The withdrawal of the United States from the World Health Organisation (WHO) constitutes a significant disruption to the architecture of international health governance,[1] with major implications for funding, cooperation, and disease surveillance worldwide.[2] The U.S. has historically been the largest funder and leading voice in global health initiatives, so its decision to exit the WHO substantially impacts ongoing global health efforts and the organisation’s agenda-setting power.[3] In particular, the resulting budget deficit has forced the WHO to scale back programs and reduce staff, leaving a funding void for crucial operations—especially in low- and middle-income countries that depend on WHO support for essential services.[4] Uganda provides a compelling case study here, given its reliance on WHO coordination, technical assistance, and norm-setting to support its public health system. The WHO Country Office in Uganda is deeply involved in health sector planning, emergency response (like during the Ebola outbreak), and development of operational plans, in addition to supporting major immunisation and disease-control initiatives.[5] Despite chronic underfunding and a stagnant government health budget, Uganda has made important gains in areas like immunisation coverage—gains that are closely linked to longstanding WHO support and collaborative projects with partners such as the CDC.

 WHO, International Cooperation, and Shared Responsibility

The United States, as the WHO’s largest historical contributor, played a decisive and multidimensional role in sustaining the organisation’s core functions, including global emergency response capacity, international disease surveillance networks, and the provision of technical assistance to low-income and aid-dependent countries.[6] The consistent financial support of the U.S.—often accounting for up to 20% of the WHO’s biennial budget—underpinned major immunisation campaigns, rapid pandemic response, research and development pipelines, and the deployment of expert technical teams to health crises in resource-constrained settings.[7] For example, U.S. contributions through both assessed and voluntary channels have supported WHO’s Global Influenza Surveillance and Response System, polio eradication, and urgent field responses to outbreaks such as Ebola and mpox, while sustaining training initiatives and laboratory capacity building in sub-Saharan Africa.[8] By underwriting the WHO’s operations at this scale, the United States empowered the international community to address both endemic and emergent public health threats in a coordinated manner.

Following its abrupt withdrawal in January 2026, these mechanisms have been significantly weakened. The resulting gap in WHO’s funding has triggered budgetary shortfalls, forced programmatic cuts and staff reductions, and compromised the organisation’s capacity to maintain disease surveillance and coordinate emergency responses globally.[9] Low- and middle-income countries, whose public health systems are most dependent on WHO support, are particularly exposed to this disruption, facing increased risks in areas such as vaccine-preventable disease outbreaks, supply chain maintenance, and pandemic preparedness. Analytical reports warn of a broader fragmentation in international response systems, making disease detection slower and less reliable and undermining collective efforts to realise the right to health.

From a legal perspective, this raises substantial questions regarding the consistency of unilateral withdrawal with the international duty to cooperate in the realisation of economic, social, and cultural rights. These obligations—articulated in instruments including the International Covenant on Economic, Social and Cultural Rights, and supported by customary legal principles—emphasise the need for concerted, good-faith action among states to progressively fulfil the right to health.[10] The U.S. withdrawal thus not only curtails technical and financial contributions to global health but also challenges the integrity of multilateral cooperation required by international law, raising concerns about the erosion of legal and ethical responsibilities that underpin the protection of health as a universal human right.[11]

IMPLICATIONS FOR UGANDA’S RIGHT TO HEALTH

The 1995 Constitution of Uganda establishes public health as one of its directive principles of state policy, particularly under Objective XXVII, which places a duty on the State to ensure access to medical services and to prevent disease. While not directly justiciable, these principles guide the interpretation of other rights, such as the rights to life and dignity.[12] Uganda’s public health system is characterised by high burdens of communicable and non-communicable diseases, such as malaria, HIV/AIDS, tuberculosis, and periodic outbreaks of viral hemorrhagic fevers.[13] Fiscal constraints limit the government’s ability to provide comprehensive health coverage, resulting in heavy reliance on external technical and financial support—most notably from the World Health Organisation.[14]WHO assistance has been critical in strengthening Uganda’s compliance with the International Health Regulations (2005) (IHR), supporting surveillance systems, enhancing laboratory diagnostic infrastructure, training epidemiologists, and mounting rapid responses to public health emergencies.[15] For instance, collaboration with the WHO has enabled Uganda to detect and contain Ebola outbreaks quickly and to build case-tracking and laboratory networks aligned with international standards.[16]

The reduction of WHO resources as a consequence of the U.S. withdrawal presents acute risks to these hard-won capacities. ⁵ With less funding and fewer technical resources available, Uganda faces the prospect of weakened disease surveillance, impaired laboratory functioning, and slower outbreak response—all of which undermine the enjoyment of the right to health, especially for rural and marginalised communities. Empirical analyses warn that the capacity for pandemic preparedness, vaccine distribution, and rapid diagnostics may deteriorate, with tangible effects on preventable morbidity and mortality.

From a human rights perspective, such diminished surveillance and delayed response could constitute retrogressive measures, particularly if an increase in preventable disease or death is observed.⁶ General Comment No. 3 and No. 14 of the Committee on Economic, Social and Cultural Rights (CESCR) establish a strong presumption against the permissibility of retrogressive measures in realising economic and social rights, including the right to health, unless governments can show that the most compelling resource constraints justify the action and that all alternative means have been exhausted.⁷ Uganda’s limited fiscal and technical capacity to replace lost WHO support, therefore, heightens the risk of rights regression, especially among vulnerable groups such as children, women, persons living with HIV, and refugees. The situation exemplifies the interconnectedness of international assistance, state capacity, and the realisation of rights under evolving global health governance.

