equivalent of a C.D.C. or a Food and Drug Administration rely on the W.H.O. for public health guidelines, childhood vaccinations and drug approvals, among many other health efforts.
“Ministries of health typically won’t move unless there’s a W.H.O. guideline,” said Dr. Chris Beyrer, director of the Duke Global Health Institute and an adviser to the W.H.O.
That dynamic has implications for American businesses, allowing pharmaceutical and health technology companies to operate in countries that adhere closely to W.H.O. recommendations, said Anil Soni, chief executive of the W.H.O. Foundation, an independent entity that facilitates partnerships and funding for the organization.
“The U.S. won’t be at the table to set the evidence and quality standards that enable competitive positioning of U.S. companies and directly lead to U.S. business,” Mr. Soni said.
Mr. Trump and others have criticized the W.H.O. for not holding China accountable early in the pandemic, and for taking too long to declare the Covid-19 pandemic a public health emergency.
But the W.H.O. cannot reprimand its member countries, noted Ms. Clark, who was a co-chair of the Independent Panel for Pandemic Preparedness and Response, which led an inquiry into the W.H.O.’s response to the Covid-19 pandemic.
“W.H.O. has no power to compel countries to do anything,” Ms. Clark said. “It has only the power of persuasion. China was not transparent, and that hindered W.H.O.’s response.”
Mr. Trump has also said that China has too much influence over the W.H.O. But “actually, the real problem is that tiny Pacific islands with 100,000 people have too much power,” Dr. Frieden said.
“W.H.O. works by consensus, and so any country can throw a monkey wrench in and stop proceedings,” he said.
It is unclear whether Mr. Trump can unilaterally sever ties with the W.H.O. Unlike most international agreements, which may stem from executive action or require Senate ratification, membership in the W.H.O. was enshrined by a congressional joint resolution and may have to be dissolved in the same way.
“There’s a very good argument to be made that the president cannot do this himself — that is, without congressional participation,” said David Wirth, a former State Department official and an expert in foreign relations law at Boston College.
If Congress approves, the United States must still give one-year notice of withdrawal and fulfill its financial obligations for the year.
Some experts worry that Mr. Trump’s action will prompt nations like Hungary and Argentina, whose leaders are ideologically similar, to follow suit. Already, Italy’s deputy prime minister has proposed a law to leave the W.H.O.
U.S. withdrawal may also empower authoritarian member states in the organization, like Russia and China. Public health decisions in Russia and China are “much more politically controlled, and that’s a danger to everybody,” Dr. Beyrer said. “None of us wants to live in a world where Russia has a larger voice in global health governance.”
In his executive order, Mr. Trump said the United States would cease negotiations on amendments to the International Health Regulations, legally binding rules for countries to report emerging outbreaks to the W.H.O. But the latest amendments were adopted by the World Health Assembly last year and are expected to come into force in September.
Ironically, it was the first Trump administration that proposed the amendments because of frustration with the lack of transparency from certain countries during Covid-19, said Ms. Pace, who oversaw negotiations during the Biden administration.
Ms. Pace also led negotiations for a pandemic treaty that would allow countries to work together during an international crisis. The treaty had been stalled and may now collapse.
Science
Trump administration slashes number of diseases U.S. children will be regularly vaccinated against
The U.S. Department of Health and Human Services announced sweeping changes to the pediatric vaccine schedule on Monday, sharply cutting the number of diseases U.S. children will be regularly immunized against.
Under the new guidelines, the U.S. still recommends that all children be vaccinated against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV) and varicella, better known as chickenpox.
Vaccines for all other diseases will now fall into one of two categories: recommended only for specific high-risk groups, or available through “shared clinical decision-making” — the administration’s preferred term for “optional.”
These include immunizations for hepatitis A and B, rotavirus, respiratory syncytial virus (RSV), bacterial meningitis, influenza and COVID-19. All these shots were previously recommended for all children.
Insurance companies will still be required to fully cover all childhood vaccines on the CDC schedule, including those now designated as optional, according to the Department of Health and Human Services.
Health Secretary Robert F. Kennedy Jr., a longtime vaccine critic, said in a statement that the new schedule “protects children, respects families, and rebuilds trust in public health.”
But pediatricians and public health officials widely condemned the shift, saying that it would lead to more uncertainty for patients and a resurgence of diseases that had been under control.
“The decision to weaken the childhood immunization schedule is misguided and dangerous,” said Dr. René Bravo, a pediatrician and president of the California Medical Assn. “Today’s decision undermines decades of evidence-based public health policy and sends a deeply confusing message to families at a time when vaccine confidence is already under strain.”
