US Health Policy Changes Threaten Global Public Health Cooperation
Su H Wang, MD, FACP, MPH, cautions that the US withdrawal from the WHO and cuts to critical health programs may reverse progress in global health, with vulnerable populations being particularly at risk.
Recent changes in US health policy have raised serious concerns within the global health community. In a recent Lancet correspondence, Su H. Wang, MD, FACP, MPH, and fellow clinicians and public health experts highlighted the alarming impact of the US administration’s decisions to withdraw from the World Health Organization (WHO), halt vital CDC communications, and freeze foreign aid. These actions have placed international health partnerships at risk and threaten progress made in disease control, particularly for vulnerable populations worldwide.1
Experts agree that swift action is needed to restore these programs and safeguard the progress made in global health. The freezing of foreign aid, particularly programs like PEPFAR, which supports more than 20 million people, is of particular concern. The current situation is a stark reminder of how interconnected the world’s health systems are and how vulnerable these systems are to political shifts.1
The US, traditionally a key player in global health, is no longer participating in critical collaborations with the WHO.2 Wong, medical director for the Chinese Medical Program and the Viral Hepatitis Programs at Cooperman Barnabas Medical Center spoke out about the implications of this withdrawal. "The US not only is a member state of the WHO, but there is also a lot of work done between the CDC and the WHO," Wong said. "We wanted to make sure people realized that our global health ecosystem really relies so importantly on these international collaborations— between different countries— but also that different countries support a lot of the work that the WHO actually sponsors or has many committees that require input from people of all different countries."
Wong explained that without the CDC’s participation in WHO meetings, critical communication channels have been severed, delaying the exchange of timely information on epidemics such as smallpox and avian influenza. Countries affected by outbreaks rely on the CDC's guidance to manage disease control, and the absence of that collaboration could have global consequences.3 "Countries that are having outbreaks rely on the CDC for information and for timely responses. A lot of the labs actually provide services abroad so that, as a global community, we can identify outbreaks and respond quickly, preventing them from going out of control."
Another concern raised in the correspondence is the freezing of CDC communications, particularly the suspension of essential reports like the Morbidity and Mortality Weekly Report (MMWR).4 These reports, a cornerstone of public health monitoring, have been vital in tracking diseases such as the flu and avian influenza. Wong emphasized the importance of these reports, “The MMWR, which has been around since the 1800s but has been published weekly since the 1950s, did not have a publication for the first time. This was concerning because that publication is used to convey important, timely things that are happening— like avian influenza. We were kind of expecting the flu report, and many of us use this to track what's happening."
As the availability of other CDC resources diminished, Wong expressed concern about the broader implications for public health. Databases containing critical data on infectious diseases, sexual health, and other pressing medical issues have been removed or reformatted.5 "Some of this data was taken offline, and some of it is being reformatted. The good news is that we’ve heard that some scientists have actually archived a number of these pages so that we have them for reference," Wong said. "But as a scientific and medical community, we have to stay on top of these things."
Wong highlighted that vulnerable populations, including those in need of reproductive health services and gender equity programs, could be disproportionately affected. Clinics that serve marginalized communities may face funding cuts, leaving patients without access to essential care.5 “A lot of the work that addresses gender equity, LGBTQ care, reproductive rights, as you mentioned, and gender issues— I think these are all really being targeted,” Wong said. “I think a lot of those resources and the support of care for such marginalized populations is really going to be affected.”
She also stressed the need for healthcare providers to be proactive in filling the gaps left by these policy changes. "Some clinics are not getting funding. Those of us who can provide care may not be affected by the funding freezes. I think we need to be open and realize that we may not traditionally provide care for these individuals, but let’s open up our doors and make sure that we can be available for patients so that they don’t completely lose care," Wong expressed. "So, equity is important because those people who are already having difficulty accessing care may be more likely to not come, right? If there are some immigration issues, and so I think there are some informal networks that are happening in order to make sure patients feel safe accessing healthcare."
As the global community grapples with these challenges, the hope is that these health programs will be reinstated and that global collaboration will once again be prioritized. Wong closed off the first part of our interview by stating, "Our health security depends on our ability to work together as a global community. If we don’t restore these collaborations, we risk undoing decades of progress in health equity and disease control."
Part 2 of this interview: Science Is Science: Navigating Clinical Trust Amid Political Shifts
