Opinion
Guest Essay
Without
the United States, Global Health Will Fall Apart
Jan. 24,
2025, 1:00 a.m. ET
By Kathleen
Sebelius
Ms.
Sebelius, a former governor of Kansas, was the secretary of health and human
services in the Obama administration.
https://www.nytimes.com/2025/01/24/opinion/who-trump-us-global-health.html
The United
States has long been a leader in global health, and it is critical to the
safety of Americans that we remain so — which is why some of President Trump’s
isolationist impulses are worrisome.
On Monday,
hours after taking office, Mr. Trump signed an executive order announcing the
United States will move to withdraw from the World Health Organization
(something he tried to do during his first term, before Joe Biden reversed the
decision as president). His plans to impose massive tariffs on goods imported
into the country could be devastating to the manufacturing of medicines within
our borders, given that many of the necessary ingredients come from abroad,
including an estimated 60 percent from India and China, according to one
analysis.
Americans’
health is at stake. Border walls and protectionist policies can’t stop
infectious diseases from entering the country. Only with vigilant international
monitoring of infections, containment of outbreaks and eventual eradication of
infectious diseases around the world can Americans ever be protected and
secure. We must prioritize sharing vaccines with other countries, training
medical providers to offer care abroad, collaborating on clinical trials and
research studies with other institutions and constant factual
information-sharing about outbreaks and health trends throughout the world. And
the United States must continue to lead the way.
Many regard
America’s global health work as smart diplomacy. Even the most hostile
countries welcome our medical expertise and support, because health security is
essential to international security and to every country’s economy. The first
Trump administration tempered active engagement in global health security
initiatives shortly after coming into office. That left us far less capable of
mounting a timely and robust response to the global outbreak of Covid-19,
devastating the world’s economy and exacerbating conflicts around the world.
Since the
end of World War II, the United States has been the pre-eminent world leader in
global health thanks to the Department of Health and Human Services’ global
health programs, U.S.A.I.D., and dozens of foundations and nonprofit groups,
like the Gates Foundation. Many of its efforts have historically been organized
under the umbrella of the W.H.O., whose members work together throughout the
year to prevent pandemics, further vaccine programs that save lives and tackle
issues like maternal mortality and Alzheimer’s disease that affect all
countries.
U.S.
leadership has always been critical to these efforts. Last year, the country
led the team that successfully negotiated new amendments to the 2005
International Health Regulations, which govern the rights, obligations and
reporting requirements for 196 countries. These amendments are, in part,
designed to strengthen the W.H.O.’s ability to declare and respond to a
pandemic. U.S. leadership also helped spearhead meetings between country
leaders on pandemic response, tuberculosis and antimicrobial resistance at some
of the latest United Nations General Assembly meetings.
While the
W.H.O. desperately needs an updated organizational and operational structure,
withdrawing from this global body, as announced by Mr. Trump, would be
disastrous. Its role is second to none in providing timely responses and more
targeted deployment of resources when public health crises strike.
For several
decades, the Centers for Disease Control and Prevention has helped to train and
position epidemiologists in various parts of the world to respond to new
disease outbreaks and rapidly identify and address emerging pathogens long
before they reach U.S. borders. We saw the fruits of this effort bear out
during the 2014 outbreak of Ebola in Lagos, Nigeria. Patient contacts were
identified, isolated and visited by personnel trained by the C.D.C. and its
partners — efforts that helped prevent Ebola from consuming the rest of Nigeria
and affecting other countries in Africa and across the globe.
H.H.S. also
led the government effort to eradicate polio in collaboration with the Gates
Foundation and C.D.C. workers overseas. Training local health workers, funding
vaccine initiatives and encouraging vaccination efforts led to India and Africa
being certified as polio free, wiping out the disease from most corners of the
globe.
Some suggest
that withdrawing from international collaboration on global health won’t hurt
the United States, and that it’s feasible to simply close our borders and
restrict travel when outbreaks are identified. But we live in an intertwined
world: In addition to a majority of the ingredients in our medicines, about 15
percent of the country’s food supply is imported. About eight million Americans
leave the country each month for business, tourism and family visits, and about
66 million international visitors travel across the country each year. By the
time a travel ban was even put in place for Covid-19 by the first Trump
administration, the disease was already within American communities. It’s
foolish to believe the country can protect itself against every potential
infectious disease outbreak without more proactive solutions.
In fact, the
country is already facing an impending crisis in the form of bird flu. The
disease has ravaged poultry stock, is spreading rapidly among cattle, and has
even found its way to infecting a handful of humans. Hospitalized cases
(including the first recorded death) have only exacerbated fears.
There is
still time for Mr. Trump to come to his senses and reverse course. It is in our
national security interests — and essential to the health and well-being of the
country — that we continue to lead in global health.
Kathleen
Sebelius, a Democrat elected to two terms as governor of Kansas, was secretary
of health and human services from 2009 to 2014.
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