Trumps Budget Would Gut Global Health Programs

President Donald Trump’s proposed budget for 2021 seeks deep and widespread cuts to global health , slashing over $3 billion in funding.

The proposed cuts include a 34% reduction to the State Department and USAID’s global health funding and a 7% cut to the Centers for Disease Control and Prevention. Trump’s budget wants to gut funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria with a 58% cut, and decrease U.S. funding for the World Health Organization by 50%.

Although there are some boosts in funding such as a $50 million increase for the CDC’s global health security activities and $15 million for a USAID Global Health Security programs to target the Covid-19 coronavirus outbreak they are paltry in comparison with the billions of dollars the administration seeks to take away.

Like all presidential budgets, it’s a statement of priorities that’s unlikely to go into effect. But the statement made in this one is deeply troubling to lawmakers and public health experts, particularly given the current threat from the virus that has killed nearly a thousand people since it emerged in Wuhan, China, and spread to over 25 countries around the world in recent weeks. 

“I’ve been working to keep in close touch with our health officials as they need to respond to the novel coronavirus, and I can tell you no one has suggested the thing they really need right now is a budget cut,” Sen. Patty Murray (D-Wash.) told HuffPost.

Cuts Come During Global Health Fears

The proposed budget cuts come as health officials and medical experts urge greater funding and cooperation to deal with emerging threats to global health, such as the recent coronavirus outbreak. Although international health authorities have rapidly mobilized to mitigate the damage from the Covid-19 outbreak, experts warn that pandemics and infectious disease outbreaks are a growing threat. They argue the only way to address these future diseases is through international cooperation rather than implementing nativist policies and turning away from global health.

“We can’t build a border wall that will prevent microbes from getting in. They’re going to travel the world as they always have,” said Dr. Stephen Morse, a professor of epidemiology at Columbia Medical University and leading expert on emerging diseases. “We’re going to be living with this reality, and it’s only proof that we can’t isolate ourselves.”

Trump has been largely silent and vaguely dismissive of the virus.

“It will all work out well,” Trump tweeted in January, one of only a few mentions of the virus. Trump claimed on Monday that “a lot of people think” the virus “goes away in April with the heat,” and assured “we’re in great shape.”

But the extent to which the coronavirus outbreak will “work out” has very little to do with Trump, whose administration has made numerous attempts to slash health programs each year in office and forced out top experts in preparing for pandemics.

The White House has repeatedly tried to implement deep budget cuts to global health programs in the past, including those that specifically targeted programs on emerging and infectious diseases such as Ebola and coronaviruses. The Trump administration attempted to cut $2.5 billion overall for the 2020 fiscal year from the State Department and USAID’s global health programs, as well as $50 million from pandemic preparedness operations. These programs carry out a wide range of activities from research and monitoring of emerging diseases to immunization.

Trump’s apparent disengagement contrasts with his fervent criticism of the Obama administration’s handling of the 2014 Ebola outbreak, when he groundlessly accused Obama of not doing enough to prevent the virus from spreading to the United States and spouted conspiracy theories about the virus on Fox News. But as president, Trump worked to eliminate the emergency funds that Obama implemented for combating Ebola along with his other proposed cuts. 

Members of Congress came together to vote against budget proposals and instead managed to increase funding. But there’s still the question of who in the administration will coordinate a broad interagency response to an outbreak such as Covid-19 if it starts to spread rapidly in the United States. Right now, there is nobody who would be in an obvious position to do that after former national security adviser John Bolton disbanded the National Security Council team in charge of global health security and effectively pushed out its well-respected director Rear Adm. Timothy Ziemer.

“We are losing some really good people in the U.S. government who are frustrated with some of [the administration’s actions],” said Dr. Paul Spiegel, director of the Center for Humanitarian Health at John Hopkins. “We’re losing some pretty important technical leaders in the field which will have a longer-term impact.”

Trump’s attempted cuts in global health programs have taken place as experts warn of a persistent threat from infectious diseases, as we’ve seen in recent decades from SARS, MERS, Ebola and other outbreaks. The Covid-19 virus is the latest of these to highlight why turning away from international health commitments is dangerous policy. 

“It’s a reminder yet again of the importance of strengthening public health capacities, nationally and globally,” said Dr. James M. Hughes, former chief of infectious diseases at the CDC and a professor emeritus of medicine at Emory University. “If we don’t do that, we’ll continue to see these kinds of tragic events occuring.”

Lawmakers Condemn Cuts

Lawmakers, political candidates and the public health community have spoken out against Trump’s attempts to cut funding for global health programs.

Former Vice President Joe Biden, now running for president, called Trump the “worst possible person to lead our country through a global health challenge” in an op-ed last month and fellow presidential hopeful Sen. Elizabeth Warren (D-Mass.) announced a plan for combating infectious diseases that includes increasing funding for health agencies and developing vaccines. Sens. Gary Peters (D-Mich.), Patrick Leahy (D-Vt.), Patty Murray (D-Wash.) and Bob Menendez (D-N.J.) issued an open letter last week calling on the president to fully fund global health efforts. 

“In light of the current novel coronavirus outbreak and the persistent threat of global pandemics, we urge you to fully fund infectious disease and pandemic preparedness and response efforts in your fiscal year 2021 proposed budget,” the senators wrote. “A failure to do so would not only be a danger to the health and welfare of all Americans, but also a threat to our national security.”

The Trump administration’s proposed cuts have also frustrated staffers who work on health and aid policies, as the budget decisions appear to lack any rationale beyond blunt cost-cutting measures.

Trump’s proposed reductions in funding make little sense even as a means of saving money, health experts argue, since they act as a relatively low-cost insurance policy against diseases and outbreaks which can wreak economic havoc as they disrupt trade, tourism, and many other aspects of the global economy.

“We’ve come to expect that they cut programs that either they don’t know about and therefore wrongly assume are not important, or that they don’t care about,” said Tim Rieser, chief foreign policy aide to Leahy. “They don’t give us justifications, other than that the White House ordered it. Instead, they dress up the cuts with happy talk that everyone who works on these programs knows is meaningless.”

Jenavieve Hatch contributed reporting to this article.