Last January, U.S. President Donald Trump announced that his country would withdraw from the World Health Organization (WHO). Shortly afterwards, like a shadow following a corpse, Argentine President Javier Milei announced that Argentina would do the same. What is the WHO and why did both presidents adopt this definition?
By Alejandro Iturbe
The WHO was created in 1948 as an autonomous organization within the structure of the United Nations (UN). It is based in Geneva , Switzerland and has 194 member countries. Its health and financial policies are set by the World Health Assembly, which meets annually with delegations from member countries. The Assembly elects a Director-General and a 34-member Executive Board “technically qualified in the field of health” for a three-year term[1].
Its objectives are “to coordinate the global response to health emergencies, to promote health, to prevent disease and to improve access to health care.” To achieve these goals, the WHO has a “team of more than 8,000 professionals, including the world’s leading public health experts… physicians, epidemiologists, scientists and administrators.” In this sense, the WHO is the world’s leading authority on the prevention, diagnosis and treatment of diseases, as well as on the approval of medicines and vaccines.
At the same time it plays this role in caring for the health of the world’s population, the WHO suffers from the same insurmountable limitations as other UN agencies trying to tackle the deep-rooted and structural ills that capitalism has created in the world. For example, this is also true of the FAO (Food and Agriculture Organization) on the question of hunger.
These are organizations that usually carry out very objective studies of real data. However, both their general analyses and their proposals are an integral part of imperialist capitalism and the absolute respect of property, without ever going beyond its limits. For this reason, they limit themselves to “advising” governments and companies, or to drawing up plans that are incapable of solving problems such as pandemics or hunger.
The WHO and the Covid-19 pandemic
This was evident during the recent Covid-19 pandemic and the issue of vaccines against this disease. The WHO never asked the governments, especially those of the imperialist countries, for international non-profit cooperation to coordinate the research and development of an effective vaccine. It simply waited for the big medical companies (in isolation, in each country) to achieve this. When vaccines against this disease appeared, it never demanded that governments break the patent rights with which these companies made billions of dollars at the expense of the terrible consequences of this pandemic[2].
On the other hand, although it promoted “quarantine,” and “social isolation” to prevent the spread of infection, it did not open its mouth to denounce how companies and governments forced a whole swathe of workers to go to their workplaces, classifying them as “essential,” crammed into public transport and often without the companies guaranteeing them minimum prevention conditions. This aggravated and extended the impact of the pandemic.
Finally, it also failed to denounce the criminal capitalist policies of the “new normal,” which had the same result, but on a much larger scale[3]. Because of all these “omissions,” we can say that the WHO ended up being an “accomplice” of the bourgeois governments and corporations in the deaths of millions of people and the great suffering of workers and the poor around the world.
The “privatized” WHO
In addition to this fundamental limitation (being part of the capitalist system), there is another central issue that increasingly conditions the actions of the WHO: its sources of funding to cover its budget. At the beginning of the last decade, its total expenditure amounted to 2.3 billion dollars[4]. This budget was mainly covered by direct and official contributions from the United States (about 40%) and, in decreasing order, from Germany, the European Commission, the United Kingdom and Canada. This established a deep dependence of the WHO on the governments of the imperialist powers.
As the destruction of nature progresses, misery and hunger increase, public health deteriorates, new diseases and pandemic risks appear or others that were thought to be under control or extinct reappear. In this context, the WHO needs an ever-increasing budget.
Contributions from countries are no longer sufficient, and it is beginning to receive large private donations. Among them, the big pharmaceutical companies, which already in 2015 gave it almost 100 million dollars between cash and donations of the medicines they produce.
But these companies “do not give without getting something in return.” Germán Velázquez, a Spanish doctor and former director of the WHO’s Global Medicines Program, denounced in 2016 that “private funding conditions the decisions of the WHO,” which “works in favor of private interests because it has undergone a process of privatization”[5].
What is Bill Gates doing out there?
The WHO’s expenditures are constantly increasing (with a high impact during the last pandemic) and so is the need for new contributors. Leaving aside the member states, two contributors stand out: the Bill & Melinda Gates Foundation (run by the computer tycoon and his ex-wife) and the Vaccine Alliance (known as GAVI), in which the Gates Foundation also participates alongside pharmaceutical companies[6].
The following table shows the weight of non-governmental contributions in the WHO budget. Bill Gates’ foundation contributes almost as much as Germany. If we add GAVI’s contribution (in which it has a large share), it exceeds that of the U.S.
