US exits WHO, leaves behind a $260 million bill and a mess over who pays

Washington’s formal exit from the World Health Organization is complete, but its unpaid dues are now at the centre of a legal, financial and diplomatic fight.

• US formally exits WHO, leaving $260 million in unpaid mandatory dues
• WHO faces budget cuts and program reductions due to missing US funding
• Legal and diplomatic questions remain over US obligation to pay arrears

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The United States has formally walked out of the World Health Organization. The paperwork is done, the door is shut, and the lights are still on. When the exit became official on January 22, 2026, the US left behind roughly $260 million in unpaid dues, triggering an awkward question that WHO officials and diplomats are now forced to confront: Can the world’s largest former donor simply leave without settling the bill?

The short answer, according to WHO records and international reporting, is no. The longer answer is where the trouble begins.

What the $260 million actually is

The $260 million figure comes straight from WHO’s own assessed contributions schedule for 2024–25, which lists the United States at 22 percent of the organisation’s mandatory budget, the highest share of any member state.

Under that schedule, the US owed $260.6 million for the two-year budget cycle, split evenly across:

$130.3 million for 2024

$130.3 million for 2025

These are assessed contributions, mandatory dues approved by the World Health Assembly and calculated using a UN-linked formula. They are not optional, not earmarked, and not subject to political discretion once approved.

Multiple media outlets, including Reuters and the Associated Press, have independently confirmed that these assessed dues remain unpaid as of the date the US withdrawal took effect.

That is the core of the 'debt' now hanging over the WHO.

Why some reports cite $130 million, not $260 million

The discrepancy has caused confusion, but the math is straightforward.

Some reports cite 'over $130 million' because they focus on one year’s unpaid dues, typically 2024. Others refer to 'around $260 million', which captures both years of the biennium, 2024 and 2025, neither of which has been paid.

WHO’s financial documents support the larger number. The smaller figure is a partial snapshot, not a contradiction.

What about voluntary funding?

This is where the picture gets murkier.

In addition to assessed dues, the US has historically been WHO’s largest voluntary donor, funding specific programmes ranging from disease surveillance to maternal health. According to Health Policy Watch and corroborated by budget documents, total expected US support for 2024–25, assessed plus voluntary, was well above $700 million.

However, unlike assessed contributions, voluntary funding operates through programme-level agreements. Some commitments may never have been contractually finalised; others may have been paused or cancelled once President Donald Trump ordered the withdrawal process in January 2025.

WHO officials have publicly confirmed the non-payment of assessed dues but have not issued a definitive public accounting of unpaid voluntary commitments, making the $260 million figure the only fully verifiable debt at this stage.

The legal wrinkle Washington can’t ignore

US law complicates the exit.

A federal statute governing WHO membership explicitly states that while the US may withdraw with one year’s notice, it must 'meet its financial obligations in full for the Organisation’s current fiscal year.'

That clause is why legal experts and former US health officials have questioned the legality of a withdrawal completed with dues outstanding. Reuters has reported that this issue is now being discussed internally at the WHO and among member states, though enforcement options are limited once a country has formally exited.

In practical terms, this is less about courtrooms and more about diplomacy (and reputation).

Why the unpaid dues matter to WHO

WHO’s approved programme budget for 2024–25 stands at $6.83 billion. The US has historically contributed about 18 percent of the WHO’s total funding, making its sudden departure and the missing dues financially destabilising.

The consequences are already visible:

• WHO has cut staff and senior management positions
• Programmes have been scaled back
• Budget assumptions have been rewritten without US participation

Reuters has reported that the WHO leadership has warned member states that the funding gap cannot be filled overnight.

Now what?

WHO’s Executive Board, meeting in February 2026, is expected to take up the issue of the US exit and outstanding obligations. While the WHO cannot suspend the voting rights of a former member, it can formally record the arrears and pursue diplomatic or negotiated remedies.

Whether Washington ever pays the $260 million remains unclear. The Trump administration has made no public commitment to settle the dues, and Congress would ultimately control any appropriation.

Why this story isn’t over

This is not just about money. It’s about precedent.

If a major power can exit a UN agency while leaving mandatory dues unpaid, it weakens the financial and legal scaffolding that holds multilateral institutions together. That is why diplomats, health officials and donor governments are watching this case closely.

For now, the US has left the building, but the invoice is still on the table.