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d="M14.095479,10.316482L22.286354,1h-1.940718l-7.115352,8.087682L7.551414,1H1l8.589488,12.231093L1,23h1.940717 l7.509372-8.542861L16.448587,23H23L14.095479,10.316482z M11.436522,13.338465l-0.871624-1.218704l-6.924311-9.68815h2.981339 l5.58978,7.82155l0.867949,1.218704l7.26506,10.166271h-2.981339L11.436522,13.338465z" class="icon-fill" fill="none"/></svg> </button> </li> <li> <button data-social-sharing-linkedin class="a-icon-btn"> <span class="sr-only">Share on LinkedIn</span> <svg class="icon--linkedin" aria-hidden="true"> <use xlink:href="#icon--linkedin"></use> </svg> </button> </li> <li> <button data-social-sharing-permalink class="a-icon-btn"> <span class="sr-only">Copy link</span> <svg class="icon--link" aria-hidden="true"> <use xlink:href="#icon--link"></use> </svg> </button> </li> </ul> </div> </div> </div> <div class="o-article-header o-article-header--immersive-image o-article-header--bg-5"> <header class="g-header"> <div class="g-header__top" data-behavior="analytics"> <div class="g-header__left"> <button class="g-menu__toggle" data-menutoggle data-analytics-left-navigation> <span class="sr-only">Toggle side menu</span> <svg aria-hidden="true" class="icon--menu"> <use xlink:href="#icon--menu"></use> </svg> </button> </div> <div class="g-header__center"> <a class="g-header__logo" href="/"> <span class="sr-only">Go to homepage</span> <svg aria-hidden="true" class="icon--site-logo"> <use xlink:href="#icon--site-logo"></use> </svg> </a> </div> <div class="g-header__right"></div> </div> </header> <div class="o-article-header__text"> <a href="/topic/governance" class="m-card__label" data-analytics-eyebrows>Governance</a> <h1><span property="schema:name">U.S. WHO Exit Could Expand China's Influence </span> </h1> <p> Donald Trump's executive order could inadvertently pave the way for China to reshape global health governance </p> </div> <div class="o-article-header__image">  <img loading="eager" srcset="/sites/default/files/styles/max_325x325/public/2025-01/2019-06-29T030535Z_611972487_RC193D24B180_RTRMADP_3_G20-SUMMIT-TRUMP-XI.JPG?itok=WZ723SSj 325w, /sites/default/files/styles/max_650x650/public/2025-01/2019-06-29T030535Z_611972487_RC193D24B180_RTRMADP_3_G20-SUMMIT-TRUMP-XI.JPG?itok=LyJTdOpb 650w, /sites/default/files/styles/max_1300x1300/public/2025-01/2019-06-29T030535Z_611972487_RC193D24B180_RTRMADP_3_G20-SUMMIT-TRUMP-XI.JPG?itok=HxnnHHYa 1300w, /sites/default/files/styles/max_2600x2600/public/2025-01/2019-06-29T030535Z_611972487_RC193D24B180_RTRMADP_3_G20-SUMMIT-TRUMP-XI.JPG?itok=P_qKgVrh 2600w" sizes="(min-width: 1290px) 1290px, 100vw" width="325" height="204" src="/sites/default/files/styles/max_325x325/public/2025-01/2019-06-29T030535Z_611972487_RC193D24B180_RTRMADP_3_G20-SUMMIT-TRUMP-XI.JPG?itok=WZ723SSj" alt="U.S. President Donald Trump and China's President Xi Jinping pose for a photo ahead of their bilateral meeting during the G20 leaders' summit, in Osaka, Japan, on June 29, 2019. " typeof="foaf:Image" /> </div> <div class="o-article-header__caption"> U.S. President Donald Trump and China's President Xi Jinping pose for a photo ahead of their bilateral meeting during the G20 leaders' summit, in Osaka, Japan, on June 29, 2019. <span class="o-article-header__caption-credit">REUTERS/Kevin Lamarque</span> </div> </div> <div class="o-article-body" id="articleBody"> <div class="o-article-meta"> <span class="f-ui-1">by <a href="/author/yanzhong-huang">Yanzhong Huang</a> </span> <span class="f-caption"></span> <span class="f-ui-2"> <time datetime="2025-01-30T07:00:10-05:00" title="Thursday, January 30, 2025 - 07:00">January 30, 2025</time> </span> <ul class="m-social" data-behavior="share"> <li> <button data-social-sharing-facebook class="a-icon-btn"> <span class="sr-only">Share on Facebook</span> <svg class="icon--facebook" aria-hidden="true"> <use xlink:href="#icon--facebook"></use> </svg> </button> </li> <li> <button data-social-sharing-twitter class="a-icon-btn"> <span class="sr-only">Share on X</span> <svg class="icon icon-twitter" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" width="19px" height="19px" viewBox="0 0 24 24" style="enable-background:new 0 0 24 24;" xml:space="preserve"><path