Lives in the Balance: Infectious Disease and the Trump Administration

The Administration has made serious inroads on safeguards against infectious disease.

The federal government has traditionally worked to limit the risks and impacts of epidemics.  At a time when scientists are increasingly worried about a possible H1N5 epidemic like the 1917 flu, the erosion of the U.S. public health system by the current Administration creates particular ground for alarm. Disease control, like many other traditional government activities, has been under a MAGA-driven onslaught.

Earlier this year, the Trump Administration moved to destroy AID, the U.S. international aid organization.  The effects on global health will be dire. For example, AID was monitoring bird flu in 49 countries. According to the science journal Nature, more than twenty million people with HIV, including over a million children and pregnant women, receival retroviral drugs through AID.  Even if funding for these programs is later restored, many of those people may suffer from a rebound effect with worse infections than ever.  Likewise, the abrupt closure of AID left people having experimental drugs or devices in their bodies with no continuing medical support. Along with the U.S. pullout from the World Health Organization, the AID closure will pull billions of dollars away from effort to fight infectious diseases such as HIV and malaria.

It is not only foreign lives that are at risk. AIDS began in Africa. COVID began in China.  Viruses do not respect national boundaries, and they can’t be repelled by raising tariffs. Yet the U.S. is abandoning its support for monitoring and early responses to infectious diseases before they reach our country.

The outlook for U.S. control of infectious diseases is also uncertain.  Trump appointed Robert Kennedy Jr., an anti-vaccine advocate, to head the Department of Health and Human Services (HHS).  HHS includes the Federal Drug Administration, which licenses vaccines; the Centers for Disease Control, which fights epidemics; the National Institutes of Health, which is the main source of funding for medical research.  During the COVID pandemic, Kennedy favored remedies that have been debunked by medical researchers.

In terms of the recent Texas measles outbreak, he did issue a statement calling on parents to vaccinate their kids, but coupled that with an endorsement of better nutrition as a way to fight disease (which is relevant to measles only for children suffering from malnutrition). And then HHS renewed research into the long-since debunked claim that vaccines cause autism, which will only raise concerns among parents about vaccination.

Putting Kennedy himself aside, the Administration has done much to weaken the federal government’s support for disease control.   Spending freezes, for instance, disrupted biomedical research projects across the country and left researchers in a state of confusion. Control of the CDC’s research journal has been taken over by political appointees, who seemingly suppressed important research on H1N5. Without notice, the NIH slashed a key component of medical research grants, reducing total research funding by billions of dollars, which could kill many projects. Then, the Administration fired a quarter of the workers who were coordinating the labs monitoring bird flu.

We cannot know in advance how the Administration would respond to a public health emergency, and current misgivings may turn out to be misplaced. But at the very least, we cannot be sure that the government will be there when we most need it.

disease control, pandemic, public health, RFK Jr., Trump Administration