When Alexander the Great arrived in Gordion, an ancient capital in western Anatolia, an oracle declared that whoever could untie the intricate knot fastening an oxcart to a post would one day rule Asia. Many tried and failed. Alexander, refusing the premise of the challenge, sliced the knot cleanly in two.

The Trump administration has approached the World Health Organization with a similarly Alexandrian instinct. To its critics in Washington, the WHO is not a puzzle to be patiently untangled but a bureaucratic tangle in need of a decisive cut. The U.S. Health and Human Services Secretary, Robert F. Kennedy Jr., dismissed the organization as “bloated” and “moribund,” describing it as “mired in bureaucratic bloat, entrenched paradigms, conflicts of interest, and international power politics.” When the United States ultimately withdrew funding, the administration cited the WHO’s “inability to demonstrate independence from the inappropriate political influence of member states.”

Reform efforts have been underway for years, aimed at making the organization more transparent and accountable. Yet the WHO’s upper tiers remain shaped by quiet bargaining and geopolitical horse trading. As in any institution where favor can be extended or withdrawn, real authority concentrates at the top, insulated from scrutiny and difficult to challenge.

When U.S. funding was pulled, attention quickly turned to Tedros Adhanom Ghebreyesus, the WHO’s Ethiopian Director-General, and to President Donald Trump’s long-running antagonism toward him. In a 2020 letter, Trump accused the WHO of opposing early travel restrictions that the administration believed would have slowed the spread of COVID-19. The letter argued that despite credible information in December 2019—including evidence of human-to-human transmission—Dr. Tedros failed to act decisively while publicly praising China for its transparency. Trump’s critique was blunt, but it was hardly unique.

During Dr. Tedros’s campaign for Director-General, scrutiny resurfaced over his tenure as Ethiopia’s health minister in the early 2000s. At the time, the country struggled to contain outbreaks of cholera, a fast-moving and often fatal disease. On three occasions, cases surged while the government declined to acknowledge the outbreaks publicly. According to Human Rights Watch, health workers were pressured not to identify the disease by name. Dr. Tedros rejected the allegations, calling them a smear designed to undermine his candidacy.

The controversy did not end with his election. Soon after taking office, Dr. Tedros faced renewed criticism when several infectious-disease specialists accused him in an open letter of refusing to classify a cholera outbreak in Sudan, allegedly to shield the country from reputational harm. To critics, the episode reinforced concerns about a troubling tolerance for opacity—particularly when political sensitivities are involved.

That same tolerance, they argue, may help explain Dr. Tedros’s early acceptance of Chinese government assurances during the initial phase of the COVID-19 outbreak, when verified information was scarce, and public clarity was urgently needed. It may also shed light on one of the most controversial decisions of his early tenure: the nomination of Zimbabwe’s longtime ruler, Robert Mugabe, as a WHO goodwill ambassador.

The appointment was met with near-universal condemnation. Mugabe’s record of corruption and human-rights abuses made the gesture appear, at best, tone-deaf and, at worst, cynical. Within days, Dr. Tedros reversed course, announcing that he was “rethinking” the decision in light of WHO values. The episode raised uncomfortable questions about judgment and motive, including whether the nomination reflected a quid pro quo for political support during the Director-General election.

Taken together, these episodes sketch a portrait of a leader whose ascent has been accompanied by persistent allegations of obfuscation and an uneasy proximity to authoritarian power. They also suggest a preference for centralized authority, where loyalty is rewarded and dissent is managed rather than addressed. In such systems, reform is less a matter of principle than of control.

The story recalls another Greek myth. Tasked by King Eurystheus to destroy the Hydra, Hercules hacked off its many heads, only to see new ones grow back in their place. The beast was defeated only when each severed neck was cauterized, preventing regeneration. Trump has begun the lopping. Whether the deeper cauterization—structural, institutional, and political—will follow remains the unanswered question.