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President Donald Trump as global health’s displacement activity

  • Sophie Harman (a1) and Sara E. Davies (a2)

Abstract

The United States presidential election of Donald Trump in 2016 was observed by global health commentators as posing dire consequences for the progress made in global health outcomes, governance, and financing. This article shares these concerns, however, we present a more nuanced picture of the global health governance progress narrative pre-Trump. We argue that Trump’s presidency is a displacement activity to which global health’s pre-existing inequalities and problems of global health security, financing, and reproductive health can be attributed. Unfettered access to sexual and reproductive rights, sustained financing of health system strengthening initiatives, affordable medicines and vaccines, and a human security-centred definition of global health security were already problematic shortfalls for global health governance. Trump no doubt exacerbates these concerns, however, to blame his presidency for failings in these areas ignores the issues that have been endemic to global health governance prior to his presidency. Instead of using Trump as a displacement activity, his presidency could be an opportunity to confront dependency on US financing model, the lack of a human-security centred definition of global health security, and the norm of restricting reproductive health. It is such engagement and confrontation with these issues that could see Trump’s presidency as being a catalyst for change rather than displacement as a means of preserving the uncomfortable status quo in global health. We make this argument by focusing on three specific areas of US-led global health governance: reproductive health and the ‘global gag rule’, health financing and the President’s Emergency Plan for AIDS Relief (PEPFAR), and pandemic preparedness and global health security.

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Copyright

Corresponding author

*Corresponding author. Email: s.harman@qmul.ac.uk

References

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1 Claire Cohen, ‘Donald Trump sexism tracker: Every offensive comment in one place’, The Telegraph (2017), available at: {http://www.telegraph.co.uk/women/politics/donald-trump-sexism-tracker-every-offensive-comment-in-one-place/} accessed November 2017; Katie Reilly, ‘Here are all the times Donald Trump insulted Mexico’, Time (2016), available at: {http://time.com/4473972/donald-trump-mexico-meeting-insult/} accessed November 2017.

2 Brugha, Ruaiŕi, Bruen, Carlos, and Tangcharoensathien, Viroj, ‘Understanding global health policy’, in Garrett W. Brown, Gavin Yamey, and Sarah Wamala (eds), The Handbook of Global Health Policy (Oxford: Wiley Blackwell, 2014), pp. 2145 ; Gilson, Lucy, Health Policy and Systems Research: A Methodology Reader (Geneva: Alliance for Health Policy and Systems Research/WHO, 2012).

3 Clinton, Chelsea and Sridhar, Devi, Governing Global Health (Oxford: Oxford University Press, 2017).

4 This article focuses on global health rather than US health, but for more on concerns regarding Trump and the Affordable Care Act or ‘Obamacare’, see Berwick, Donald M., ‘Understanding the American healthcare reform debate’, The British Medical Journal (BMJ), 357:13 (2017); Butler, Stuart M., ‘Repeal and replace Obamacare: What could it mean?’, The Journal of the American Medical Association (JAMA), 317:3 (2017), pp. 244245 ; Jaffe, Susan, ‘Dismantling the ACA without help from Congress’, The Lancet, 390 (2017), pp. 441442 ; Ryan Lizza, ‘The entire Trump agenda is at a tipping point’, The New Yorker (2017), available at: {https://www.newyorker.com/news/ryan-lizza/the-entire-trump-agenda-is-at-a-tipping-point} accessed November 2017.

5 Merino, Jose G. et al., ‘Standing up for science in the era of Trump’, BMJ, 356 (2017), p. 775 .

6 Damian Paletta and Danielle Parquette, ‘Ivanka Trump and the World Bank have a new idea to help women globally’, The Washington Post (2017), available at: {https://www.washingtonpost.com/news/wonk/wp/2017/07/08/after-proposed-aid-cuts-ivanka-trump-and-the-world-bank-have-a-new-idea-to-help-women-globally/?utm_term=.797c30d944dc} accessed November 2017.

7 Liz Ford, ‘Melinda Gates “deeply troubled” by Donald Trump’s planned budget cuts’, The Guardian (2017), available at: {https://www.theguardian.com/global-development/2017/jul/11/melinda-gates-deeply-troubled-by-trump-cuts-to-family-planning-funds} accessed November 2017; David Smith, ‘Bill Gates: Trump twice asked me the difference between HIV and HPV’, The Guardian (2018), available at: {https://www.theguardian.com/us-news/2018/may/18/bill-gates-donald-trump-difference-hiv-hpv} accessed June 2018.

8 The Lancet, ‘The Trump global gag rule: an attack on US family planning and global health aid’, The Lancet, 389 (4 February 2017); The Lancet Editorial, ‘A hundred days: What is to show for it?’, The Lancet, 389 (29 April 2017).

