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
CDC replaces website on vaccines and autism with false and misleading statements
The U.S. Centers for Disease Control and Prevention has altered its website on autism and vaccines, removing unequivocal statements that immunizations don’t cause the neurodevelopmental disorder and replacing them with inaccurate and misleading information about the links between the shots and autism.
Until Wednesday, the CDC page, “Autism and Vaccines,” began: “Studies have shown that there is no link between receiving vaccines and developing autism spectrum disorder (ASD).”
This was followed, in large font, by the blunt statement: “Vaccines do not cause autism.”
The rest of the page summarized some of the CDC’s own studies into autism and vaccine ingredients, none of which found any causal links between the two.
On Wednesday, the page was altered so that it now begins: “The claim ‘vaccines do not cause autism’ is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism.”
The words “Vaccines do not cause autism” still appear near the top, but with an asterisk that leads to a note at the bottom.
“The header ‘Vaccines do not cause autism’ has not been removed due to an agreement with the chair of the U.S. Senate Health, Education, Labor, and Pensions Committee that it would remain on the CDC website,” the site states.
The chair of that committee, Sen. Bill Cassidy (R-La.), cast the deciding vote to advance Robert F. Kennedy Jr.’s appointment as Health and Human Services secretary, in exchange for Kennedy’s promise that he wouldn’t erode public confidence in vaccines.
“What parents need to hear right now is vaccines for measles, polio, hepatitis B and other childhood diseases are safe and effective and will not cause autism. Any statement to the contrary is wrong, irresponsible, and actively makes Americans sicker,” Cassidy said in a post on X on Thursday afternoon. “Families are getting sick and people are dying from vaccine-preventable deaths, and that tragedy needs to stop.” Cassidy’s office did not immediately respond to further requests for comment Thursday.
“Studies supporting a link have been ignored by health authorities,” HHS spokesman Andrew Dixon said in an email. “We are updating the CDC’s website to reflect gold standard, evidence-based science.”
The news was met with outrage and alarm by scientists and advocates.
“Can we trust what’s coming from CDC anymore? I don’t know the answer to that question,” said Dr. Sean O’Leary, chair of the infectious disease committee at the American Academy of Pediatrics, adding that the website change reflects a “tragic moment” for U.S. public health.
“We are appalled to find that the content on the CDC webpage ‘Autism and Vaccines’ has been changed and distorted, and is now filled with anti-vaccine rhetoric and outright lies about vaccines and autism,” the nonprofit Autism Science Foundation said in a statement. “The CDC’s previous science- and evidence-based website has been replaced with misinformation and now actually contradicts the best available science.”
Alison Singer, the organization’s co-founder and president, expressed further frustration.
“Just like we no longer study whether the Earth is flat, at some point with regard to autism and vaccines, you have to call it and say ‘enough is enough,’” Singer said. “We don’t have an unlimited amount of money with which to study autism, and if we keep asking the same questions, we will never find the true causes of autism.”
The current CDC page now says the rise in autism diagnoses correlates with an increase in the number of vaccines given to infants. Multiple researchers have argued that the rise in autism spectrum disorder diagnoses is better explained by an expanding diagnostic definition of the disorder, along with better monitoring and diagnosis for more children.
“This issue has been studied exhaustively, and it has been shown over and over again that vaccines do not cause autism,” said Colin Killick, executive director of the Autistic Self-Advocacy Network. “This administration continues to lie about autism in ways that endanger both our community and the broader population.”
Science
California regulators approve rules to curb methane leaks and prevent fires at landfills
In one of the most important state environmental decisions this year, California air regulators adopted new rules designed to reduce methane leaks and better respond to disastrous underground fires at landfills statewide.
California Air Resources Board members voted 12-0 on Thursday to approve a batch of new regulations for the state’s nearly 200 large landfills, designed to minimize the release of methane, a powerful greenhouse gas produced by decomposing organic waste. Landfills are California’s second-largest source of methane emissions, following only the state’s large dairy cow and livestock herds.
The new requirements will force landfill operators to install additional pollution controls; more comprehensively investigate methane leaks on parts of landfills that are inaccessible with on-the-ground monitoring using new technology like drones and satellites; and fix equipment breakdowns much faster. Landfill operators also will be required to repair leaks identified through California’s new satellite-detection program.
The regulation is expected to prevent the release of 17,000 metric tons of methane annually — an amount capable of warming the atmosphere as much as 110,000 gas-fired cars driven for a year.
It also will curtail other harmful landfill pollution, such as lung-aggravating sulfur and cancer-causing benzene. Landfill operators will be required to keep better track of high temperatures and take steps to minimize the fire risks that heat could create.
