Science
Leaving the W.H.O. Could Hurt Americans on a Range of Health Matters
![Leaving the W.H.O. Could Hurt Americans on a Range of Health Matters Leaving the W.H.O. Could Hurt Americans on a Range of Health Matters](https://static01.nyt.com/images/2025/01/24/multimedia/00WHO-01-lkbf/00WHO-01-lkbf-facebookJumbo.jpg)
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.
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Science
NIH Research Grants Lag Behind Last Year’s by $1 Billion
![NIH Research Grants Lag Behind Last Year’s by Billion NIH Research Grants Lag Behind Last Year’s by Billion](https://static01.nyt.com/images/2025/02/14/multimedia/14NIH-GRANTS-hbpv/14NIH-GRANTS-hbpv-facebookJumbo-v2.jpg)
Federal research funding to tackle areas like cancer, diabetes and heart disease is lagging by about $1 billion behind the levels of recent years, reflecting the chaotic start of the Trump administration and the dictates that froze an array of grants, meetings and communications.
The slowdown in awards from the National Institutes of Health has been occurring while a legal challenge plays out over the administration’s sudden policy change last week to slash payments for administrative and facilities costs related to medical research. A federal judge in Massachusetts has temporarily blocked the cutbacks, pending hearings later this month.
Federally funded research has driven major advances in cutting-edge gene therapies and immune-system-boosting treatments for certain cancers, cystic fibrosis and sickle cell disease.
The broader lag in funding is being felt at universities and medical centers from Baton Rouge to Boston, according to congressional lawmakers who are tracking it. Federal spending records show the allocations are about $1 billion lower than last year’s disbursements were at this time.
N.I.H. funding has ground to a halt in the past 10 days, according to Senator Tammy Baldwin, Democrat of Wisconsin.
“The president has completely stopped funding for research that discovers cures for diseases that devastate families across the country, like cancer and Alzheimer’s disease, all so he can give tax breaks to billionaires and big corporations,” Ms. Baldwin said in a statement on Friday. “Make no mistake, their efforts to rob Peter to pay Paul means crushing families’ hopes and dreams of having cures.”
It was not clear whether the stalled funding reflected an administrative backlog or efforts by Trump officials to defy the rulings of judges who have temporarily quashed efforts to freeze federal grant-making and spending.
In the first six weeks of 2024, the N.I.H. awarded more than 11,000 grants amounting to roughly $2.5 billion. During the same time period this year, the agency doled out about $1.4 billion, a figure hundreds of millions of dollars lower than the amount awarded within this period for the last six years. The agency issued about $36 billion in grants last year.
Some administration officials have criticized the research grants, saying they reflect a liberal bias and are dedicated to diversity and equity efforts. Some critics also contend that certain universities receive far larger outlays to cover overhead costs than other institutions.
A spokeswoman for the N.I.H. did not immediately return a request for comment.
Earlier this week, Senator Patty Murray, Democrat of Washington, tried to add a provision to a budget bill that would have restored the N.I.H. funding to agreed-upon levels. The effort failed on a party-line vote.
“Trump and Elon — either through sheer ignorance or a genuine lack of caring — are putting lifesaving research in America on life support,” she said in a statement, referring to the billionaire Elon Musk.
The N.I.H. has undergone considerable turmoil in recent days, with two high-ranking officials announcing sudden departures. The agency has no permanent leader in place yet, though Jay Bhattacharya, the Trump administration nominee and a Stanford professor, has begun to make the rounds in Congress as his confirmation hearings approach.
Robert F. Kennedy Jr., the secretary of the top federal health agency, has said he wants to back off on infectious disease research, a core N.I.H. study area, and focus instead on chronic diseases, which the agency also studies. The agency has 27 separate institutes and centers that fund studies and develop treatments for diseases like cancer and heart conditions as well as infectious diseases like AIDS and Covid.
Meetings at the agency — during which experts review grant applications and make funding recommendations — were abruptly canceled at the end of January after the new administration issued a sweeping communications ban, effectively halting the funding of new research. Some of those meetings have since resumed. The White House budget office also ordered a pause on all federal grants, which it rescinded days later.
The proposed cuts to indirect costs to medical research alone have been enough to raise deep concerns at Dartmouth and at other institutions.
“If the federal government cuts its investment, we will have to scale back on research, and cutting-edge science will be cut short,” Dean Madden, the vice provost for research at Dartmouth’s medical school, said at a news conference on Friday. “You don’t know what discoveries won’t be made as a result, but they might include a cure for some childhood cancer or treatment for Alzheimer’s or dozens of other diseases that are afflicting patients across our country.”
Science
Texas County Declares an Emergency Over Toxic Fertilizer
![Texas County Declares an Emergency Over Toxic Fertilizer Texas County Declares an Emergency Over Toxic Fertilizer](https://static01.nyt.com/images/2025/02/14/multimedia/14CLI-PFAS-blfv/14CLI-PFAS-blfv-facebookJumbo.jpg)
A Texas county is taking steps to declare a state of emergency and seek federal assistance over farmland contaminated with harmful “forever chemicals,” as concerns grow over the safety of fertilizer made from sewage.
Johnson County, south of Fort Worth, has been roiled since county investigators found high levels of chemicals called PFAS, or per- and polyfluoroalkyl substances, at two cattle ranches in the county in 2023.
The county says the PFAS, also known as forever chemicals because they don’t break down in the environment, came from contaminated fertilizer used on a neighboring farm. That fertilizer was made out of treated sewage from Fort Worth’s wastewater treatment plant. A New York Times investigation into the use of contaminated sewage sludge as fertilizer focused in part on the experience of ranchers in Johnson County.
PFAS, which is used in everyday items like nonstick cookware and stain-resistant carpets, has been found to increase the risk of certain types of cancer, and can cause birth defects, developmental delays in children, and other health harms.
