An article authored by Dr. Haruka Sakamoto, Senior Manager at Health and Global Policy Institute (HGPI) has been published in Wedge ONLINE.

Drawing upon the United States’ formal notification of withdrawal from the World Health Organization (WHO)  in January 2025 and the subsequent procedural developments, the article examines the severe financial and governance-related challenges currently confronting the WHO. It further considers the role that Japan ought to assume within a WHO operating in the absence of the United States.

In the article, Dr. Sakamoto outlines the projected consequences of the US withdrawal for the WHO’s 2026–2027 budget, including a reduction from the originally planned US$5.3 billion to approximately US$4.2 billion, as well as the resulting implications for programs ranging from infectious disease surveillance to maternal and child health. She argues that the difficulties facing the WHO cannot be understood merely as the consequence of a single country’s withdrawal, but rather stem from more structural dynamics, including the rise of nationalism, the growing emphasis on bilateral assistance, and governance arrangements in which member states’ financial contributions are not necessarily aligned with their influence over decision-making processes. The article additionally emphasizes that the WHO’s role as a “norm-setting institution”, exemplified by the WHO Framework Convention on Tobacco Control, constitutes an international public good that is inseparable from global responses to infectious disease pandemics, antimicrobial resistance (AMR), and broader issues of economic security.

Against this backdrop, Sakamoto notes that Japan is serving as a member state on the WHO Executive Board in 2026 and is the only G7 country currently participating in those deliberations. She contends that Japan’s longstanding post-war commitment to the principle of “human security”, together with its accumulated experience in technical cooperation and the establishment in 2025 of the Universal Health Coverage (UHC) Knowledge Hub in Japan, provide an important foundation of trust capable of facilitating dialogue beyond geopolitical divisions. Looking ahead to the appointment of the next Director-General following the conclusion of Dr Tedros Adhanom Ghebreyesus’s term in August 2027, the article further highlights the strategic importance of Japan engaging proactively in discussions on WHO reform, particularly with regard to restoring the organization’s norm-setting functions and enhancing fiscal transparency.