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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