The U.S. decision to pullout from the World Health Organization earlier this year reflects more than a single dispute with a multilateral body. It fits a broader America First posture sceptical of blank-check internationalism, driven by Covid-era credibility failures, and sharpened by geopolitical strategy in a bipolar U.S.–China landscape.
This realpolitik framing matters. With the closure of USAID, health diplomacy is now squarely under Marco Rubio’s State Department – the first person since Henry Kissinger (1973-1975) to serve simultaneously as Secretary of State and National Security Advisor.
But critics warn—with some justification—that an incoherent American pullback from multilateralism will open space for China – in soft power, biotech, standards-setting, and supply chains.