d="M14.095479,10.316482L22.286354,1h-1.940718l-7.115352,8.087682L7.551414,1H1l8.589488,12.231093L1,23h1.940717 l7.509372-8.542861L16.448587,23H23L14.095479,10.316482z M11.436522,13.338465l-0.871624-1.218704l-6.924311-9.68815h2.981339 l5.58978,7.82155l0.867949,1.218704l7.26506,10.166271h-2.981339L11.436522,13.338465z" class="icon-fill" fill="none"/></svg> </button> </li> <li> <button data-social-sharing-linkedin class="a-icon-btn"> <span class="sr-only">Share on LinkedIn</span> <svg class="icon--linkedin" aria-hidden="true"> <use xlink:href="#icon--linkedin"></use> </svg> </button> </li> <li> <button data-social-sharing-permalink class="a-icon-btn"> <span class="sr-only">Copy link</span> <svg class="icon--link" aria-hidden="true"> <use xlink:href="#icon--link"></use> </svg> </button> </li> </ul> </div> <div class="o-article-body__content" data-behavior="analytics"> <p><span lang="EN-US">Hours after his second inauguration, President Donald Trump announced that the United States would withdraw from the World Health Organization (WHO). To justify the decision, Trump </span><a href="https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/"><span lang="EN-US">cited</span></a><span lang="EN-US"> both the organization's alleged susceptibility to China's "inappropriate political influence" and the disproportionate financial burden on the United States, noting that despite China's population being three times larger, Beijing's contributions to the WHO remain nearly 90% smaller. </span><span> </span></p><p><span lang="EN-US"></span></p><p><span lang="EN-US">Yet even the staunchest supporters of Trump's decision find themselves contemplating an uncomfortable truth: Washington's withdrawal could inadvertently pave the way for Beijing's expanded influence in global health governance.</span><span> </span></p><p><span lang="EN-US">The notion that China must—or will—fill the United States' shoes at the WHO, however, fundamentally misreads Beijing's approach to global health leadership. China's strained relationship with the WHO and its clear preference for bilateral aid give it little appetite for matching U.S. contributions. Yet this might hardly matter. </span></p><p><span lang="EN-US">Through its Health Silk Road initiative, strategic personnel placement, and growing influence among developing nations, Beijing is carving a path to global health leadership that doesn't require writing big checks to Geneva. As Trump pursues a </span><a href="https://www.reuters.com/world/us/trump-raises-prospects-negotiated-reset-us-china-ties-2025-01-21/"><span lang="EN-US">potential G2 arrangement</span></a><span lang="EN-US"> with China and retreats from international institutions and commitments, he could help Beijing achieve precisely what his WHO withdrawal aimed to prevent: China's dominant influence in the international health agency. </span><span> </span></p><h4><span lang="EN-US"></span><span> </span><span lang="EN-US">China's Approach to Aid Funding</span><span> </span></h4><p><span lang="EN-US"></span></p><p><span lang="EN-US">Beijing's approach to international health funding reveals a strategic preference to maximize diplomatic leverage through direct bilateral assistance over multilateral commitments. Despite publicly </span><a href="http://www.news.cn/20250121/f442be65c67c4b3ba28964eff03635cb/c.html"><span lang="EN-US">advocating</span></a><span lang="EN-US"> for strengthening the WHO's role, China has shown a lack of interest in significantly increasing its multilateral funding. The country's response to the COVID-19 pandemic illustrated this approach: Only 8% of China's vaccines distributed internationally went through the WHO-supported multilateral COVAX mechanism. Even President Xi Jinping's ambitious </span><a href="https://cn.wsj.com/articles/%E4%B8%AD%E5%9B%BD%E5%9B%BD%E5%AE%B6%E4%B8%BB%E5%B8%AD%E4%B9%A0%E8%BF%91%E5%B9%B3%E6%89%BF%E8%AF%BA%E6%8F%90%E4%BE%9B20%E4%BA%BF%E7%BE%8E%E5%85%83%E7%94%A8%E4%BA%8E%E5%85%A8%E7%90%83%E6%8A%97%E7%96%AB-11589845511"><span lang="EN-US">pledge</span></a><span lang="EN-US"> at the World Health Assembly in May 2020, when he promised $2 billion for global pandemic control over two years, </span><a href="https://www.gavi.org/news/media-room/china-pledges-us-100-million-towards-equitable-access-covid-19-vaccines"><span lang="EN-US">allocated</span></a><span lang="EN-US"> just $100 million to COVAX—though this is China's largest voluntary pledge to an international organization to date.