There are underground fires burning in at least two landfills in Southern California — smoldering chemical reactions that are incinerating buried garbage, releasing toxic fumes and spewing liquid waste. Regulators found explosive levels of methane emanating from many other landfills across the state.
During the three-hour Air Resources Board hearing preceding the vote, several Californians who live near Chiquita Canyon Landfill — one of the known sites where garbage is burning deep underground — implored the board to act to prevent disasters in other communities across the state.
“If these rules were already updated, maybe my family wouldn’t be sick,” said Steven Howse, a 27-year resident of Val Verde. “My house wouldn’t be for sale. My close friend and neighbor would still live next door to me. And I wouldn’t be pleading with you right now. You have the power to change this.”
Landfill operators, including companies and local governments, voiced their concern about the costs and labor needed to comply with the regulation.
“We want to make sure that the rule is implementable for our communities, not unnecessarily burdensome,” said John Kennedy, a senior policy advocate for Rural County Representatives of California, a nonprofit organization representing 40 of the state’s 58 counties, many of which own and operate landfills. “While we support the overarching goals of the rule, we remain deeply concerned about specific measures including in the regulation.”
Lauren Sanchez, who was appointed chair of the California Air Resources Board in October, recently attended the United Nations’ COP30 climate conference in Brazil with Gov. Gavin Newsom. What she learned at the summit, she said, made clear to her that California’s methane emissions have international consequences, and that the state has an imperative to reduce them.
“The science is clear, acting now to reduce emissions of methane and other short-lived climate pollutants is the best way to immediately slow the pace of climate change,” Sanchez said.
Science
See How Home Insurance Premiums Are Changing Near You
Insurance premiums are rising fast in the parts of the United States most exposed to climate-related disasters like wildfires and hurricanes.
New research shows that, as insurance has sharply pushed up the cost of owning a home, the price shock is starting to reverberate through the broader real estate market.
Rising insurance costs are eating into household budgets.
In some areas of the country that are exposed to disasters, homes are not selling because prospective buyers can’t afford both the mortgage and the insurance.
In parts of the hail-prone Midwestern states, insurance now eats up more than one-fifth of the average homeowner’s total housing payments, including mortgage costs and property taxes. In Orleans Parish, La., that number is nearly 30 percent.
Home insurance costs have soared where climate hazards are highest.
Nationally, insurance rates have risen by an average of 58 percent since 2018, outpacing inflation by a substantial margin. But that growth has been highly uneven across the United States.
Places that are most vulnerable to climate-related disasters like hurricanes, fires and hail are seeing some of the largest premium increases. It’s not always the case that the highest climate risk translates into the highest insurance costs. Local policies and regulations have helped keep prices lower in high-risk places, like parts of California. Other factors, like a homeowner’s credit score, can affect premiums, too.
What’s driving up insurance prices?
Since 2017, an obscure part of the insurance market, known as reinsurance, has helped push up premiums. Insurance companies buy reinsurance to help limit their exposure when a catastrophe hits. Over the past several years, reinsurance companies have experienced what Benjamin Keys and Philip Mulder, the researchers who led the new study, call a “climate epiphany.” As a result, the rates they charge to protect home insurance companies against catastrophic losses have roughly doubled.
Insurance providers have, in turn, passed these costs on to homeowners. The rapid repricing of climate risk is responsible for about 20 percent of home insurance premium increases since 2017, according to Dr. Keys and Dr. Mulder.
What else is contributing to high rates? Rebuilding costs are responsible for about 35 percent of the recent changes, the research found. Population shifts and inflation are factors, too.
High insurance prices are weighing down home values.
Since 2018, a financial shock in the home insurance market has meant that homes in the ZIP codes most exposed to hurricanes and wildfires sell for an average of $43,900 less than they otherwise would have, the research found.
In many places, insurance has been a relatively small part of the homebuying equation. Now, for many, it’s a major consideration.
For several homeowners we interviewed in Louisiana, monthly insurance costs are now higher than their home loan payments.
The research shows buyers may be factoring rising insurance costs into the prices they’re willing to pay for homes. As a result, homes in some areas are selling for less.
Methodology
Benjamin Keys and Philip Mulder calculated annual homeowners’ insurance costs by separating mortgage and tax payments from loan-level escrow data obtained from CoreLogic, a property and risk analytics firm. Households whose payments were captured by CoreLogic were not necessarily present in all years of data from 2014 to 2024.
The home insurance share of total home payments is based on mean values. Total home payments include insurance, property tax and mortgage principal and interest costs. Escrow payments typically do not include utilities, homeowners’ association fees.
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