9 Harman, Sophie, Global Health Governance (London: Routledge, 2012), p. 2 .

10 Greer, Scott L. and Rominski, Sarah D., ‘The global gag rule and what to do about it’, BMJ, 356 (2017), p. 1 ; Starrs, Ann M., ‘The Trump global gag rule: an attack on US family planning and global health aid’, The Lancet, 389:4 (2017), pp. 485486 ; The Lancet, ‘Sexual health and reproductive rights at a crossroad’, The Lancet, 389 (2017), pp. 23612362 .

11 Starrs, ‘The Trump global gag rule’, p. 485.

12 Gullard, Anne, ‘Trump expands antiabortion rule to include all global health funding’, BMJ, 356 (2017), p. 1 ;

Greer and Rominski, ‘The global gag rule and what to do about it’, p. 1.

13 Starrs, ‘The Trump global gag rule’, p. 485.

14 Guttmacher Institute, ‘Induced Abortion Worldwide: Global Incidence and Trends’ (2018), available at: {https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide} accessed January 2018.

15 Gold, Rachel Benson and Starrs, Ann M., ‘US reproductive health and rights: Beyond the global gag rule’, The Lancet, 3 (2017), e122e133 ; The Lancet HIV, ‘Gag rule at odds with progress in HIV/AIDS’, The Lancet HIV, 4 (2017), e93 .

16 The Lancet, ‘Sexual health and reproductive rights at a crossroad’, pp. 2361–2.

17 Ibid.

18 The Lancet Diabetes and Endocrinology, ‘Into the unknown: Trump’s stance on health’, The Lancet Diabetes and Endocrinology, 5 (2017), p. 1 .

19 Starrs, ‘The Trump global gag rule’, pp. 485–6.

20 Singh, Jerome A. and Abdool Karim, Salim S., ‘Trump’s “global gag rule”: Implications for human rights and global health’, The Lancet, 5 (2017), e387e388 .

21 Starrs, ‘The Trump global gag rule’, p. 485.

22 UNFPA, International Conference on Population and Development (New York: UNFPA, 1994), available at: {http://www.unfpa.org/publications/international-conference-population-and-development-programme-action} (accessed November 2017).

23 Greer and Rominski, ‘The global gag rule and what to do about it’, p. 1.

24 Gordon Darroch, ‘Dutch respond to Trump’s “gag rule” with international safe abortion fund’, The Guardian (25 January 2017), available at: {https://www.theguardian.com/global-development/2017/jan/25/netherlands-trump-gag-rule-international-safe-abortion-fund} accessed December 2017.

25 Joseph Frankel, ‘Will Trump’s expanded policy against abortion harm HIV/AIDS relief?’, The Atlantic (2017), available at: {https://www.theatlantic.com/health/archive/2017/05/mexico-city-policy-hiv-aids/527268/} (accessed November 2017); Sam Francis, ‘Nationalism: Old and new’, Chronicles (June 1992), pp. 18–22; Francis, Sam, Leviathan and its Enemies (Washington, DC: Washington Summit Publishers, 2016); Jean-François Drolet and Michael C. Williams, Radical Conservatism and Global Order: International Theory and the New Right (forthcoming, on file with authors).

26 Frankel, ‘Will Trump’s expanded policy against abortion harm HIV/AIDS relief?’.

27 Center for Reproductive Rights. The World’s Abortion Laws Map (2014), available at: {https://www.reproductiverights.org/document/the-worlds-abortion-laws-map} accessed November 2017.

28 United Nations, ‘Goal 5: Improve Maternal Health’ (2000), available at: {http://www.un.org/millenniumgoals/maternal.shtml} (accessed November 2017); United Nations, ‘Goal 3: Ensure Healthy Lives and Promote Well-Being for All at All Ages’ (2015), available at: {http://www.un.org/sustainabledevelopment/health/ (accessed November 2017).

29 Harman, Sophie, ‘Women and the millennium development goals: Too little too late too gendered’, in R. Wilkinson and D. Hulme (eds), Beyond the Millennium Development Goals (London: Routledge, 2012); Harman, Sophie, ‘Ebola, gender and conspicuously invisible women in global health governance’, Third World Quarterly, 37:3 (2016).

30 Coombes, Rebecca, ‘Out of stock: Summit highlights global lack of access to contraceptives’, BMJ, 358 (2017).

31 Brittney McNamara, ‘Trump signs a global anti-abortion executive order’, Teen Vogue (2017), available at: {https://www.teenvogue.com/story/trump-signs-global-anti-abortion-executive-order} accessed November 2017.

