Sweeping Public Health Changes Creates US and Global Turmoil
With the Trump Administration’s plans to cease funding for Gavi, the Vaccine Alliance as well as to reduce HHS personnel, public health both internationally and domestically, are going to be widely affected.
The Trump Administration’s proposed public health policy changes are occurring on 2 fronts: domestically and internationally. And these sweeping changes that are happening are widespread enough that they will affect everyone’s health to some degree.
One example on the international front is the administration’s plan to stop funding Gavi, the Vaccine Alliance. Last month, the US State Department detailed its planned cuts to foreign aid, and as part of that, it decided to cancel its over $1 billion grant to Gavi. The organization is a public-private partnership that helps vaccinate more than half the world’s children against some of the deadliest diseases. Gavi brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Gates Foundation, and other private sector partners.¹
Through Gavi’s vaccine programs, 1.1 billion children have been immunized through routine programs; an estimated 18.8 million future deaths have been prevented; 1.9 billion vaccinations have been administered through preventative campaigns; and $250 billion in economic benefits have been estimated for participating countries.²
The US is one of the 3 largest governmental donors to Gavi, along with the United Kingdom and Norway.³ This loss of funding will greatly impact global vaccination efforts.
“This could lead to things like an uptick in diseases and deaths in some of the poorest countries. And these effects could actually be quite staggering,” said Janeen Madan Keller, policy fellow and deputy director of the Global Health Policy program at the Center for Global Development (CGD). “Some back-of-the-envelope calculations that my colleagues here at the Center for Global Development did suggest that the US terminating its support of Gavi—as well as clawing back some of its bilateral funding for global immunization efforts—could actually result in as many as 20,000 to 500,000 more deaths globally from vaccine-preventable diseases each year.”
Madan Keller covered this subject recently in a CGD blog. During Trump’s first term, the administration supported Gavi by pledging $1.16 billion to the alliance—a slight increase from the previous US pledge. The Biden Administration later pledged at least $1.58 billion to Gavi’s replenishment round.⁴
Closer to home, the Department of Health and Human Services (HHS) recently announced it would reduce its workforce by laying off 10,000 full-time employees. Combined with other efforts, HHS expects to downsize its workforce by 20,000 employees overall. This restructuring would reduce the agency’s size from 82,000 to 62,000 full-time employees.⁵
Again, these domestic and international public health actions are confounding, particularly given how drastically they contrast with previous policies and commitments.
“The Trump administration's actions are really hindering the work of HHS—federal agencies as well as global organizations—through potential funding cuts to Gavi and decisions such as the withdrawal from the World Health Organization,” Madan Keller said. “All of these organizations play a central and pivotal role in monitoring, preventing, and stopping the spread of outbreaks and other biological threats before they reach us here in the United States. I would argue that, taken together, these sweeping changes are going to have significant consequences. And I think what they will boil down to is making us much less safe. They’re also going to have very important consequences and ramifications for people's health and safety all around the world.”