The American Academy of Pediatrics condemned the changes as “dangerous and unnecessary,” and said that it will continue to publish its own schedule of recommended immunizations. In September, California, Oregon, Washington and Hawaii announced that those four states would follow an independent immunization schedule based on recommendations from the AAP and other medical groups.
The federal changes have been anticipated since December, when President Trump signed a presidential memorandum directing the health department to update the pediatric vaccine schedule “to align with such scientific evidence and best practices from peer, developed countries.”
The new U.S. vaccination guidelines are much closer to those of Denmark, which routinely vaccinates its children against only 10 diseases.
As doctors and public health experts have pointed out, Denmark also has a robust system of government-funded universal healthcare, a smaller and more homogenous population, and a different disease burden.
“The vaccines that are recommended in any particular country reflect the diseases that are prevalent in that country,” said Dr. Kelly Gebo, dean of the Milken Institute School of Public Health at George Washington University. “Just because one country has a vaccine schedule that is perfectly reasonable for that country, it may not be at all reasonable” elsewhere.
Almost every pregnant woman in Denmark is screened for hepatitis B, for example. In the U.S., less than 85% of pregnant women are screened for the disease.
Instead, the U.S. has relied on universal vaccination to protect children whose mothers don’t receive adequate care during pregnancy. Hepatitis B has been nearly eliminated in the U.S. since the vaccine was introduced in 1991. Last month, a panel of Kennedy appointees voted to drop the CDC’s decades-old recommendation that all newborns be vaccinated against the disease at birth.
“Viruses and bacteria that were under control are being set free on our most vulnerable,” said Dr. James Alwine, a virologist and member of the nonprofit advocacy group Defend Public Health. “It may take one or two years for the tragic consequences to become clear, but this is like asking farmers in North Dakota to grow pineapples. It won’t work and can’t end well.”
Science
For Oprah Winfrey, a croissant is now just a croissant — not a struggle
Yes, Oprah Winfrey has discussed her weight loss and weight gain and weight in general before — many, many times before. The difference this time around, she says, is how little food noise there is in her daily life, and how little shame. It’s so quiet, in fact, that she can eat a whole croissant and simply acknowledge she had breakfast.
“Food noise,” for those who don’t experience it, is a virtually nonstop mental conversation about food that, according to Tufts Medicine, rarely shuts up and instead drives a person “to eat when they’re not hungry, obsess over meals and feel shame or guilt about their eating habits.”
“This type of obsessive food-related thinking can override hunger cues and lead to patterns of overeating, undereating or emotional eating — especially for people who are overweight,” Tufts said.
Winfrey told People in an exclusive interview published Tuesday that in the past she would have been thinking, “‘How many calories in that croissant? How long is it going to take me to work it off? If I have the croissant, I won’t be able to have dinner.’ I’d still be thinking about that damn croissant!”
What has changed is her acceptance 2½ years ago that she has a disease, obesity, and that this time around there was something not called “willpower” to help her manage it.
The talk show host has been using Mounjaro, one of the GLP-1 drugs, since 2023. The weight-loss version of Mounjaro is Zepbound, like Wegovy is the weight-loss version of Ozempic. Trulicity and Victroza are also GLP-1s, and a pill version of Wegovy was just approved by the FDA.
When she started using the injectable, Winfrey told People she welcomed the arrival of a tool to help her get away from the yo-yo path she’d been on for decades. After understanding the science behind it, she said, she was “absolutely done with the shaming from other people and particularly myself” after so many years of weathering public criticism about her weight.
“I have been blamed and shamed,” she said elsewhere in that 2023 interview, “and I blamed and shamed myself.”
Now, on the eve of 2026, Winfrey says her mental shift is complete. “I came to understand that overeating doesn’t cause obesity. Obesity causes overeating,” she told the outlet. “And that’s the most mind-blowing, freeing thing I’ve experienced as an adult.”
She isn’t even sharing her current weight with the public.
Winfrey did take a break from the medication early in 2024, she said, and started to regain weight despite continuing to work out and eat healthy foods. So for Winfrey the obesity prescription will be renewed for a lifetime. C’est la vie seems to be her attitude.
“I’m not constantly punishing myself,” she said. “I hardly recognize the woman I’ve become. But she’s a happy woman.”
Winfrey has to take a carefully managed magnesium supplement and make sure she drinks enough water, she said. The shots are done weekly, except when she feels like she can go 10 or 12 days. But packing clothes for the Australian leg of her “Enough” book tour was an off-the-rack delight, not a trip down a shame spiral. She’s even totally into regular exercise.
