President-elect Donald Trump's nominees for the country's top health agencies and his previous track record in office have sparked concerns globally about a potential rise in "anti-science" views and the defunding of global public health efforts.
For example, during the start of the COVID-19 pandemic, the Trump administration severed US ties with the World Health Organization (WHO). Even though President Joe Biden restored the relationship, the subsequent struggle to get US-made vaccines in lower-income countries allowed countries like Russia and China to play greater-than-expected roles in the global pandemic response.
Trump also previously defunded or threatened to defund programs that didn't align with his agenda on reproductive rights, known as the global gag rule. This is why Trump's new round of nominees and their potential global reach is concerning global public health experts.
US health agencies, along with the European Medicines Agency (EMA) and the UK's Medicines and Healthcare products Regulatory Agency (MHRA), are still the gold standard for drug approval and disease-fighting strategies. However, that could diminish, several experts told Yahoo Finance.
"It already happens that the FDA [Food and Drug Administration], EMA, and MHRA make a few different decisions," said Martin McKee, a professor of European public health at London's School of Hygiene and Tropical Medicine. "However, the FDA decisions are adopted by many countries without their own regulatory bodies, so I assume that they will look to EMA instead — but it's all very uncertain."
Trump nominated Marty Makary, a professor at Johns Hopkins University and chief medical officer of telehealth platform Sesame, to lead the FDA. Makary is viewed as a potentially uncontroversial pick by experts, which could help allay concerns. But some experts say the top health agency nominee, Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS), is the greater concern.
How much damage? Robert Kennedy Jr. speaks with members of the press at Trump Tower in New York City, on Jan. 10, 2017. REUTERS/Stephanie Keith ·REUTERS / Reuters
Angie Rasmussen, a virologist at the University of Saskatchewan in Canada, said many of Trump's nominees are aligned on some topics and have some level of skepticism toward science.
"It's going to bring down the standing of the US no matter what, to put anti-vaxxers in charge of public health agencies," she said.
She added, "The extent of the damage will depend on how effective [the nominees] are at implementing some of their promised changes," Rasmussen noted it is hard to predict the time frame of any changes.
But some experts suggested that the impact of the president-elect's nominees could be limited.
That's because the FDA and CDC have layers of institutional leaders and staff that hold steady during administration changes after every presidential election. But even those jobs could be in jeopardy if Trump's government efficiency efforts, led by Vivek Ramaswamy and Elon Musk, are successful, according to Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.
The second key area of impact if all of Trump's healthcare nominees are confirmed is the role of the US in providing aid to fight epidemics and provide support for global public health needs.
Volunteers of the Ukrainian NGO Base UA consult with an elderly Ukrainian woman in Myroliubivka, Ukraine, on Jan. 21, 2024. (Ignacio Marin/Anadolu via Getty Images) ·Anadolu via Getty Images
That includes the GAVI Vaccine Alliance, which helps fund vaccination efforts, and the United States Agency for International Development (USAID), which has helped set up public health efforts domestically in other countries.
Gavin Yamey, a professor of global health and public policy at Duke University, told Yahoo Finance that while it's hard to know how impactful the nominees will be in these efforts, concern is brewing. "I think there's every reason to be deeply concerned about the future of global health cooperation by the United States in a Trump 2.0," he said.
"There's plenty of evidence to show that he really took steps to withdraw from multilateralism. His surrogates like [US Rep.] Marjorie Taylor Greene have said publicly that [they think] he's going to once again withdraw the US from WHO," he added.
McKee, a past president of the European Public Health Association, told Yahoo Finance that the global public health community is already discussing the implications of Trump's picks. He coauthored an opinion piece in the British Medical Journal (BMJ) last week emphasizing the level of uncertainty.
In addition to the WHO, the US could also pull funding from other efforts like global vaccination due to the beliefs of RFK.
"Risks include reduced contributions to international health organizations and pressure to modify intellectual property regimes and trade agreements to support US corporate interests," McKee wrote.
It's why, if fears become reality, the US could set a bad example for the world, Rasmussen said.
"[Trump] is installing nominees at key agencies who are going to dismantle them," Rasmussen said. "If the FDA is no longer a functional regulatory agency, if the CDC can't investigate disease outbreaks, and if NIH can't carry out or fund research, the US will be a cautionary tale for the world and that is definitively unfavorable."
And a spillover effect is already happening in Canada.
Dr. Madhukar Pai, chair of the Department of Global and Public Health at McGill University, said anti-abortion policies "might expand well beyond the US, and there are already such initial efforts in Canada, which might get fanned [by] the conservatives from our government in the elections next year."
That's why experts are wary of the nominees and their global impact.
"Everything's sort of unknown at this point," Hotez said. "I think we're kind of waiting to see how it all happens."
Anjalee Khemlani is the senior health reporter at Yahoo Finance, covering all things pharma, insurance, care services, digital health, PBMs, and health policy and politics. That includes GLP-1s, of course. Follow Anjalee on social media platforms X (Twitter), LinkedIn Bluesky @AnjKhem.
