Aides to President Donald Trump are debating some potentially far-reaching moves to punish the World Health Organization in the wake of the coronavirus pandemic, including cutting off U.S. funding and trying to create an alternative institution.

Officials have begun drafting a letter that — if the decision is made — will announce a suspension of U.S. funding to the WHO and a related body, the Pan American Health Organization, according to a person familiar with the issue. The draft document also tells officials at the State Department, the U.S. Agency for International Development and other institutions to try to route the money to existing alternative organizations.

Trump on Friday teased a forthcoming announcement about the WHO next week, hinting that his administration would place a hold on its funding to the global health body. But he did not go into details Friday, instead launching into a litany of complaints about how the WHO is allegedly too close to Beijing despite the U.S. being its top donor.

“As you know, we give them approximately $500 million a year,” he said, “and we’re going to be talking about that subject next week. We’ll have a lot to say about it. We’ll hold it.”

For now, some U.S. officials are urging caution, saying it will be more fruitful to try to reform the U.N. body through existing legal and political mechanisms. Some are concerned about undermining the WHO as it responds to a still-unfolding pandemic that has killed more than 100,000 people so far. Any effort to rescind U.S. funding from the WHO is also likely to be met with fierce international blowback, including from some U.S. allies, and could strengthen China’s influence on the organization.

“If you’re going to accuse the WHO of being soft on China, you have to accuse them equally of being soft on the U.S.” — Jeremy Konyndyk, former disaster response official in Obama administration

The internal administration discussion comes as Trump and his supporters paint the WHO as partly responsible for the spread of the COVID-19 illness. The president has accused the WHO of being too “China centric,” while some Republican lawmakers have called for the ouster of the organization’s leader. Several of the loudest anti-WHO voices are hawkish on China, and they allege that WHO leaders have been too timid in holding Beijing accountable for being slow to detail the extent of the outbreak that began on Chinese soil.

A spokesperson for the WHO said the organization had no comment.

It wasn’t immediately clear how much funding could be on the chopping block. The United States gave more than $400 million to the WHO in 2019, according to the State Department. It’s possible the U.S. could decide to suspend some of those dollars for certain functions while letting others flow. And it’s possible the U.S. could make funding decisions on a case-by-case basis if the situation is urgent and the WHO is the only choice to deliver whatever service is needed.

For now, however, the administration has told USAID, State and other agencies that send money to the WHO to obtain higher-level clearance before doing so, something critics say will slow down the funding process.

Andrew Bremberg, a U.S. ambassador who is based in Geneva and deals with the United Nations and other international organizations, is among those pushing hardest for reforming the WHO.

Bremberg has extensive health policy experience and previously directed Trump’s Domestic Policy Council. Bremberg is skeptical of multilateral institutions, but at the same time he’s well aware of how critical the WHO’s vast global architecture is in trying to end the pandemic, which is only now starting to hit the poorest nations where the WHO is well-established.

Those pushing hardest for a suspension of funds or even a new alternative to the WHO are political appointees at the White House, including at the National Security Council, many of whom also happen to be hawkish on China, people familiar with the issue said.

According to two of the people, some of those aides have suggested modeling the alternative institution on UNAIDS, a U.N. body devoted to eradicating HIV/AIDS. That institution was set up in the mid-1990s amid widespread unhappiness with the WHO’s handling of the AIDS epidemic. It wasn’t clear exactly what in the structure of UNAIDS would make it appealing to Trump aides, and some analysts were flummoxed at the idea.

“WHO for the last 25 years has had some bad knocks,” said Stephen Morrison, a global health policy specialist at the Center for Strategic and International Studies. “But it still remains the central entity for setting norms and standards and for guiding emergency response.”

Morrison argued that while at times the solutions to the frustrations with WHO have been to establish workarounds, like UNAIDS, the body itself can be reformed. In the wake of the 2014 Ebola crisis in West Africa, there was a lot of unhappiness with WHO, including from the Obama administration, he pointed out. That led to some helpful reforms of WHO’s emergency response operations.

At the very least, Trump political appointees want to find ways to tweak international health regulations to incentivize WHO leaders to more quickly call out countries like China that are not being transparent nor quick to deliver information about health crises in their borders. There’s also a desire to make it easier for the WHO to declare a “public health emergency of international concern.”

The current WHO director-general, Ethiopia’s Tedros Adhanom Ghebreyesus, was elected to the role for a five-year term in 2017 in part due to support from China. He’s come under fierce criticism from Republican U.S. lawmakers and others for initially praising China’s response to the coronavirus, among other steps.

Defenders of Tedros, and more broadly the WHO, say he’s being scapegoated by Republicans eager to deflect blame from Trump and his administration for their own slow response to the virus.

Further, they point out that the WHO is largely a technical body that operates at the mercy of member states and has limits on what it can say in public. Plus, they note, Tedros has to get along with the Chinese especially if he wants them to cooperate on ending the pandemic. Serious reforms to the WHO’s authority will require other member states’ agreement, they note.

“You’re not going to have powerful countries in the world saying, ‘Yes, please call us out on this’ — and that goes for the U.S., too,” said Jeremy Konyndyk, a former top Obama administration official involved in disaster response. He noted that the WHO hasn’t slammed the Trump team for its slow response to the coronavirus, either.

“If you’re going to accuse the WHO of being soft on China, you have to accuse them equally of being soft on the U.S.,” he said.

The State Department and USAID appear to be caught in the middle trying to balance competing impulses within the administration. Many officials at both those institutions support the idea of reforming the WHO — and broader reforms at the U.N. in general — and many are wary of China’s often harsh influence operations.

At the same time, they worry about slashing funding and other far-reaching actions, especially given that the pandemic is nowhere near finished.

Observers pointed out that just a few days ago, Secretary of State Mike Pompeo announced that the U.S. was going to give an additional $225 million in foreign assistance to help other countries battle the virus. That’s on top of $274 million already pledged by the United States. At least some of that money will likely have to go through the WHO, which is sometimes the only game in town in impoverished countries with poor health infrastructures.

“If the administration is really going to be serious about not funding WHO, then we need to stop thumping our chest about leading the world in coronavirus response,” one U.S. official said.

In an appearance alongside Trump earlier this week, Pompeo appeared to be walking a tightrope when asked about the WHO’s performance and Tedros’ future. He said the WHO “hasn’t accomplished what it was intended to deliver,” as far as ensuring global health, and that its U.S. funding deserved an evaluation.

But when asked if Tedros should be pushed out, Pompeo said “this is not the time to be doing that kind of change.”

A person familiar with the issue said that there is a sense among administration officials that Tedros would resist leaving his position early.

State Department, USAID and White House press officials did not immediately respond to requests for comment for this story. But in a statement earlier this week, the State Department listed a litany of grievances with the WHO while nonetheless suggesting it wanted the organization to continue its work during the pandemic.

“There will be many lessons to learn from the COVID-19 pandemic, including where and how the WHO system fell short in fulfilling its mission so that we can avoid future crises,” a State spokesperson said. “We believe a full assessment of WHO’s performance would be appropriate after we have addressed the current pandemic.”

The coronavirus isn’t the first time there have been discussions among Trump aides about reforming or simply abandoning the WHO, two people familiar with the issue said.

Political appointees at places like the State Department, the Department of Health and Human Services and USAID who have strong pro-life beliefs have at times pushed the idea of creating an alternative to the WHO.

Some of them have been unhappy with the United Nations’ overall handling of issues related to sexual and reproductive health. They have demanded the elimination of phrases like “sexual and reproductive health,” from U.N. documents.

Dan Diamond and Daniel Lippman contributed to this report.