The US has completed its withdrawal from the World Health Organization, the US Department of Health and Human Services said on Thursday, finalizing a longstanding goal of President Donald Trump.

Trump tried to leave WHO during his first term, then gave notice through an executive order on the first day of his second term that the US would leave the organization. By law, the US must give WHO a one-year notice and pay all outstanding fees before its departure.

The US still owes WHO roughly $260 million, but legal experts said the US is unlikely to pay up and WHO has little recourse.

CNN has reached out to WHO for comment.

“As a matter of law, it is very clear that the United States cannot officially withdraw from WHO unless it pays its outstanding financial obligations,” said Dr. Lawrence Gostin, an expert on global health law and public health at Georgetown University. “But WHO has no power to force the US to pay what it owes.”

WHO could pass a resolution saying the US can’t withdraw until it pays, but Gostin said it probably won’t risk creating further tension when Trump is likely to withdraw anyway.

On Thursday, HHS said all US government funding to WHO had been terminated and all personnel and contractors assigned or embedded with the organization have been recalled. It also said the US had ceased official participation in WHO-sponsored committees, leadership bodies, governance structures and technical working groups.

HHS left the door open to some continued collaboration, however. Asked if the US would participate in an upcoming WHO-led meeting to decide the composition of next year’s flu vaccines, the administration said conversations about that are still ongoing.

During a call with reporters on Thursday, a senior administration official said the United States has “not been getting much return for our value, on our money, on the personnel that we’ve given.”

“A promise made and a promise kept,” said a senior administration official. The official said WHO “has acted contrary to the US interest in protecting the American public.”

Although the US was the largest funder to the organization, the official noted there had never been an American director-general of WHO.

HHS said WHO had never owned up to what the US government views as failures during the Covid-19 pandemic. HHS said WHO had delayed declaring a global public health emergency, which cost the world critical weeks as the virus spread.

“During that period, WHO leadership echoed and praised China’s response despite evidence of early underreporting, suppression of information and delays in confirming human-to-human transmission,” the agency said in a news release.

HHS also pointed to WHO’s reluctance to acknowledge airborne spread of the virus and said it downplayed the idea that people without symptoms could spread the infection.

“This action means our country’s health policies can no longer be constrained by unaccountable foreign bureaucrats,” the HHS official said.

Despite the divorce, the administration asserted that the US will continue to be a global health leader.

Details of the new strategy have not yet been released, but officials said the US would continue to collaborate with other countries on infectious disease surveillance and data sharing, through agreements with individual countries, and by working with non-governmental organizations and religious groups.

That effort is expected to be led by the US Centers for Disease Control and Prevention’s Global Health Center.

“We’ve assessed all of the gaps and the potential gaps. We’ve done analysis. We have plans in place. We will continue to work work through countries and the ministries of health as we have for decades, and we’ll continue to develop those relationships and utilize those relationships in a way that’s mutually beneficial,” another senior administration official said.

The administration promised a “number of new announcements” in the coming months.

Some experts said trying to manage global health through agreements with individual countries would create a patchwork system that won’t replace what the World Health Organization can do.

“It doesn’t allow the same level of partnership and surveillance as working with WHO,” said a former CDC official, who asked not to be named. “There’s not enough funding to replace it all.”

The former official noted that the CDC has staff in about 60 countries, but that’s not every country, “which is why an overarching structure like the WHO is important.”

Critics said the move could blind the US and the world to potential biological threats.

“The U.S. withdrawal from the World Health Organization is a shortsighted and misguided abandonment of our global health commitments. Global cooperation and communication are critical to keep our own citizens protected because germs do not respect borders,” Dr. Ronald Nahass, president of the Infectious Disease Society of America said in a statement.

“Withdrawing from the World Health Organization is scientifically reckless. It fails to acknowledge the fundamental natural history of infectious diseases. Global cooperation is not a luxury; it is a biological necessity,” Nahass added.

Others agreed with that assessment.

“Today is a day where the world’s public health took a sad and consequential hit. We will experience more deadly worldwide outbreaks. They will occur because the experts in the US public health community won’t be at the table to lead the global response. These outbreaks will spread to the US and do us great harm,” said Dr. Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota.

“This is the most ruinous presidential decision in my lifetime,” Gostin, of Georgetown, said. “Not being a member of WHO is deeply harmful to our national self-interests and security.

“We will not have rapid and full access to the epidemiological data, virus samples, and genomic sequencing data to create vaccines and treatments. And we will not be able to work internationally to curb serious health threats before they arrive on our shores. When the next pandemic hits (and it will) the United States will not be prepared and our response will be slow and weak. That harms all Americans,” Gostin added.

In a news conference last spring, WHO Director-General Dr. Tedros Adhanom Ghebreyesus called the US withdrawal a “lose-lose” proposition.

“The US loses, and the rest of the world, we know for sure, loses,” he said. (CNN)

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