The White House has formally notified the United Nations that it is pulling the United States out of the World Health Organization, despite the surging number of COVID-19 cases in the country.

President Donald Trump froze U.S. funding for the WHO in April and a month later announced his intentions to drop out. He accused the organization of having a pro-China bias in its handling of the coronavirus outbreak and demanded reforms.

“We have detailed the reforms that it must make and engaged with them directly, but they have refused to act. Because they have failed to make the requested and greatly needed reforms, we will be today terminating the relationship,” Trump said in May.

Under WHO rules, any country leaving the organization must give one year’s notice. If Trump loses the November election, the next president could decide to remain.