</span><span> </span></p> <blockquote class="m-pull-quote m-pull-quote--left_aligned"> <p>Washington's withdrawal could inadvertently pave the way for Beijing's expanded influence in global health governance</p> <span class="a-attribution"> </span> </blockquote> <p><span lang="EN-US">On the surface, filling the WHO funding gap does not appear insurmountable for China. The United States is </span><a href="https://open.who.int/2024-25/contributors/contributor?name=United%20States%20of%20America"><span lang="EN-US">slated</span></a><span lang="EN-US"> to give $261 million in assessed contributions (membership dues calculated based on a country's GDP) for the 2024–25 budget period. China's promise is $175 million for the same time frame. China's swift response during previous funding uncertainties—such as in April 2020 when it </span><a href="https://www.washingtonpost.com/world/asia_pacific/china-pledges-additional-30-million-funding-for-world-health-organization/2020/04/23/24f9b680-8539-11ea-81a3-9690c9881111_story.html"><span lang="EN-US">pledged</span></a><span lang="EN-US"> an additional $30 million on top of its earlier $20 million commitment following Trump's funding halt—suggests readiness to step up.</span><span> </span></p><p><span lang="EN-US"></span></p><p><span lang="EN-US">The reality, however, is more complex when considering the WHO's complete funding structure. Assessed contributions represent only a fraction of the organization's operating budget, with voluntary donations accounting for more than 80% of the total budget. China's approach to voluntary contributions has shown only modest increases despite significant growth in its assessed contributions. The disparity is striking: Whereas the United States provided approximately $700 million in voluntary contributions for 2024, China's voluntary funding amounted to less than $30 million. The total funding gap is substantial: China's combined contributions of $202 million pale in comparison with the United States's $959 million. This places China eighth among all donors, trailing nations such as Germany and the United Kingdom as well as private entities such as the Gates Foundation.</span><span>  </span></p><h4><span lang="EN-US">China and the WHO</span><span> </span></h4><p><span lang="EN-US"></span></p><p><span lang="EN-US">The evolution of China-WHO relations provides important context for understanding Beijing's funding decisions. China's 2020 funding commitments coincided with what many considered a honeymoon period in China-WHO relations. During its initial COVID outbreak, China viewed the WHO favorably for its support and defense against Western criticism. This goodwill was reflected in Chinese netizens affectionately </span><a href="https://www.voachinese.com/a/world-health-organization-needs-more-information-on-china-covid-situation-20221230/6897850.html"><span lang="EN-US">nicknaming</span></a><span lang="EN-US"> Director General Tedros Adhanom Ghebreyesus "Secretary Tan," a term typically reserved for Communist Party officials. This warmth, however, cooled following the release of the WHO-China joint study on the origins of the COVID-19 pandemic in March 2021. </span><span> </span></p><p><span lang="EN-US"></span></p><p><span lang="EN-US">Facing widespread criticism, the WHO adjusted </span><a href="https://apps.who.int/gb/COVID-19/pdf_files/2021/28_03/20210328-%20Full%20report.pdf"><span lang="EN-US">its stance</span></a><span lang="EN-US"> on the origins investigation and Tedros </span><a href="https://apnews.com/article/joe-biden-world-news-health-science-coronavirus-pandemic-c0c594f9060f676c0ea48c2d1c69daec"><span lang="EN-US">urged Chinese cooperation</span></a><span lang="EN-US">. In response, the Chinese media's tone also changed dramatically, </span><a href="https://www.sohu.com/a/716891180_121119017"><span lang="EN-US">accusing</span></a><span lang="EN-US"> Tedros of becoming "America's mouthpiece" and abandoning scientific neutrality. This strained relationship influenced funding discussions, China grudgingly accepting a 20% increase in assessed contributions in 2023 while </span><a href="https://www.sohu.com/a/716891180_121119017"><span lang="EN-US">criticizing</span></a><span lang="EN-US"> the adjustment as "unfair" and "unacceptable."