Public health experts say the United States’ departure could cripple the WHO’s operations or leave an opening for China to assume greater control over the agency.

Ooh, that’s a big one,” Donald Trump said Monday as he signed an executive order – one of dozens during his first hours as president – to withdraw the United States from the World Health Organization.

The U.S. has traditionally been the most generous benefactor of the WHO. A Trump executive order to cut ties with the WHO could pose a threat to global public health.