History Shows the Danger of Trump and RFK Jr.'s Health Policies

Time​ Magazine

a day ago

On May 11, 2023, President Joseph Biden ended the COVID-19 public health emergency, calling an finish to the pandemic. By the end of 2023, COVID-19 claimed the lives of over 20 million people around the world. But through international cooperation and evidence-based science, vaccines were developed and the world moved on.
Indeed, perhaps the biggest success of the period was the quick production of a COVID-19 vaccine. The research behind the mRNA vaccine had been ongoing since the 1970s, but the emergency of the pandemic and international sharing of knowledge helped bring the vaccine to fruition. Today, the COVID-19 vaccine has been credited with saving 2.4 million lives around the world.
But now, the U.S. is choosing competition over cooperation. With President Donald Trump's day one executive order to leave the World Health Organization (WHO)—blaming their COVID-19 response—and the shuttering of USAID, the country is taking steps towards further dividing health efforts across the globe. Here in the U.S., a sudden end to $11.4 billion of covid-related grants is stifling national pandemic preparedness efforts on the local and state levels. And most recently, Health and Human Services Secretary RFK Jr. purged experts from the CDC Advisory Committee, putting lives at risk.
Historical lessons demonstrate the need for global health infrastructure that works together, shares knowledge, and remembers that pathogens do not stop at borders.
One of the greatest global health achievements of all time— smallpox eradication —provides a perfect example of what can be done with independent scientific research and international cooperation. During the Cold War between the U.S. and USSR, decades of tension brought the world to the brink of nuclear war. Yet, incredibly, the nations managed to find common ground to support the efforts of smallpox eradication. Indeed, they understood the strategic benefits that came from letting public health practitioners and scientists work outside of political divides.
The WHO was founded after World War II in 1948. Its formation marked a move from international health, that focused on nations, to global health, that would serve humanity first. The WHO's first eradication effort was the failed, U.S.-backed, Malaria Eradication Program from 1955 to 1969. The Smallpox Eradication Program, with intensive efforts beginning in 1967, provided a chance for redemption for the U.S. and WHO.
For the United States, investing in disease eradication and poverty helped to mitigate growing backlash against the Vietnam War. In June of 1964, President Lyndon B. Johnson stated, 'I propose to dedicate this year to finding new techniques for making man's knowledge serve man's welfare.' He called for 1965—the same year he ordered ground troops to Vietnam to stop the spread of communism —to be a year of international cooperation that could bypass the politics of the Cold War.
Previously, the USSR did not participate in the U.S. and WHO's first, failed global eradication plan for malaria. But upon rejoining the WHO in 1956, it was the Soviets who made the first call and investment into global eradication of smallpox in 1958.
The WHO functioning as a mediator was crucial to allowing the USSR and the U.S. to work together. It allowed both nations to avoid giving credit to each other; rather success went to science itself. President Johnson called this 'a turning point' away from 'man against man' towards 'man against nature.'
The limited role of politicians in the program proved to be key to its success. Scientists made decisions and worked together—no matter what country they came from—by focusing on disease and vaccination, not international tensions. The Soviet-initiated program was lead by Donald A. Henderson, a U.S. epidemiologist, who worked alongside the Russians until the last case of smallpox occurred in Somalia on October 26, 1977.
During the 20th century, smallpox was responsible for an estimated 300 to 500 million deaths. Smallpox was officially declared eradicated by the WHO in October 1980, and is today still the only human disease to achieve this distinction.
Less than a year after the declaration of smallpox eradication, the emergence of another pandemic, the HIV/AIDS crisis, reinforced the importance of science-first cooperation over politically-driven decision making. In June 1981, the first cases of a new unknown disease were reported in the CDC's Morbidity and Mortality Weekly Report. In short order, gay men were stigmatized and blamed in what would become one of the biggest public health disasters of all time. It took years of grassroots science-based activism to move beyond HIV/AIDS victim-blaming and find medical solutions.
Too often, governments across the globe placed blame on the gay community for their 'sins' and did not provide needed support, leaving the sick to suffer and die. The pharmaceutical companies profited from the limited medications they had available and did not pursue sufficient development. The FDA process for new drugs was scheduled to take nine years, at a time when life expectancy after receiving an HIV/AIDS diagnosis was one year. These issues sparked activism, spawning the AIDS Coalition to Unleash Power (ACT UP) in 1987.
ACT UP organizers took science into their own hands and began educating themselves. Members began reading scientific journals religiously, learning the chemistry and epidemiology of drug manufacturing and clinical trials. Members learned how to translate these dense scientific messages to educate the community members on what was—and what was not—being done to help. Because of this work, the FDA changed policies to allow for new treatments to be tested at accelerated rates in times of emergency. ACT UP was able to shift the cultural blame showing that the issue was a result of politics getting in the way of scientific advancements. By 1990, ACT UP influenced the largest federal HIV program to pass Congress, the Ryan White CARE Act. This program was a vital precursor to the 2003 PEPFAR (The U.S. President's Emergency Plan for AIDS Relief) global initiative.
Both of these histories offer a powerful lesson: global health is national health, and national health is local health. With the recent funding cuts from the U.S. government, the future of global health is going in an unknown direction. And yet, the occurrence of pandemics is expected to increase in frequency due to climate change, mass migration, urbanization, and ecosystem destruction. It has been estimated that there is about a 25% chance we will have another COVID-sized pandemic within the next 10 years. No matter how secure the world makes borders, history shows that it can not protect us from disease if we do not have a strong, interconnected public health infrastructure.
Luke Jorgensen is a Master of Public Health student at Purdue University where his epidemiology research examines human migration and infectious disease.