Understanding the U.S. Withdrawal from the World Health Assembly and the Abstention of 11 Other Nations on the WHO Pandemic Agreement

The World Health Assembly (WHA) is the forum through which the World Health Organization (WHO) is governed by its 194 member states.

The WHO pandemic agreement was accepted after a vote in the Committee, where 124 members said yes and 11 refused to vote.

The United States has skipped the World Health Assembly (WHA) for the first time since its inception in 1948.

However, they were not alone in their decision, as 11 other countries including Bulgaria, Egypt, Iran, Israel, Italy, Jamaica, the Netherlands, Paraguay, Poland, Russia, and Slovakia, abstained from voting on the WHO pandemic agreement. 

Global support is growing for the U.S. and 11 other countries that abstained from voting on the recent WHO pandemic agreement.

For the first time since 1948, the United States chose not to attend the World Health Assembly (WHA). On the other hand, China sent a huge group of over 180 delegates, which might be their biggest team ever. This group includes many top health officials and experts from the Ministry of Health and the Centers for Disease Control, as well as leading scholars from universities all over China. The assembly is happening from May 19 to May 27.

China’s 180 delegates: https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_DIV1-en.pdf [copy and paste the link]

The US’s withdrawal from WHO is set for January 2026, and its funding contributions have significantly decreased, leading to a drastic budget cut for WHO. 

Why Did the US Choose Not to Participate?

Secretary Kennedy, a prominent figure in the United States government, has been vocal about holding the WHO accountable for its actions. In a recent statement to the World Health Assembly, Secretary Kennedy criticized the organization for its bureaucratic inefficiencies and conflicts of interest, highlighting the need for greater transparency and oversight. He also raised concerns about China’s influence over the WHO, calling attention to the ways in which certain countries have used their power to manipulate the organization to their advantage.

Why did other countries abstain from voting?

Each country had its reasons for not supporting the treaty.

1. Poland: The Polish delegate cited the need for a domestic review as the reason for not supporting the agreement.
2. Russia: Russia expressed concerns about national sovereignty, which influenced its decision to abstain from voting.
3. Iran: The Iranian representative highlighted that the treaty did not address key concerns of developing countries, such as unhindered access to medical countermeasures and technology transfer. They also expressed regrets about the lack of binding commitments on equitable access to medical resources.
4. Slovakia: Prime Minister Robert Fico’s skepticism about COVID-19 vaccines might have contributed to the country’s decision to abstain from voting on the agreement.
   
5. Overall, these countries had varying reasons for abstaining from voting on the WHO pandemic agreement, showcasing the complexity and diversity of perspectives in global health governance.

There are two main committees in which each Member State delegation participates during the WHA—the first is Committee A (focused on program and budget matters) and the second is Committee B (handling administrative, financial, and legal issues).

To explain step by step:

1. The WHA’s proceedings are structured so that agenda items are discussed in two distinct committees. Committee A focuses primarily on the programme and budget aspects of WHO’s work, whereas Committee B deals with administrative, financial, and legal matters. This structure is common to ensure that each Member State delegation can concentrate on the different facets of WHO’s decision‐making process.
2. The WHA’s proceedings are structured so that agenda items are discussed in two distinct committees. Committee A focuses primarily on the program and budget aspects of WHO’s work, whereas Committee B deals with administrative, financial, and legal matters. This structure is common to ensure that each Member State delegation can concentrate on the different facets of WHO’s decision‐making process
3. Although other bodies such as the General Committee and the Executive Board exist under the WHA framework, the “committee by Member State delegation” mechanism refers to the two primary committee sessions (Committee A and Committee B) where each country’s delegation is present and has the opportunity to contribute.
4. By design, every Member State delegation is expected to actively engage in both of these sessions, thereby ensuring that the full scope of policy, budget, and administrative concerns are addressed from all member states.

Thus, based on these official descriptions and discussions in authoritative WHO documents and related reports, the answer is: two committees

Ref: https://en.wikipedia.org/wiki/World_Health_Assembly

The WHA’s 194 member states will review approximately 75 agenda items during the extensive eight-day session.

Ref: https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_1Rev1-en.pdf

The Assembly will look at new ideas and plans to tackle climate change, health issues, air pollution, antibiotic/antimicrobial resistance, and mental health, among other things.

Pledges to the WHO Investment Round

The Investment Round, launched by WHO in May 2024, aims to mobilize predictable and flexible resources from a broader base of donors for WHO’s core work for the period 2025–2028. The funding requirement at the time the Investment Round was launched was US$ 7.1 billion. 

The Investment Round is an inclusive engagement process, and existing and potential new donors were and are invited to make commitments.

Pandemic Agreement Negotiations

• WHA approval of the Pandemic Agreement is not the final step.
• Negotiations on an annex for e pathogen access and benefit-sharing (PABS) system are required before ratification.
• Developed countries aim for free access to pathogen samples and genetic sequencing to accelerate medical product development.
• Developing nations seek assured supply of “benefits” in medicine and vaccines from pathogen information sharing.
• Fixed formulas for “benefit sharing” are challenging due to pandemic-specific medicine and vaccine needs.
• The agreement will not be open for signature immediately after the main text of the Pandemic Agreement is adopted.

Source: nmpa-image