</span><span> </span></p><p><span lang="EN-US"></span></p> <figure class="m-media m-media--image" > <div class="m-media__container"> <img loading="lazy" src="/sites/default/files/styles/max_1300x1300/public/2025-01/2021-02-03T053926Z_775707802_RC2TKL9TGQ1R_RTRMADP_3_HEALTH-CORONAVIRUS-WHO-CHINA.JPG?itok=1W-eLOsV" width="1300" height="867" alt="Security personnel keep watch outside Wuhan Institute of Virology during the visit by the WHO team tasked with investigating the origins of COVID-19, in Wuhan, China, on February 3, 2021." typeof="foaf:Image" /> </div> <div class="m-media__caption"> Security personnel keep watch outside Wuhan Institute of Virology during the visit by the WHO team tasked with investigating the origins of COVID-19, in Wuhan, China, on February 3, 2021. <span class="m-media__caption-credit">REUTERS/Thomas Peter</span> </div> </figure> <p><span lang="EN-US">Despite those challenges, China could enhance its WHO influence without matching U.S. contributions by leveraging its support from countries part of the Belt and Road Initiative and championing the goal of universal health coverage by 2030. China's recent $50 billion </span><a href="https://www.gov.cn/yaowen/liebiao/202409/content_6972495.htm"><span lang="EN-US">commitment</span></a><span lang="EN-US"> to African development for 2025 through 2027, which includes establishing joint medical centers, deploying 2,000 medical personnel, and supporting the Africa Centres for Disease Control and Prevention, marks a $10 billion increase from 2021. That funding also makes headway on achieving universal health coverage. By contrast, the new Trump administration appears to be retracting its international commitments. Secretary of State Marco Rubio ordered a </span><a href="https://www.cbsnews.com/news/rubio-orders-freeze-new-funding-u-s-foreign-aid-programs/"><span lang="EN-US">funding freeze</span></a><span lang="EN-US"> for nearly all U.S. foreign aid programs in late January 2025. </span><span> </span></p><p><span lang="EN-US">China can also capitalize on opportunities to place its citizens in WHO positions vacated by </span><a href="https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/"><span lang="EN-US">departing U.S. personnel and contractors</span></a><span lang="EN-US"> following Trump's decision to withdraw. China's systematic preparation for international leadership is evident in its educational initiatives. By 2020, </span><a href="https://link.springer.com/article/10.1007/s10734-022-00938-1"><span lang="EN-US">90% of China's top universities</span></a><span lang="EN-US"> had established specialized programs training students for careers in international organizations.</span><span> </span></p><p><span lang="EN-US">Furthermore, the U.S. withdrawal from various international commitments could create opportunities for a new form of bilateral cooperation between the United States and China, amplifying Beijing's global influence. Trump's recent statements suggest potential openness to this approach. In December 2024, as president-elect, he </span><a href="https://www.scmp.com/news/china/diplomacy/article/3291081/trump-says-china-us-can-work-together-solve-all-worlds-problems"><span lang="EN-US">expressed</span></a><span lang="EN-US"> optimism about U.S.-China collaboration "to solve all of the problems of the world." His January 2025 conversation with President Xi </span><a href="https://www.fmprc.gov.cn/eng/xw/zyxw/202501/t20250117_11538172.html#:~:text=As%20the%20most%20important%20countries,work%20together%20for%20world%20peace."