Conclusion

For Uganda, the consequences of such disruptions are not merely administrative or financial, but fundamentally legal and normative, with direct implications for its ability to comply with obligations under the International Covenant on Economic, Social and Cultural Rights (ICESCR)—in particular Article 12, which guarantees the right to the highest attainable standard of physical and mental health.[17]Uganda is required not only to respect and protect the right to health, but also to fulfil it through concrete legislative, administrative, and budgetary measures, in accordance with the principle of progressive realisation. This obligation is accompanied by the requirement to seek and make effective use of international cooperation and assistance.[18] The Committee on Economic, Social and Cultural Rights has clarified that, regardless of available resources, States must always ensure the immediate satisfaction of minimum core obligations—including access to essential primary health care, essential medicines, and effective disease prevention and control.[19] Any failure to provide for these minimum standards, particularly due to avoidable disruptions or insufficient international support, constitutes a prima facie violation of the right to health.[20] For Uganda, reliant on the WHO’s technical and financial assistance for these very aspects of public health, the curtailment of such support elevates the risk of non-compliance with its binding core obligations under the ICESCR.

[1]TIME, ‘The U.S. Has Pulled Out of the WHO. Here’s What That Means for Public Health’ (22 January 2026)

[2] The Conversation, ‘How the U.S. withdrawal from WHO could affect global health powers and disease threats’ (20 January 2026)

[3]Implications of U.S. withdrawal from the World Health Organisation on health financing in Africa (8 May 2025)

[4]Johns Hopkins Bloomberg School of Public Health, ‘The Consequences of the U.S.’s Withdrawal from the WHO’ (30 January 2025)

[5]WHO Uganda, ‘WHO Uganda Annual Report 2022’ https://www.afro.who.int/sites/default/files/2024-

[6] World Health Organisation, ‘Top Donors: United States of America’ (WHO, 23 December 2024) https://www.who.int/about/funding/contributors/usa  accessed 24 January 2026; L. Mugisha et al, ‘Implications of U.S. withdrawal from the World Health Organisation on health financing in Africa’ (2025) 4(2) Global Health 77 https://www.sciencedirect.com/science/article/pii/S2590229625000073

[7]World Health Organisation, ‘The United States and WHO: A Partnership for Global Health Security’ (WHO, 23 December 2024) https://www.who.int/news-room/feature-stories/detail/the-united-states-and-who-a-partnership-for-global-health-security accessed 24 January 2026; Statista, ‘Leading voluntary contributors to the World Health Organisation’ (2025) https://www.statista.com/statistics/1299898/who-voluntary-contributions-top-donors/

[8]Centres for Disease Control and Prevention, ‘CDC and WHO Collaboration’ https://www.cdc.gov/global-health/what/cdc-who-collaboration.htm

[9]Johns Hopkins Bloomberg School of Public Health, ‘The Consequences of the U.S.’s Withdrawal from the WHO’ (30 January 2025) https://publichealth.jhu.edu/2025/the-consequences-of-the-us-withdrawal-from-the-who‘At risk of retreat: How WHO’s restructuring and member state withdrawals could undermine global health R&D’ (GHTC Blog, 23 January 2026) https://www.ghtcoalition.org/blog/at-risk-of-retreat-how-who-s-restructuring-and-member-state-withdrawals-could-undermine-global-health-r-dOpens a new window accessed 24 January 2026

[10]International Covenant on Economic, Social and Cultural Rights (adopted 16 December 1966, entered into force 3 January 1976) 993 UNTS 3, arts 2(1) and 12; ‘The Obligation of Cooperation’ in James Crawford, Alain Pellet and Simon Olleson (eds), The Law of International Responsibility (OUP 2010) https://academic.oup.com/book/56258/chapter/473795205  accessed 24 January 2026

[11]US withdrawal from WHO is unlawful and threatens global and US health and security (The Lancet, 1 August 2020) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31527-0/fulltext ; Oxford Public International Law, ‘Cooperation, International Law of’ https://opil.ouplaw.com/display/10.1093/law:epil/9780199231690/law-9780199231690-e1427

[12] Constitution of the Republic of Uganda, 1995, Objective XXVII; Art. 8A.

[13] WHO Uganda Annual Report 2022 https://www.afro.who.int/sites/default/files/2024-09/WHO%20Uganda%20Annual%20Report%202022.pdf

[14] Uganda - World Health Organisation (WHO) Country Profile https://www.who.int/about/accountability/results/who-results-report-2024-2025/country-profile/2024/uganda

[15]WHO Uganda Annual Report 2022; Uganda Technical Assistance in the Development of Health Sector Operational Plans https://extranet.who.int/uhcpartnershiplivemonitoring/activity/uganda-technical-assistance-development-health-sector-operational-plans-and-conduct-health

[16] Uganda's Ministry of Health and WHO Unveil Key Strategies to Strengthen Health Care Services for Refugees and Migrants https://www.who.int/news/item/31-10-2024-uganda-ministry-of-health-and-who-unveil-key-strategies-to-strengthen-health-care-services-for-refugees-and-migrants

[17]International Covenant on Economic, Social and Cultural Rights (adopted 16 December 1966, entered into force 3 January 1976) 993 UNTS 3.

[18]Ibid, arts 2(1) and 12; see also General Comment No 3: The Nature of States Parties’ Obligations (Art 2, para 1 of the Covenant) (1990) UN Doc E/1991/23 [13].

[19]UN Committee on Economic, Social and Cultural Rights, General Comment No 14: The Right to the Highest Attainable Standard of Health (Art 12) (2000) UN Doc E/C.12/2000/4 [43]-[44].

[20] General Comment No 14 (n 3) [47]; Alicia Ely Yamin and Sakiko Fukuda-Parr, “What constitutes ‘failure to perform’ under the ICESCR’s minimum core obligations?” (2023) 25 Health and Human Rights Journal 9.