Sh36 billion debt row at heart of US-WHO divorce

The United States has entered its third week as a non-member of the World Health Organization (WHO), leaving behind a Sh36.1 billion (USD278 million) funding gap that the Trump administration has refused to settle.

The formal withdrawal, completed on January 22, 2026, has triggered an immediate fiscal emergency at the Geneva-based agency.

At the heart of the crisis is a dispute over mandatory membership dues.

WHO bylaws require departing members to settle all outstanding arrears before an exit is considered final.

However, the United States government has maintained it has no intention of making further payments.

In a joint statement released following the withdrawal, United States Secretary of State Marco Rubio and Health and Human Services Secretary Robert F. Kennedy Jr. argued that American taxpayers had already provided sufficient support.

They accused the WHO of pursuing a "politicised, bureaucratic agenda" and failing to reform its operations following the COVID-19 pandemic.

The administration has indicated it will bypass the WHO entirely, opting instead for bilateral health partnerships.

This shift marks the end of a 78-year era of American leadership within the multilateral health framework established in 1948.

The financial shortfall has prompted the WHO to initiate its most significant structural contraction in history.

The organisation has confirmed the elimination of approximately 2,300 positions, representing roughly 22 per cent of its global staff.

During the 158th session of the WHO Executive Board in early February 2026, Director-General Tedros Adhanom Ghebreyesus warned that while the agency is attempting to protect lifesaving work, "pockets of poverty" are emerging in critical areas.

These include emergency preparedness and antimicrobial resistance research.

The American exit and the resulting debt row pose a direct threat to public health infrastructure in Kenya.

The WHO provides the technical expertise and regulatory oversight required for the procurement of affordable vaccines and medications.

Key sectors currently at risk include:

• Polio Eradication: The Global Polio Eradication Initiative is facing a funding shortfall of approximately Sh57.2 billion (USD440 million). This has resulted in a 30 per cent budget reduction for operations scheduled for the 2026 calendar year.

• Disease Surveillance: By withdrawing, the U.S. has ceased participation in the Global Influenza Surveillance and Response System. This network is essential for monitoring viral mutations and developing annual flu vaccines.

• HIV/AIDS and Malaria: Programs heavily reliant on external technical guidance and funding are bracing for disruptions in drug procurement and prevention campaigns.

To mitigate the impact of the U.S. withdrawal, the WHO is encouraging member states to transition toward self-reliance.

The agency is advocating for "domestic resource mobilisation," which includes the introduction of higher health taxes on tobacco, alcohol, and sugary drinks to fund national healthcare systems.

While other member nations, including China and several European states, have increased their mandatory contributions, experts suggest these will not fully replace the lost American revenue.