SEATTLE — The current global health system is burdened with displacement, mass migration, inequality, climate change, urbanization, deforestation, wars and humanitarian crises. A global health crisis is looming with emerging health risks ranging from drug-resistant bugs and the H7N9 flu outbreak in China to famine in Africa.
While all attention is focused on many diversions, global health is becoming increasingly unstable. The Trump administration has announced a $54 billion increase in defense spending while reducing funding to the State Department and the U.S. Agency for International Development (USAID) by 37 percent. This decision reflects the administration’s lack of appreciation for their role in enhancing national and international security by downsizing poverty and alleviating the threat of a global health crisis. The anticipated 61 percent funding cuts to global health would have dire consequences for millions around the world.
In 2015, the U.S. ranked first in military spending at $598 billion, nine times Russia’s and four times China’s defense budget. While the average U.S. citizen believes the nation contributes 26 percent of the federal budget to foreign assistance, it is actually one of the least generous nations. Compared to Sweden, Norway, U.K. and Turkey who spend 1.41 to .54 percent of their Gross National Income (GNI) on foreign aid, U.S. contributes only 0.17 percent.
The Trump administration expressed skepticism over humanitarian funding to Africa and questioned the value of the President’s Plan for AIDS Relief (PEPFAR). PEPFAR was established by President George W. Bush in 2003 and has been essential in reducing mortality and morbidity, with increased access to HIV/AIDs treatment to millions of men, women and children. It has also led to political and social stability and reduced the risk of a global health crisis.
The Lake Chad Basin is facing the worst humanitarian crisis on the African continent. The U.N. has been successful in raising one-third of the $1.5 billion urgently needed to avert massive loss of life due to famine. It was confident of a U.S. contribution considering that the U.S. has until now been the largest donor to the region. Nonetheless, the Trump administration’s “America First” ideologies are rendering their assumptions wrong and jeopardizing the lives of millions. The administration’s indifference towards humanitarian aid shows an unknowing of its role in preventing a global health crisis.
The Trump administration has also indicated 40 percent less funding to the U.N. and the World Health Organization (WHO), both critical response coordinators during a global health crisis. Insufficient funds played a significant role in the inefficient WHO response to Ebola, which led to its escalation into a global threat. These cuts from the U.S. would further impede the underfunded WHO in effectively responding to a future global health crisis. Two U.S. legislative bills seeking to withdraw WHO membership and all funds from the U.N. further lend fear to an already uncertain situation.
Meanwhile, the U.S. Center for Disease Control (CDC), USAID and the U.S. Department of Health and Human Services are without adequate leadership. The CDC is also anticipated to have a 12 percent budget cut. These agencies are vital in managing and responding to internal and external health emergencies. Ebola, one of the greatest security threats in recent history was ended by the international community including the CDC, the USAID, global aid agencies and nongovernmental organizations working together. The 1,450 CDC personnel deployed to respond to the crisis played a crucial role in containing the Ebola epidemic and keeping Americans safe.
President Trump signed an Executive Order on March 5 instating a new travel ban. Travel bans limit critical work done by scientists and doctors in life-threatening situations by curtailing their freedom of movement. The first successful Ebola vaccine was developed through cross-country collaborations between West Africa, Europe, U.S. and the WHO. The current H7N9 outbreak in China is proving resistant to available drugs and taking a toll on lives. Such situations require a swift global response to develop effective remedies.
Most tropical infectious diseases are a result of poverty, climate change or unplanned urbanization. High-income countries like the U.S. need to support development and health programs in poor, developing countries to prevent epidemics like Ebola from occurring and becoming global threats. With the next pandemic, imminent with the H7N9 outbreak and drug-resistant bugs, the U.S. cannot stay protected by isolating itself.
Pandemics are managed with cross-border alliances through idea and resource sharing. The Trump administration, in the interest of America, should abandon the isolationist philosophy it has shown, embrace the proven strategy of collaboration, and realize its responsibility in averting a global health crisis.
– Preeti Yadav