At this point it is necessary to take a closer look at Bill Gates. He was a programmer and systems engineer working for IBM. In the late 1970s and early 1980s, he created a software program (the DOS system) and applied it to new hardware devices (PCs), revolutionizing the computer industry. He founded Microsoft, which became one of the giants of information technology, and became one of the richest men in the world; in 2020, Forbes magazine estimated his fortune at nearly $107 billion[7].
A billionaire “philanthropist”?
In the 21st century, Bill Gates began to shift the focus of his interests and activities. In 2000, he stepped down as CEO of Microsoft, although he remained the “software architect.” In 2014, he ceased to be the company’s main shareholder and put half of his fortune into the hands of the foundation he runs with his ex-wife. Finally, in 2020, he gave up all relations with the company and devoted all his time to the foundation[8].
Bill Gates has built up a public image as a billionaire who is sensitive to the suffering of the world’s masses, concerned and trying to help as a “benefactor” on issues such as mass vaccination against various diseases or the low level of public education in the U.S.
He has said that he wants to “leave his legacy to society”[9]. Last year he came out in favor of “the rich paying more taxes”[10], in line with the proposals of the Democratic Party (which he has always supported) in the last election campaign, as opposed to those of Donald Trump. On the other hand, his foundation announced that this year it would give away “$8.6 billion to help meet growing resource needs and fund innovative ways to save and improve lives”[11].
This public image of a “sensitive billionaire and benefactor” contrasts sharply with the disgust generated by Elon Musk, another tech mogul. However, if we scratch the surface and look at the deeper reality, we see that Bill Gates is a big bourgeois who does everything in his interests and in defense of imperialist capitalism.
When he owned Microsoft, the company was accused of “unfair competition” and monopolistic practices and faced several lawsuits[12]. Most importantly, he had no problem using the semi-slave labor of Foxconn in China to manufacture his products at a very low price and make a fortune selling them around the world (he is the second largest customer after Apple).
The foundation itself operates according to clearly bourgeois criteria: it has a capital of 50 billion dollars, which is invested “with the sole objective of maximizing the return on investment, without taking into account the objectives of the foundation. As a result, its investments include companies that have been criticized for exacerbating poverty in the same developing countries where the foundation is trying to reduce it. These include companies that cause severe pollution and pharmaceutical companies that do not sell their products in developing countries”[13].
The truth about Bill Gates, the “vaccinator”
The issue of “pharmaceutical companies” brings us directly to the role of the Gates Foundation in the WHO, as the largest non-governmental contributor. This foundation has a decisive influence on the Global Access to Vaccines Fund (COVAX), which played a central role during the last Covid-19 pandemic.
In 2021, the pharmaceutical companies that had already developed effective vaccines began to sell them “at a premium” by charging patent fees, an internationally accepted capitalist criterion. Only the world’s economic powers could afford to buy them, and the poorest countries could not afford them or could only buy them in insufficient quantities.
India, South Africa, Argentina and Brazil had the capacity to produce the vaccines. India was actually the world’s leading producer of vaccines, but it still had to pay the patent fee and did not have the funds to buy the vaccines it produced itself to protect its population.
In this context, the governments of India and South Africa submitted a request to the World Trade Organization to “waive intellectual property rights [patents]” for vaccines and drugs used against Covid-19 until the end of the pandemic. The request stated: “A global pandemic is no time for business as usual. There is no place for patents or corporate profiteering while the world faces the threat of COVID-19″[14].
This request had an impact on the WHO, especially on COVAX, which was trying to organize a global vaccination campaign. Some sectors of the WHO presented a “softer” proposal (a temporary, emergency suspension). At Covax, Bill Gates defended the patents to the hilt and prevented them from supporting any kind of suspension, as denounced by Professor Linsey McGoey (Professor of Sociology at the University of Essex-United Kingdom) in her book on Bill Gates and global public health entitled No Such Thing as a Free Gift: The Gates Foundation and the Price of Philanthropy[15]. Covax said only that “it hopes to begin allocating vaccines to low- and middle-income countries in the first quarter of 2021”.
Behind his hypocritical mask, Bill Gates didn’t care that millions of people in the poorest countries were still dying from Covid-19. What mattered to him was to defend private property and the profits of the “pharmaceutical companies” in which he is heavily invested and with which he is associated. In a cowardly way, the WHO accompanied him in silence.
At that time, the IWL raised the slogan of the immediate breaking of the patents and proposed a great mobilization campaign for it, demanding that the governments of the countries that could produce vaccines do so without having to pay anything for the use of the formula[16].
Trump’s anger at the WHO
However, Trump’s decision to withdraw the U.S. from the WHO has nothing to do with the profound limitations of the organization’s actions in the fight against the Covid-19 pandemic or Bill Gates’ role in vaccine patents. On the contrary.