32 Schoen, Johanna, Choice and Coercion: Birth Control, Sterilization and Abortion in Public Health and Welfare (North Carolina: University of North Carolina Press, 2005).

33 PEPFAR, ‘PEPFAR Funding’ (2017), available at: {https://www.pepfar.gov/documents/organization/252516.pdf} accessed November 2017.

35 PEPFAR, ‘PEPFAR Funding’ (2017), available at: {https://www.pepfar.gov/documents/organization/252516.pdf} accessed November 2017.

36 Harman, Sophie, ‘15 years of “War on AIDS”: What impact has the global HIV/AIDS response had on the political economy of Africa?’, Review of African Political Economy, 42:145 (2015), pp. 467476 .

37 Remme, Michelle et al., ‘Financing the HIV response in sub-Saharan Africa from domestic sources: Moving beyond a normative approach’, Social Science and Medicine, 169 (2016), pp. 6676 .

38 UNAIDS, ‘UNAIDS and UNFPA Launch Road Map to Stop New HIV Infections’ (October 2017), available at: {http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2017/october/20171010_prevention-roadmap} accessed December 2017.

39 Enemark, Christian, Biosecurity Dilemmas: Dreaded Diseases, Ethical Responses, and the Health of Nations (Washington, DC: Georgetown University Press, 2017), xviii .

40 The Lancet Editorial, ‘A hundred days’, p. 1669.

41 Ibid.; Robert Pear, ‘Congress rejects Trump’s proposals to cut health research funds’, New York Times (2017), available at: {https://www.nytimes.com/2017/09/11/us/politics/national-institutes-of-health-budget-trump.html} accessed November 2017; McCarthy, Michael, ‘Trump proposes slashing funding for Medicaid, poverty programs, and medical research’, BMJ, 357 (2017), p. 2549 ; Jaffe, Susan, ‘High stakes for research in US 2018 budget negotiations’, The Lancet, 390 (2017), pp. 10171018 .

42 Jaffe, Susan, ‘Marching for science as budget cuts threaten US research’, The Lancet, 389 (2017), pp. 16831684 .

43 McCarthy, ‘Trump proposes slashing funding for Medicaid, poverty programs, and medical research’, p. 2549; Jaffe, ‘High stakes for research in US 2018 budget negotiations’, pp. 1017–18.

44 Youde, Jeremy, Global Health Governance (Cambridge: Polity Press, 2012).

45 Pear, ‘Congress rejects Trump’s proposals to cut health research funds’.

46 Ed Yong, ‘How an epidemic may play out under Trump’, The Atlantic (2016), available at: {https://www.theatlantic.com/science/archive/2016/12/outbreaks-trump-disease-epidemic-ebola/511127/} accessed November 2017.

47 Gostin, Lawrence, ‘How will President Trump’s policies affect domestic and global health and development?’, JAMA, 317:7 (2017), pp. 685686 .

48 Piot, Peter, ‘Editorial: Ebola’s perfect storm’, Science, 345:6202 (2014), p. 1221 ; Benton, Adia, ‘Who’s security? Militarization and securitization during West-Africa’s Ebola outbreak’, in M. Hofman and S. Au (eds), The Politics of Fear: Medécins san Frontières and the West African Ebola Epidemic (Oxford: Oxford University Press, 2017), pp. 2550 ; Anderson, Emma Louise and Beresford, Alex, ‘Infectious injustice: the political foundations of the Ebola crisis in Sierra Leone’, Third World Quarterly, 37:3 (2016), pp. 468486 ; Harman, ‘Ebola, gender and conspicuously invisible women in global health governance’; Suerie Moon, Jennifer Leigh, Liana Woskie, Francesco Checchi, and Victor Dzau, ‘Post-Ebola reforms: Ample analysis, inadequate action’, BMJ, 356 (23 Jan 2017).

49 WHO, ‘Health Emergencies Programme’, available at: {http://www.who.int/about/who_reform/emergency-capacities/emergency-programme/en/} accessed November 2017.

50 Clare Wenham and D. B. L Farias, ‘Securitizing Zika: the case of Brazil’, paper presented at European International Studies Association Annual Conference, Barcelona, 13 September 2017; Rasanathan, Jennifer, MacCarthy, Sarah, Diniz, Debora, Torreele, Els, and Gruskin, Sofia, ‘Engaging human rights in the response to the evolving Zika virus epidemic’, American Journal of Public Health, 107:4 (2017), pp. 525531 .

51 Enemark, Biosecurity Dilemmas, ch. 7.

52 Stephanie L. Smith and Jeremy Shiffman, ‘Setting the global health agenda: the influence of advocates and ideas on political priority for maternal and newborn survival’, Social Science & Medicine, 166 (October 2016), pp. 86–93.

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