In mid-April, when President Trump declared, “Today I’m instructing my administration to halt funding of the World Health Organization,” Jimmy Kolker did a double take.

“We were already in arrears before he said anything,” says Kolker, who was an assistant secretary for global health affairs during the Obama administration.

Kolker has seen the U.S. get behind before on its payments to the WHO, though never to the degree that it has during the Trump administration. Amid the worst global health disaster of the past century, he notes that close to $200 million was already past due the WHO.

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