The WHO officially declared the existence of the pandemic on March 1, 2020. It presented data on the alarming rate of infection and spread, as well as the severity of the consequences of the disease.
In this context, it expressed its “deep concern at the alarming level of inaction” by governments around the world[17]. In this context, while effective vaccines and a mass vaccination campaign were being developed, it recommended treatment for infected people and a series of measures to slow the rate of spread. These included quarantine and isolation not only of infected persons, but also, as a preventive measure, of those who had been in contact with them and of areas where a case had occurred. It also recommended restricting the movement and concentration of people except where absolutely necessary, and keeping them apart when necessary.
Many governments began to make these measures mandatory. But they strongly affected the capitalist production and trade and with it the profits of the bourgeoisie, so that a few months later they moved to the hypocritical policy of the “new normal”.
During his first presidency, Trump was one of the rulers who denied the existence of the pandemic, which he called a “serious flu,” and for several months he did nothing. In particular, in order to defend the interests of business, he refused to apply restrictions on the movement and concentration of people. This meant that for many months the United States (one of the countries with the greatest medical and pharmaceutical resources in the world) led the tragic ranking of the number of people infected, published daily by the WHO and reproduced by the media all over the world.
Angered by the way the WHO statistics exposed the consequences of his criminal policies in the first months of the pandemic, Trump decided to “suspend funding for the WHO.” And he tried to counterattack by accusing the WHO of “mismanagement and covering up the spread of the coronavirus”[18].
As a result, Trump changed his policy towards the pandemic: he began to apply some of the measures proposed by the WHO and started to buy all the Covid-19 vaccines already produced by U.S. companies such as Pfizer[19]. But he was unable to change his “denialist” image or the consequences of his criminal policy, which the WHO exposed with its statistics.
This was probably one of the main factors that led to his defeat by Joe Biden in his bid for re-election at the end of 2020. Now that he has regained the presidency, Trump is taking “revenge” on the WHO, which he probably holds responsible for his defeat in 2020.
An austerity plan
However, Trump’s reasons for withdrawing from the WHO run much deeper. Saving the money that the U.S. has contributed to the organization is part of a larger plan to adjust the U.S. federal budget and drastically reduce spending, a plan that Trump has entrusted to his friend, businessman Elon Musk.
This adjustment is essential from a bourgeois point of view, given the loss of income that will result from the reduction in corporate taxes already announced by Trump. Musk, who constantly praises the brutal adjustment carried out by the Argentine government of Javier Milei, has already warned that the minimum basis of this adjustment will be a 26% reduction in spending[20].
For this reason, the withdrawal from the WHO will be accompanied by a freeze of funds and the possible closure of USAID (United States Agency for International Development), through which the United States provides funds to various countries around the world. According to official data, USAID distributed a total of $42 billion in 2023, “primarily in the areas of economic development and humanitarian assistance.”[21] Elon Musk has publicly called USAID “evil” and “a criminal organization,” while Trump said, “I don’t want my taxes going to that garbage.”
But the cuts are not limited to this foreign spending, but will also greatly affect social spending, which is made through subsidies and loans of various kinds to entities and institutions. One of the hardest hit will be the public health sector. The National Institutes of Health (NIH), the Federal Agency for Medical Research and the Centers for Disease Control and Prevention (CDC) could be crippled, as the medical journal The Lancet denounced in its editorial[22].
One of the hardest hit will be the Medicaid program. To understand the importance of this program, we must remember that the United States has one of the most expensive and discriminatory health care systems in the world: it is almost entirely private and takes the business approach to medicine to the extreme.
An initial consultation with a general practitioner starts at a minimum of $100, with a specialist at $300; an X-ray costs $500; surgery or childbirth require several thousand. The same goes for hospitalization or long-term treatment. And this is without mentioning the price of medicines. There are families, for example, who have had to sell their homes to pay for these expensive treatments.
Part of the population covers all or part of these costs through the health insurance provided by the companies for which they work, while another part contracts directly with private companies. Meanwhile, a significant part of the population (the lower social sectors) is completely uninsured, with no coverage at all or only the coverage provided by the “community clinics” in the poorest neighborhoods.
In an attempt to alleviate this situation, a Democratic administration passed a law in 1965 that created Medicare (administered by the federal government) and Medicaid (administered by the states with financial support from the federal government). In 2010, the Obama administration strengthened both programs through the Affordable Care Act (ACA), known as Obamacare.