Plus along with the “quiet strength” she has found in the absence of food noise, Winfrey has experienced another cool side effect: She pretty much couldn’t care less about drinking alcohol.
“I was a big fan of tequila. I literally had 17 shots one night,” she told People. “I haven’t had a drink in years. The fact that I no longer even have a desire for it is pretty amazing.”
So back to that croissant. How did she feel after she scarfed it down?
“I felt nothing,” she said. “The only thing I thought was, ‘I need to clean up these crumbs.’”
Science
Owners of mobile home park destroyed in the Palisades fire say they’re finally clearing the debris
Former residents of the Palisades Bowl Mobile Home Estates, a roughly 170-unit mobile home park completely destroyed in the Palisades fire, received a notice Dec. 23 from park owners saying debris removal would start as early as Jan. 2.
The Bowl is the largest of only a handful of properties in the Palisades still littered with debris nearly a year after the fire. It’s left the Bowl’s former residents, who described the park as a “slice of paradise,” stuck in limbo.
The email notice, which was reviewed by The Times, instructed residents to remove any burnt cars from their lots as quickly as possible, since contractors cannot dispose of vehicles without possessing the title. It followed months of near silence from the owners.
“The day before Christmas Eve … it triggers everybody and throws everybody upside down,” said Jon Brown, who lived in the Bowl for 10 years and now helps lead the fight for the residents’ right to return home. “Am I liable if I can’t get this done right now? Between Christmas and New Year’s? It’s just the most obnoxious, disgusting behavior.”
Brown is not optimistic the owners will follow through. “They’ve said things like this before over the years with a bunch of different things,” he said, “and then they find some reason not to do it.”
Earlier this year, the Federal Emergency Management Agency denied requests from the city and the Bowl’s owners to include the park in the U.S. Army Corps of Engineers cleanup program, which FEMA said was focused on residential lots, not commercial properties. In a letter, FEMA argued it could not trust the owners of the Bowl to preserve the beachfront property as affordable housing.
A tattered flag waves in the wind at Asilomar View Park overlooking the Pacific Palisades Bowl Mobile Estates.
(Myung J. Chun/Los Angeles Times)
The Bowl, which began as a Methodist camp in the 1890s, was purchased by Edward Biggs, a Northern California real estate mogul, in 2005 and split between his first and second wives after his death in 2021. The family has a history of failing to perform routine maintenance and seeking to redevelop the park into a more lucrative resort community.
After FEMA’s rejection, the owners failed to meet the City of L.A.’s debris removal deadlines. In October, the city’s Board of Building and Safety Commissioners declared the park a public nuisance alongside seven other properties, giving the city the authority to complete the debris removal itself and charge the owners the bill.
But the city has yet to find funds to front the work, which is expected to cost millions.
On Dec. 10, City Councilmember Traci Park filed a motion that would order the city to come up with a cost estimate for debris removal and identify funding sources within the city. It would also instruct the city attorney’s office to explore using criminal prosecution to address the uncleared properties.
The Department of Building and Safety did not immediately respond to requests for comment.
Despite the recent movement on debris removal, residents of the Palisades Bowl still have a long road ahead.
On Wednesday, numerous burnt out vehicles still remained at the Pacific Palisades Bowl Mobile Estates. The owners instructed residents they must get them removed as quickly as possible.
(Myung J. Chun/Los Angeles Times)
In mobile home parks, tenants lease their spaces from the landowners but own the homes placed on the land. Before residents can start rebuilding, the Bowl’s owners need to replace or repair the foundations for the homes; fix any damage to the roads, utilities and retaining walls; and rebuild facilities like the community center and pool.
The owners have not responded to multiple requests for comment, but in February, Colby Biggs, Edward Biggs’ grandson, told CalMatters that “If we have to go invest $100 million to rebuild the park and we’re not able to recoup that in some fashion, then it’s not likely we will rebuild the park.”
Mobile home law experts and many residents doubt that the Biggs family would be able to convert the rent-controlled mobile home park into something else under existing law. The most realistic option, should the Biggs decide against rebuilding, would be to sell the park to another owner — or directly to the residents, a course of action the residents have been actively pursuing.
The lack of communication and action from the owners has nonetheless left the Bowl’s eclectic former community of artists, teachers, surfers, first responders and retirees in limbo.
Many are running out of insurance money for temporary housing and remain unsure whether they’ll ever be able to move back.
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