As the U.S. heads toward a pivotal presidential election, global health experts are weighing the potential ramifications for international health initiatives and Europe’s evolving role in this arena. The differences in health policy between Donald Trump and Kamala Harris have implications that extend well beyond the U.S., especially for European leaders, who may face increasing pressure to take on global health issues if the U.S. retreats from its leadership role.
A Divergence in Global Health Policies
The stark differences between Trump and Harris on issues like pandemic preparedness, reproductive health, and climate change underscore the stakes for Europe. Under a second Trump administration, experts expect a continuation of his previous approach, which included pulling out of the World Health Organization (WHO) and refusing to join the COVID-19 vaccine-sharing initiative, COVAX. Such decisions pushed countries like Germany to increase their contributions to WHO during the COVID-19 pandemic. However, with budget cuts and a conservative political shift across Europe, a repeat of this response may not be as feasible in the future.
“A lot of what we saw from Germany during COVID was situational,” noted Suerie Moon, co-director of the Global Health Centre at the Graduate Institute in Geneva. “It was exceptional in response to a crisis and involved a different leadership.”
Trump 2.0 and Europe’s Readiness to Step Up
If Trump is re-elected, he may again focus on withdrawing from multilateral agreements, including ongoing negotiations for a global pandemic treaty. Analysts worry that Trump’s stance could weaken international cooperation on pandemic preparedness, leaving European nations to fill the void, though with limitations.
A return of the Mexico City Policy, which restricts U.S. funding for international organizations that provide abortion services, would also affect reproductive health globally. During Trump’s first term, countries like the Netherlands launched a fund to support reproductive health initiatives that lost U.S. backing, raising €260 million to fill the funding gap. However, experts say that European resources cannot fully make up for the absence of U.S. funding, which provided $9.4 billion for global sexual and reproductive health programs in 2022.
Europe’s Potential Response Under a Harris Administration
A Kamala Harris presidency would likely align with the global health priorities set by Joe Biden, continuing support for the WHO and multilateral health initiatives. However, even a Harris administration could encounter setbacks; earlier this year, Biden’s administration proposed cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR), raising concerns about long-term support for global HIV/AIDS efforts.
If Harris is elected, her administration would likely continue participating in pandemic treaty negotiations and maintain U.S. involvement in climate-focused health initiatives. Yet, as domestic political dynamics increasingly shape foreign aid decisions, both the U.S. and Europe may see a shift toward prioritizing health threats that impact their own populations, such as antimicrobial resistance and pandemic prevention, over direct aid to lower-income countries.
Europe’s Shift in Focus
European leaders, particularly European Commission President Ursula von der Leyen, have signaled their commitment to a strong EU health strategy, particularly with an emphasis on African health development. However, recent reallocations of funds toward Ukraine reflect the pressures on Europe’s health funding. Political fragmentation within the EU over how much authority to grant Brussels may further complicate coordinated health responses.
“The European Commission is positioning itself as a leader in global health,” said Dr. Muhammad Jawad Noon, a physician affiliated with Harvard University. “However, rising nationalism across European countries could weaken collective health efforts.”
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The Future of Global Health Cooperation
Regardless of who takes the White House, there are clear signs that European and U.S. global health priorities may continue to shift from development assistance toward health security. Suerie Moon suggests that this recalibration will prioritize issues like pandemic resilience and antimicrobial resistance, framing these concerns as essential to both public health and national security.
“The rationale for global health is evolving,” Moon said, “moving away from supporting lower-income countries to emphasizing the shared health concerns of both developed and developing nations.”
The outcome of the U.S. election could redefine the international approach to health, potentially pushing Europe to take on a more prominent role – albeit with its own limitations and a different set of priorities. For now, global health experts are watching closely as Europe assesses its capacity to lead in a field where the U.S. has historically set the pace.
Source: Euronews
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