><span lang="EN-US">emphasized</span></a><span lang="EN-US"> the importance of cooperation between the world's two largest economies. A leading Chinese think tank scholar </span><a href="https://news.qq.com/rain/a/20250121A06LJS00"><span lang="EN-US">views</span></a><span lang="EN-US"> these developments as a potential sign of the emergence of a G2 global governance structure, particularly given Trump's retreat from other international commitments. </span><span> </span></p><p><span lang="EN-US"></span></p><h4><span>Other Avenues of Influence </span></h4><p><span lang="EN-US"></span></p><p><span lang="EN-US">As this article is being written, DeepSeek's arrival at the top of the app store charts is </span><a href="https://www.bbc.com/news/articles/c9w5d9new0yo"><span lang="EN-US">shaking</span></a><span lang="EN-US"> the belief that Silicon Valley will remain at the forefront of artificial intelligence (AI) development. Despite U.S. restrictions on high-tech components, such as Nvidia's processing chips, the Chinese company succeeded by developing competitive AI technology at a fraction of the cost of U.S. companies' enormous capital investments. This mirrors a common misconception about China's potential role in global health governance—that expanding its influence would require matching U.S. funding levels at the WHO.</span><span> </span></p> <blockquote class="m-pull-quote m-pull-quote--left_aligned"> <p>China's approach to global health leadership suggests that closing the WHO funding gap with the United States might be neither necessary nor likely</p> <span class="a-attribution"> </span> </blockquote> <p><span lang="EN-US">Just as DeepSeek demonstrated that innovation born of necessity can produce transformative results, China's approach to global health leadership suggests that closing the WHO funding gap with the United States might be neither necessary nor likely. Instead, Beijing appears poised to reshape global health governance through alternative channels: strengthening bilateral health partnerships, expanding its Health Silk Road initiative, and strategically placing personnel in key positions within international organizations.</span><span> </span></p><p><span lang="EN-US">This suggests a broader pattern in how China approaches global leadership—not by following established Western models or meeting traditional metrics of influence, but by crafting alternative approaches that leverage its unique strengths and relationships with the developing world. As the United States steps back from multilateral commitments under Trump 2.0, the question becomes not whether China will fill the United States' shoes at the WHO, but how it might reshape the very nature of global health governance to better serve its strategic interests.</span><span> </span></p> <figure class="m-media m-media--image m-media--large" > <div class="m-media__container"> <img loading="lazy" src="/sites/default/files/styles/max_2600x2600/public/2025-01/2025-01-29T144237Z_1696818307_RC2LICA519BR_RTRMADP_3_TECH-AI-DEEPSEEK-ACCURACY.JPG?itok=Ipdct1of" width="2600" height="1734" alt="Deepseek app icon is seen in this illustration, on January 27, 2025." typeof="foaf:Image" /> </div> <div class="m-media__caption"> Deepseek app icon is seen in this illustration, on January 27, 2025. <span class="m-media__caption-credit">UTERS/Dado Ruvic/Illustration</span> </div> </figure> <div class="m-author-bio"> <p><span><span><span><span>Yanzhong Huang is a senior fellow for global health at the Council on Foreign Relations, where he directs the Global Health Governance roundtable series, and a professor at Seton Hall University's School of Diplomacy and International Relations.</span></span></span></span></p> </div> <ul class="m-tags"> <li><a class="a-tag" href="/tag/world-health-organization" data-analytics-tag-click>World Health Organization</a></li> <li><a class="a-tag" href="/tag/global-health" data-analytics-tag-click>Global Health</a></li> <li><a class="a-tag" href="/tag/covid-19" data-analytics-tag-click>COVID-19</a></li> <li><a class="a-tag" href="/tag/china" data-analytics-tag-click>China</a></li> <li><a class="a-tag" href="/tag/united-states" data-analytics-tag-click>United States</a></li> <li><a class="a-tag" href="/tag/donald-trump" data-analytics-tag-click>Donald Trump</a></li> <li><a class="a-tag" href="/tag/artificial-intelligence" data-analytics-tag-click>Artificial Intelligence</a></li> </ul> <ul class="m-social" data-behavior="share"> <li> <button 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