In 2024, Medicaid had total expenditures of nearly $840 billion[23]. Medicaid covers medical care, treatment, and hospitalization for people over 65 and children without health insurance, people with disabilities, and families with very low incomes. In short, in order to increase the profits of U.S. businessmen, Trump and Musk are making adjustments to the health and hunger of the poorest people in the U.S. and also in the world.
Shortly afterwards, Javier Milei announced that his government would also withdraw Argentina from the WHO. Major international media commented ironically that “Milei is imitating his idol”[24].
The reasons given were very similar to those of Trump: “Milei is very critical of Tedros Adhanom [WHO Director General since 2017] and his handling of the Covid-19 pandemic, because of the consequences of the measures applied around the world […] such as the negative impact on the economies of countries…”[25]. He is referring to the quarantine and movement restrictions imposed in the country by the Peronist government of Alberto Fernández.
On this issue, Milei is acting with great hypocrisy. During the first period of the pandemic (when he was still a new figure in Argentine politics), he did not take a denialist position. On the contrary, he published a video in which he supported the compulsory quarantine of those infected or likely to be infected, including the use of public violence. Shortly thereafter, he posted a photo of himself receiving the Covid vaccine[26]. Now that he has assumed the role of Trump’s “imitator,” he wants to “rewrite” this part of his history.
But the context of this departure from the WHO is much deeper. Milei’s government has been implementing a fierce plan to adjust state spending, reducing it, closing departments and public companies or privatizing them. One of the sectors most affected is that of institutions that fulfill social functions, such as public health. Thus, the government has attacked and threatened to close all the institutions that depend on the Ministry of Health, such as the National Pediatric Hospital “Prof. Dr. Juan P. Garrahan”, the National Hospital of Mental Health “Lic. Laura Bonaparte” and the National Hospital Posadas.
Another brutal attack is the fact that PAMI (a state social security organization that provides health care to retirees and pensioners) has stopped providing free medicines to a large part of its nearly five million members, many of whom can no longer afford to buy them. For this reason, Argentina’s withdrawal from the WHO “is part of a policy whose ultimate goal is for the state to abandon the responsibilities it still has in the field of health,” as the Argentine sociologist Gabriel Puricelli has denounced[27].
Although, as we have seen, on this issue of austerity and the attack on public health, it is Milei’s government that is leading the way and Trump’s, through Elon Musk (a great admirer of Milei), that is trying to imitate it.
Some conclusions
The Milei and Trump governments have decided to carry out a frontal attack on public health and its financing by the bourgeois state in a brutal and rapid way. They are doing this for two reasons. On the one hand, to increase the profits of the businessmen by reducing their taxes. On the other hand, to go all the way with a process that has been going on for decades: the transformation of public health care into a big private business for medical centers and health care providers, for large laboratories, for manufacturers of technology for medical purposes, and for intermediaries such as health insurance companies.
Most governments are pursuing the same policies, but they are doing so more slowly and trying to hide their objectives and results in the deterioration of health care for workers and the masses. For example, what is happening in several important European countries that had very strong public health systems, such as France and Great Britain[28]. The WHO appears to be a defender of public health, but in the end it is part of this “slow motion” and disguised operation because, as we have seen, it always ends up defending the interests of the “health bourgeoisie” and its profits.
We, the workers and the masses, must fight against these plans of Milei and Trump, which lead to the total destruction of public health. In Argentina, they have begun to do so, for example, in the defense of the Bonaparte Hospital, the Garrahan and the Posadas[29]. It is necessary to coordinate these struggles, surround them with solidarity and unite them with the other struggles that the workers are waging against other consequences of the Milei government’s attack, such as layoffs in the private sector. There is a similar need in the U.S. against the attacks of the Trump administration.
But we must be aware that the public health problem is much deeper. Capitalism, with its destruction of nature, its increase in poverty and hunger, and its intensification of working conditions, is making workers more and more sick and less healthy. At the same time, it is increasingly reducing or directly trying to eliminate public health care. The last pandemic was an example of the hardship and suffering of workers in this context.
In the face of the pandemic, on this page we presented a series of proposals to achieve free and universal public health care for workers[30]. These proposals are still valid today. Some of the most important measures are the breaking of the patent rights of the pharmaceutical conglomerates and medical technology manufacturers, the expropriation of all these private companies by the state and the implementation of a free, universal, centralized health plan guaranteed by the state.
No bourgeois government (of any color) is willing to carry out these measures, even under the emergency conditions of the pandemic. For this plan to be implemented, it is necessary for the workers and masses to carry out a revolution and install their own government. The experiences that developed in the past in the former workers states, such as the Soviet Union and Cuba, and the impressive development they had in their free and universal public health systems, show that this is possible[31].
