In the volatile early months of Donald Trump’s presidency, the United States witnessed a political transformation at home. There was also a widespread unraveling of its long-standing commitments to global health. Additionally, humanitarian assistance commitments were weakened. Executive orders came swiftly. Programs were slashed with little analysis and even less foresight. A series of bureaucratic shifts began. It soon escalated into a full-blown retreat from global cooperation. This change imperils not only vulnerable populations abroad. It also threatens the very health and security of the American people. The dismantling of USAID partnerships caused significant disruptions. Withdrawals from the World Health Organization (WHO) added to these disruptions. Abrupt terminations of medical research collaborations further contributed to the upheaval. They are more than mere policy changes. These actions are a severing of moral, scientific, and strategic lifelines. These lifelines have protected and advanced U.S. interests for over a century.
From the outside, foreign assistance might seem like altruism—generosity extended to others in need. But in reality, America’s foreign aid programs have long been a delicate dance of humanitarian values and geopolitical calculus. Global health investments are not just charitable; they are strategic. They prevent wars. They create trade opportunities. They foster international goodwill and build diplomatic bridges. And perhaps most critically, they protect Americans from the spread of infectious diseases long before those threats reach our shores. The consequences of walking away from these commitments are both immediate and far-reaching. They are measured in lost lives, lost trust, and lost influence.
We need to understand how we arrived here. We must also grasp what we stand to lose. To do this, we must examine the historical roots and modern implications of U.S. global health leadership, and why retreating from it is a risk we cannot afford to take.
The Historical Blueprint: Global Health as Policy, Not Charity
The idea of foreign assistance as a means of strategic influence dates back to the First World War. In 1917, President Woodrow Wilson appointed Herbert Hoover as U.S. Food Administrator, tasking him with coordinating emergency food relief to Belgium during its occupation. This was not a random act of generosity. It was a move to stabilize a region on the brink of famine. It also aimed to maintain global order in the face of growing unrest. That initiative set a precedent for future humanitarian engagement grounded in both compassion and national interest.
The post-World War II era witnessed an expansion of this ethos. U.S. participation in establishing the World Health Organization in 1948 demonstrated a commitment to multilateralism in health. President John F. Kennedy’s launch of the U.S. Agency for International Development (USAID) was in 1961. This initiative created a centralized vehicle for channeling health and development aid to low- and middle-income countries (LMICs). These actions recognized that preventing epidemics abroad was central to America’s own national interest. Fostering political stability was also central to it. Nurturing economic development remained a key aspect. They were not separate from America’s own national interest—they were central to it.
The Centers for Disease Control and Prevention (CDC) became a hub of global collaboration. The Fogarty International Center (FIC) at the National Institutes of Health (NIH) also became a hub of global collaboration. They produced life-saving breakthroughs such as the eradication of smallpox. They also made advances in polio elimination, maternal health, and child nutrition. These were not unidirectional gifts; they were mutual investments in human survival.
When the World Heals, America Thrives
American taxpayers have directly benefited from many of the very programs Trump-era policies have sought to dismantle. Consider oral rehydration therapy (ORT), pioneered through collaborations between U.S. and South Asian scientists to combat diarrheal diseases. Today, ORT is a staple treatment in pediatric care across the United States. Similarly, global studies funded by USAID and the NIH had significant impacts domestically. These studies led to practices such as calcium supplementation to prevent preeclampsia. They also promoted the widespread use of vitamin A to prevent childhood blindness.
Community health worker models developed in LMICs have informed strategies to reach underserved populations within the United States. These are not isolated incidents—they are a pattern of reciprocal innovation, where solving global problems feeds domestic progress.
The President’s Emergency Plan for AIDS Relief (PEPFAR) is a significant example of this dual benefit. It was launched in 2003. PEPFAR has saved over 26 million lives globally. It has advanced scientific understanding of HIV/AIDS in transformative ways for American health care. Economic stability in countries receiving PEPFAR support has fostered stronger trade relationships, reinforcing U.S. markets. Pulling back from such initiatives now is not only irresponsible—it is economically shortsighted.