County commissioners passed a resolution this week calling on Texas governor Greg Abbott to join the declaration, and seek federal disaster assistance.
“This is uncharted territory,” said Larry Woolley, one of the county’s four commissioners, in an interview. The funds, he said, would be put toward testing and monitoring of drinking water, cleanup, as well as euthanization of cattle contaminated from the soil, crops and water.
Johnson county is also pressing the state of Texas to block the use of sewage sludge to fertilize local farmland. “Ultimately, our goal is to stop the flow of contaminants into the county,” said Christopher Boedeker, a county Judge.
For decades, farmers nationwide have been encouraged by the federal government to use treated sewage sludge as fertilizer for its rich nutrients, and to reduce the amount of sludge that must be buried in landfills or incinerated. Spreading sewage on farmland also cuts down on the use of fertilizers made from fossil fuels.
But a growing body of research shows that the black sludge, made from the sewage that flows from homes and factories, can contain heavy concentrations of PFAS as well as other harmful contaminants.
Last month, under the Biden administration, the Environmental Protection Agency for the first time warned that PFAS-tainted sewage sludge used as fertilizer can contaminate the soil, groundwater, crops and livestock, posing human health risks.
The Biden administration also set drinking-water standards for certain kinds of PFAS and designated two of the chemicals as hazardous substances that must be cleaned up under the nation’s Superfund law. The future of those measures is uncertain under the Trump administration. The E.P.A. says there is no safe level of exposure to those two PFAS.
There has been little testing on farms. Maine is the only state that has started to systematically test farmland for PFAS, and has shuttered dozens of dairy farms found with contamination.
Johnson County is the first to directly seek federal assistance. It remained unclear, however, exactly how the county could tap federal funds, particularly amid the Trump administration’s freeze on federal spending.
President Biden’s Bipartisan Infrastructure Law had provided $2 billion in funding to address PFAS and other contaminants in drinking water. It is the future of funds like these, which must be requested at the state level, that remain uncertain in the new administration.
The Federal Emergency Management Agency also has funds available for well testing, which must be requested by states, though that money is typically distributed after natural disasters. President Trump has also targeted FEMA funding, saying he wants states to handle disasters without the federal agency’s help. The Department of Agriculture also offers assistance to farmers affected by PFAS contamination, but that program is currently limited to dairy farmers.
That leaves Johnson County in a bind.
While President Trump has been hostile to regulations, he also spoke on the campaign trail of “getting dangerous chemicals out of our environment.” And concerns about PFAS contamination have reached some deeply red states and counties, like Johnson County, which voted overwhelmingly for Mr. Trump.
The E.P.A. and FEMA did not provide comment.
In December, Texas attorney general Ken Paxton sued the largest PFAS makers, saying they knew about the dangers of these chemicals, but continued to market their use. The G.O.P.-controlled Texas state legislature is considering bills that set limits on PFAS in sludge fertilizer and require producers to test for the chemicals.
The state of Texas has not indicated whether they will back Johnson County’s declaration and support its request for federal assistance. The governor’s office did not respond to requests for comment.
Ricky Richter, a spokesman at the state’s environmental regulator, the Texas Commission of Environmental Quality, said the agency’s own analysis of PFAS levels discovered by Johnson County investigators did not suggest any harm to human health or the environment.
The agency did not immediately provide details of its analysis.
Johnson county officials said they stood behind their findings. The ranchers are suing the fertilizer provider, alleging that the contamination on their land was slowly sickening and killing their livestock. They are still caring for the surviving cattle, but are no longer sending them to market.
Science
A new bill could require California to monitor wastewater for disease in the Central Valley
![A new bill could require California to monitor wastewater for disease in the Central Valley A new bill could require California to monitor wastewater for disease in the Central Valley](https://ca-times.brightspotcdn.com/dims4/default/a0bbcb2/2147483647/strip/true/crop/6096x3200+0+432/resize/1200x630!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Ff2%2F80%2F359577144310a7e826b6b8224761%2F1152007-me-0628-wastewater-recycling-005-ik.jpg)
State Sen. Melissa Hurtado (D-Sanger) is frustrated by the lack of wastewater monitoring for H5N1 bird flu in the state’s most at risk communities: regions of the Central Valley where dairy workers, dairy herds and commercial poultry operations are most concentrated.
On Tuesday, she introduced a bill to fix that. Called the Wastewater Surveillance Act, if passed, it would require at least one wastewater monitoring site in every California county. The bill would require the state’s department of public health to expand its current wastewater network, known as Cal-SuWers, to include all counties “and prioritize underserved and high-risk areas.”
California is ground zero for the H5N1 bird flu virus in dairy cattle and dairy workers. Since the virus was first reported in dairy herds in March 2024, California has accounted for 77% of all U.S. dairy herd infections and 38 of the nation’s 68 human cases.
Hurtado has said her father and niece were both sickened last summer by an unknown respiratory virus. She said they live in the Central Valley near poultry and dairy operations — but they were not tested for H5N1.
The Central Valley, where the majority of California dairy herds are located, has been center of the outbreak. However, when it comes to wastewater surveillance — which health officials use to alert them to the presence and concentration of pathogens, such as H5N1, seasonal influenza, COVID-19 and norovirus — little is being done in this area of the state to monitor for the virus.
In fact, it’s nonexistent in some of the counties most at risk, including Tulare and Kings.
In California, health officials say they are monitoring 78 sites in 36 counties for a range of viruses; in all but two sites they say they are looking for bird flu.
“We have a bird flu outbreak. It’s running amok among dairy cattle and herds which are largely in the Central Valley,” said Hurtado. “And right now we don’t have any waste monitor, wastewater monitoring going on there. This law would change that.”
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