How The Trump Presidency Is Already Affecting Public Health

It has been just over two weeks since President Trump took office, and there have been significant effects already on public health.

On his first day in office, Jan. 20, Trump signed an executive order initiating the United States’ withdrawal from the World Health Organization. The United States contributes hundreds of millions of dollars to WHO, expecting to donate $958 million, or 15% of the WHO’s two-year budget ending in 2025.

WHO funds critical public and global health initiatives, including but not limited to infectious disease response, vaccine development and distribution as well as bolstering maternal and child health programs.

During the COVID-19 pandemic, WHO played an instrumental role in coordinating the pandemic response by sharing data, establishing health guidelines and engaging with critical stakeholders to keep the world safe. By withdrawing from WHO, the U.S. loses its voice in shaping global health policies as well as missing out on critical global health intelligence that could literally save millions of lives with respect to future health threats.

President Trump has also issued an executive order calling for at least a 90-day freeze on most foreign aid, which initially included the President’s Emergency Plan for AIDS Relief program. PEPFAR was established under President Bush in 2003 and has historically received bipartisan support from Congress in providing life-saving HIV/AIDS care to many low-income countries throughout the world.

Recently, on February 1st, the Trump administration provided a limited waiver on the fund freeze for PEPFAR, to implement urgent life-saving HIV treatment. Life-saving treatment allowed in the waiver includes anti-retroviral therapy, HIV testing and counseling; among other services. Despited the limited waiver, many experts are still worried for the program’s future because the limited waiver does not include cervical cancer screening, PrEP for those that are not pregnant women as well as services for orphans and vulnerable children.

PEPFAR has been one of the most successful U.S. global health initiatives, saving more than 26 million lives since its inception. Annually, the State Department provides more than $6 billion in funding to over 50 countries worldwide to help combat HIV and AIDS. Funding includes providing anti-retroviral therapy to poor communities in Africa that otherwise cannot afford care, HIV testing and counseling services as well as laboratories and medical equipment. The program has prevented 5.5 million babies from being born with HIV through mother-to-child transmission, according to the CDC.

Without PEPFAR, millions of people around the world will likely suffer. Millions of individuals around the world, particularly in low-income countries may not have access to treatments and tests that will directly affect their well-being. Vulnerable children may not have access to preventive services that are funded by PEPFAR.

The impact will also be seen here in America. PEPFAR has prevented the global spread of HIV, indirectly protecting public health in the U.S. This action alone has the potential to reverse decades of progress against HIV and could allow HIV to spread more globally and here in America given the ease of international travel.

Trump’s nominee for Secretary of Health and Human Services, Robert F. Kennedy Jr., will also face a confirmation decision this week by the Senate. His confirmation will likely have positive and potentially negative effects on public health. Part of his platform seeks to investigate toxic substances in food and their effects on chronic medical conditions, which would be welcomed by many public health advocates as conditions such as obesity and diabetes are soaring in America. However, his skepticism with vaccines could exacerbate vaccine hesitancy and threaten herd immunity, thereby bringing back diseases already felt to be eradicated like Measles.

The Trump administration has also put a pause on vital health communications with the general public, such as halting the CDC’s Morbidity and Mortality Weekly Report from being published as well as the removal of multiple federal government datasets. CDC personnel have also been instructed to cut off communication with the WHO.

This comes at a time when the bird flu is surging across American farms, Ebola cases are being reported in parts of Africa, and COVID-19, RSV and the common flu are still spreading in the winter months across America.

The communication that the CDC provides is critical in safeguarding American health. The information found on its website provides helpful tips on staying safe and healthy. Information communicated by the CDC and other federal agencies provides important updates on how diseases spread, where they are occurring and what the level of public health concern is. Without this knowledge, how can the American public fight off important public health threats? Are we better equipped to handle future public health threats or even a pandemic should one occur?

Given widespread misinformation about health that remains rampant over social media, this is not an opportune time to silence scientists and health professionals. Science should never be politicized, particularly when scientific information informs decisions that determine life and death.

Doctors and healthcare professionals are already burning out at alarming numbers and are frustrated with the healthcare system in America. Physicians have been handcuffed due to the corporatization of healthcare and rampant misinformation that already exists with respect to so many issues like vaccines. In addition to being handcuffed, it feels like our mouths have now been taped shut.

Correction, Feb. 4: This article originally stated that PEPFAR was included in the Trump administration’s foreign aid freeze, but PEPFAR received a limited waiver 12 days after the freeze took effect and is currently exempt from the stipulations pause in foreign aid.