The High Cost of Disengagement
Support for global health accounts for less than 1% of the federal budget. Yet, the impact of these investments is profound. The Trump administration decided to gut USAID programs. They also retracted support from global partners. This is a departure from decades of bipartisan, evidence-based policymaking. According to numerous public health estimates, it will lead to as many as 160,000 avoidable child deaths each year. Millions will be pushed into deeper poverty.
Moreover, the decision to withdraw from the WHO reduces the United States’ influence in shaping global health policies. Defunding Gavi, the Vaccine Alliance, also weakens global pandemic preparedness. During the COVID-19 crisis, countries with stronger relationships with global health organizations mounted more coordinated and effective responses. Future pandemics will be even more devastating without an engaged United States at the table.
Some may argue that foreign assistance fosters dependency. However, the real dependency may lie in America’s reliance on a stable and healthy global community. This is crucial for securing its own health and prosperity. As food insecurity rises and child mortality climbs in parts of sub-Saharan Africa and Southeast Asia, political unrest will follow. In such vacuums, extremist groups flourish, and adversarial powers like China will step in to fill the void. America’s absence from the global health stage is not an act of independence—it is an abdication of leadership.
Reforming Aid Does Not Mean Eliminating It
To be clear, foreign aid is not a perfect system. Critics of the aid model have long warned of inefficiencies, neocolonial tendencies, and the risk of fostering long-term dependence. These are valid concerns. The structure and delivery of foreign assistance programs should indeed be reexamined. The focus should be on transparency, local leadership, and sustainable impact.
However, reform is not the same as abandonment. Reimagining aid to be more community-driven and equity-centered can coexist with strong U.S. engagement. Ending foreign assistance entirely is akin to slamming the door shut on global partnerships. These partnerships have historically benefited all parties. The answer is not less aid. It is better aid.
The Role of Clinicians, Scientists, and Citizens
In this moment of retreat and uncertainty, scientists and clinicians must not remain silent. Researchers whose work has been supported by global collaborations should testify to the real-world benefits of those alliances. Academic medical centers—whose federal grants are increasingly at risk—must advocate for stable funding of global research initiatives.
Citizens, too, must become vocal participants in this discourse. Congressional offices should be flooded with calls and letters advocating for the restoration of global health funding. Organizations in the health, science, and education sectors must form coalitions. They need to oppose the narrative that foreign aid is a frivolous expense.
Pulling back from global engagement is not just a policy decision. It is a public health hazard. It is an economic gamble. And it is a moral failure.
The Danger of Normalizing the Unthinkable
German physician and social theorist Rudolf Virchow once observed, “It is the curse of humanity that it learns to tolerate even the most horrible situations. This occurs by habituation.” Today, this curse is unfolding in real time. With every defunded program, we are being asked to accept less. Each severed partnership makes us accept less compassion. We also see less global cooperation and take on less responsibility for the shared fate of humankind.
But we must not accept it. We must reject the normalization of abandonment. Instead, we should demand a return to the values that once defined American global leadership: evidence, empathy, and engagement.
We Must Reinvest, Reimagine, Reconnect
This is not a question of left versus right, or of intervention versus isolationism. Will we allow fear and shortsightedness to dictate our role in the world? Alternatively, will we recommit to a future where global health is not seen as a burden, but as a bridge?
The dismantling of global health programs under the Trump administration is more than a bureaucratic shuffle. It dismantles decades of progress. And the consequences will not stop at distant borders. They will reach into our hospitals, our communities, and our economy.
Let us reinvest in global health not as charity, but as a strategy. Let us reimagine foreign aid not as a one-way street, but as a collaborative path forward. And let us reconnect with the world, not because we must—but because we can.
Because when the world heals, we all do!!
References
- United States Agency for International Development (USAID). (2023). USAID global health programs. Retrieved from https://www.usaid.gov/global-health
- World Health Organization. (2022). Investing in global health: Global action for healthy people. Retrieved from https://www.who.int
- U.S. Global Leadership Coalition. (2023). Foreign aid: What does it cost and why does it matter? Retrieved from https://www.usglc.org
- Kaiser Family Foundation. (2022). The U.S. government and global health. Retrieved from https://www.kff.org/global-health-policy
- Fogarty International Center. (2021). Global health training and research benefits. Retrieved from https://www.fic.nih.gov
