Putting America First’ — Undermining Health for Populations at Home and Abroa
Abstract
This Perspective critiques recent U.S. policy shifts especially under the Trump administration that dismantle foreign aid programs and weaken global health collaboration. The authors argue that global health investments, such as USAID and NIH initiatives (e.g., PEPFAR, Fogarty International Center), have benefited both low- and middle-income countries and the United States, through innovations like oral rehydration therapy and cost-effective public health tools. Abrupt program cuts, they warn, could worsen global instability, accelerate child mortality, and damage U.S. strategic interests. With examples ranging from COVID-19 to childhood malnutrition and research training, the article advocates for reform not abandonment of aid, and encourages scientists and clinicians to resist politically motivated disengagement. Calls to action include policy advocacy, institutional accountability, and preserving the editorial and scientific independence of public health institutions
Keywords:
U.S. foreign assistance
global health
USAID
PEPFAR
Fogarty International Center
NIH
political disruption
reciprocal innovation
health equity
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