Global health stands at a crossroads. After decades of remarkable progress against infectious diseases, we now face the unsettling prospect of retreat. Smallpox has been eradicated, polio is on the brink of elimination, and childhood killers like measles and whooping cough have been largely controlled through effective vaccination programs. Advances in antibiotics, public health infrastructure, and disease detection have strengthened our defenses against old and emerging threats alike.
Yet today, we find ourselves dismantling these hard-won achievements. Extraordinary cuts to disease prevention, research, and surveillance programs signal a large-scale reversal of a successful strategy of containment and elimination. Such an irresponsible pivot risks opening the door for vaccine-preventable diseases, drug-resistant infections and new pandemics to reemerge with devastating force. If we continue down this path, the consequences will be felt not just in developing nations, but across the industrialized world, where health systems already are under strain.
It could take years to regain the high ground we currently hold against infectious diseases; many countries may never get there again. While pursuing modernization and efficiencies in the global health system is vital, randomly eliminating or suppressing funding and institutions we rely on to develop the pipeline of new vaccines, therapeutics, and practices to fight tomorrow’s pathogens only weakens us further. Our most dangerous disease threats constantly evolve, probe our weaknesses, and exploit natural opportunities to strike.
The attack on America’s preeminent medical research institutions and the innovations they fuel severely undermines our ability to counter disease while degrading the very talent we need to protect us: the next generation of scientists and medical researchers.
Many prominent health leaders are sounding the alarm, but until a coalition of the informed begins to take shape, we may as well be screaming into the wind. Unless a concerted effort is made to change course, the infrastructure, jobs, institutional knowledge, and recruitment of future health experts that constitute one of humanity’s greatest achievements may be dismantled. Surely by now we have learned that research and disease prevention is dramatically less costly than deploying the vast resources necessary to respond to a new outbreak.
Here’s one path forward: U.S. health communicators, advocates, and leaders should coordinate framing the issues to state and congressional lawmakers who stand to lose the most from the current health funding policy direction. Many of the places contributing the most to America’s competitive advantage in biomedical research are in conservative districts that receive funding from the NIH and other public sources.
Similarly, emerging diseases often pose the highest threat to people battling chronic diseases or living in areas underserved by health services, which means all of us are affected, regardless of economic status or ideological belief. People at every level of the health system—from practitioners to patients, researchers to drugmakers—should be energized to speak with one voice and let policymakers know that retreat in the face of defeatable disease threats is the wrong direction for the U.S.
Disease is humanity’s greatest enemy, and it constantly hovers at our doorstep. Do we pretend not to hear it knocking, or do we recognize its dangers and act?
That’s exactly the moment we are facing now. Our situation is complicated by the fact that our most important defenses – biomedical research and disease prevention infrastructure – are being demolished before our eyes. It will take real courage to act, but we must marshal our resources, defying the ambivalence and dismissiveness that make us more vulnerable to looming infectious disease threats. This is no time to retreat.
