The first human fatality from bird flu in the US was reported on 6 January by the Centres for Disease Control and Prevention. Scientists warn the H5N1 pathogen could transmit person-to-person if it morphs with another animal or human flu to create a new virus. Meanwhile, the virus has ravaged poultry stock and is spreading among cattle.
This had no bearing on US President Donald Trump, who has unleashed a storm of fury and vengeance directed at “deep state” workers in health and other federal agencies he deems “disloyal”.
Trump let loose his torrent of unbridled executive orders aimed at retrenching the US state and its position in the world hours after his inauguration on 20 January.
Even if half of his “flood the zone” measures survive a flurry of lawsuits already triggered by his offensive, the redrawing and possible partial destruction of the US and global health infrastructure could leave millions of people at risk
The situation changes day by day as the Trump administration has rescinded some of its measures after legal challenges, for example, the order to freeze federal grants and loans worth trillions of dollars that threatened interruption of the Medicaid system of health care for low-income Americans.
Last week, Trump’s pause on purchasing meant researchers at the National Institutes of Health (NIH) refrained from ordering new test tubes to draw blood. Key supplies would have run out within days. But then they were told they could continue to work with current vendors.
Americans’ health is at stake
Trump withdrew the US from the World Health Organisation (WHO), halted most development aid for at least 90 days, paused funding to a programme that supplies much of the HIV treatment in Africa, and revived a rule that prevents federal funding for overseas non-governmental organisations that perform or promote abortions.
Trump also froze hiring, travel and communications at US federal health agencies. The bar on communications could turn into tragedy if bird flu were to worsen and the US failed to inform the rest of the world, particularly after Trump claimed repeatedly the WHO helped China to cover up the start of the COVID-19 pandemic.
“Americans’ health is at stake,” along with its expertise and leadership vital to support disease control around the world, wrote Kathleen Sibelius, former secretary of health and human services under former president Barack Obama.
Trump’s plan to impose big import tariffs may have unintended consequences on health at home
“Many regard America’s global health work as smart diplomacy. Even the most hostile countries welcome our medical expertise and support because health security is essential to international security and to every country’s economy,” she said.
Even Trump’s plan to impose big import tariffs may have unintended consequences on health at home because an estimated 60 per cent of US medicine ingredients come from China and India.
Scientists are scared for their futures
The very organisations meant to protect the health of Americans and their food supply and against disease outbreaks have been left flailing. Scientists have had job offers rescinded, new hiring frozen, workshops, training and meetings cancelled, and grant applications and reviews delayed.
This will have knock-on effects on patient trials and the research cycle, delaying or even preventing the development of life-saving therapies.
Other agencies under Trump’s crosshairs are the Food and Drug Administration and the Federal Emergency Management Agency.
Federal workers also have to “snitch” by reporting any colleagues via a special email address if they try to circumvent the shut-down of diversity, equity and inclusion (DEI) policies. They were told if anyone knows about such circumvention but does not report it within ten days, they will face “adverse consequences.”
Scientists are scared for their futures and fear speaking out
All DEI offices were shuttered immediately, and employees placed on administrative leave until being laid off next month.
Scientists are scared for their futures and fear speaking out. An anonymous scientist told CNN he had never seen anything like this in 20 years of working at the NIH. “It feels more like a government shutdown,” he said.
Health experts in the rest of the world are still grappling with what it all means for their work, particularly in conflict and low-resource settings. WHO is mandated to respond to threats such as Ebola, mpox and polio as well as co-ordinate global public health and it must scramble to find extra cash.
The US contributes about 18 per cent of the organisation’s funding, which amounted to about $261m between 2024 and 2025. The next biggest donors are Germany and the Gates Foundation.
Trump’s ever-shifting world
The halt to US foreign aid does not apply to weapons for Israel and Egypt and its impact on Ukraine was unclear. Israel will also be allowed to get 2,000-pound bombs that former president Joe Biden halted last summer.
The US is the largest single donor of aid globally, and in fiscal year 2023, it disbursed $72 billion in assistance. The United States Agency for International Development (USAID) was told to halt foreign aid during a 90-day reassessment period and to issue “stop-work” orders to groups that have received grants, triggering panic around the world.
USAID was told to halt foreign aid during a 90-day reassessment period and to issue “stop-work” orders to groups that have received grants, triggering panic around the world
The ban on outside communications also applies to those between USAID and the State Department without prior approval. The only exemptions to the halt order were humanitarian food assistance and travel by officials returning to posts.
The State Department, meanwhile, sent an email at 6.26am on 25 January asking the humanitarian organisations it funds to clear mines and other unexploded munitions to immediately cease operations. The last State Department’s annual report said this work had enhanced food security in countries such as Vietnam and Sri Lanka.
Fluctuations and reversals in policy require constant monitoring. Days after Trump announced his withdrawal from the WHO, he told a Las Vegas rally that he may reconsider rejoining the global body. “Maybe we would consider doing it again. I don't know. Maybe we would have to clean it up a little bit," Trump said.
Welcome to Trump’s ever-shifting world.
