Memo to Trump: Invest in global health security

Editor’s note: This is part of a package of memos to the president.

Memorandum for the president: Solidify US leadership in global health security

Mr. President, the United States continues to face unprecedented global health threats and stressors. From emerging disease threats like COVID-19 to the challenges of regulating  emerging technologies  that could create new threats, America must confront several converging biological risks simultaneously. Doing so will require moving past the decision paralysis that has stymied progress in the past. Despite the impressive vaccination program you oversaw,  Operation Warp Speed, the United States has since failed to maintain an advantage against an evolving COVID-19 virus that continues to cause illness and death. In 2025, we are still failing to contain the H5N1 avian influenza outbreak, which has now spread to dairy cattle, pigs, other mammals—and also dozens of humans.  When it comes to doing what it takes to prevent or limit biological risks from disease spillover from animals or rapidly improving biotechnology, the horse is out of the barn and the barn is on fire.

Recent studies show that most Americans support pandemic mitigation strategies but worry about implementation. To ensure the United States is secure against biothreats and reduce them globally, it’s vital that the Pandemic and All Hazards Preparedness Act (PAHPA) be reauthorized, a duty in which Congress has been sadly delinquent. The law is a vital component of the country’s national health security.

Second, you should invest in global health security before something like a pandemic forces us to do so. Many experts say it is a near certainty that the world will face another pandemic, and it could be even worse than COVID-19. It will redound to your credit if you get ahead of it and save lives (and taxpayer dollars). To do so, you should improve funding for the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH); for the sections of the State Department and the US Agency for International Development that deal with global health security, and for biopreparedness within the intelligence community and Defense Department.

To ensure American homeland security, it is critical for the United States to maintain a strong voice on biosecurity and pandemic prevention internationally. It’s important (and cheap) for the United States to support the Biological Weapons Convention, the Pandemic Treaty now under negotiation, and the World Health Organization (WHO). Disease knows no borders, but some are inherently more porous, and investing in global health security means aiding other countries and protecting our homeland simultaneously.

“Making America Healthy Again” means addressing tough issues that only a tough leader can help solve—social inequality, high rates of preventable diseases, and widespread distrust in government health interventions. As president, you have the power to treat the slow but steady erosion of health security around the world as the threat it actually is to all Americans—and to do something about it.