It will be even more so if this revolution spreads throughout the world, especially in the most developed countries. This will allow the creation and implementation of a global public health plan, which would be something like a WHO at the service of the needs of workers and peoples.
Sources
[1] https://www.who.int/es/about/who-we-are
[2] See https://litci.org/es/la-carrera-por-la-vacuna-contra-el-covid-19/?utm_source=copylink&utm_medium=browser and https://litci.org/es/la-carrera-por-la-vacuna-contra-el-covid-19-ii/?utm_source=copylink&utm_medium=browser
[3] https://litci.org/es/la-verdadera-cara-de-la-nueva-normalidad/?utm_source=copylink&utm_medium=browser
[4] https://es.statista.com/estadisticas/601168/gastos-totales-de-la-organizacion-mundial-de-la-salud-1995/
[5] https://www.saludyfarmacos.org/lang/es/2016/09/15/alertan-sobre-el-aumento-de-las-donaciones-de-la-industria-farmaceutica-a-la-oms/
[6] What is GAVI, the Vaccine Alliance? – The World Order – EOM
[7] https://www.forbes.com/profile/bill-gates/?list=rtb
[8] What is the real reason why Bill Gates left Microsoft – GENTE Online
[9] https://www.genbeta.com/actualidad/multimillonarios-como-bill-gates-tienen-claro-que-haran-su-herencia-no-dejarsela-a-sus-hijos
[10] https://www.ansalatina.com/americalatina/noticia/mundo/2024/11/11/bill-gates-insiste-en-mas-impuestos-a-los-ricos_c2ec78e0-5a9a-4729-bf8b-0d32e54227f0. html#:~:text=Ya%20en%202019%2C%20Gates%20hab%C3%ADa,de%20lo%20que%20pagan%20actualmente%22.
[11] https://www.gatesfoundation.org/es-es/ideas/articles/2024-gates-foundation-annual-letter
[12] https://www.diariojudicial.com/news-1748-el-fallo-en-el-juicio-us-v-microsoft-y-ahora-que
[13] https://www.swissinfo.ch/spa/politica/tiene-bill-gates-demasiada-influencia-en-la-oms/46588758
[14] https://www.msf.es/noticia/india-y-sudafrica-piden-que-no-haya-patentes-medicamentos-ni-herramientas-covid-19-durante
[15] Cited in the article in reference 13.
[16] https://litci.org/es/paremos-el-genocidio-ruptura-inmediata-de-las-patentes-de-las-vacunas/?utm_source=copylink&utm_medium=browser
[17] https://www.paho.org/es/noticias/11-3-2020-oms-caracteriza-covid-19-como-pandemia
[18] https://www.bbc.com/mundo/noticias-internacional-52289020
[19] https://elpais.com/internacional/elecciones-usa/
[20] https://www.cronista.com/usa/economia-y-finanzas/el-primer-despedido-elon-musk-reconocio-su-derrota-y-admitio-no-podra-cumplir-lo-que-le-prometio-donald-trump-fui-demasiado-optimista/
[21] https://cnnespanol.cnn.com/2025/02/04/latinoamerica/usaid-paises-america-latina-orix
[22] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00237-5/fulltext?dgcid=tlcom_carousel1_eds25_lancet
[23] https://es.statista.com/estadisticas/598544/prevision-gasto-total-medicaid-en-estados-unidos/
[24] https://www.dw.com/es/argentina-dejar%C3%A1-la-oms-milei-est%C3%A1-haciendo-m%C3%ADmica-de-trump/a-71533432
[25] https://www.infobae.com/politica/2025/02/06/javier-milei-prepara-una-denuncia-contra-el-jefe-de
[26] Se viralizó un video de Milei en el que apoyaba el aislamiento por el Covid-19 – LA NACION
[27] Ver referencia 24.
[28] https://litci.org/es/la-lucha-por-la-salud-en francia/?utm_source=copylink&utm_medium=browser and https://litci.org/es/el-ano-que-se-vivio-peligrosamente/?utm_source=copylink&utm_medium=browser source=copylink&utm_medium=browser and https://litci.org/es/el-ano-que-se-vivio-peligrosamente/?utm_source=copylink&utm_medium=browser
[29] https://www.youtube.com/watch?v=2IBOP6LNy8k&t=8s
[30] https://litci.org/es/a-un-ano-de-la-pandemia-mas-que-nunca-sanidad-100-publica-2/?utm_source=copylink&utm_medium=browser
[31] https://litci.org/es/por-que-cuba-logra-frenar-la-expansion-del-coronavirus/?utm_source=copylink&utm_medium=browser
