The World Health Organization (WHO) could see lean years ahead if the US withdraws membership under the new Trump administration. Such a withdrawal, promised on the first day of Donald Trump’s new administration, would in effect cut the multilateral agency’s funding by one-fifth.

The severe cut would be uncharted territory for the WHO, potentially curtailing public health works globally, pressuring the organization to attract private funding, and providing an opening for other countries to influence the organization. Other countries are not expected to make up the funding loss.

The WHO works to improve the health of millions of people globally – from working to eradicate polio and tuberculosis to coordinating US HIV and Aids prevention work in Africa.