In a speech to the United States Congress this week, President Donald Trump vowed to keep up his campaign of “swift and unrelenting action”.
Is the Australian Government doing enough to assess and address the health threats arising from the Trump Administration’s actions across a range of areas, from global health funding to tariffs and climate policy?
Jason Staines writes:
The Federal Government should be actively assessing Australia’s reliance on United States healthcare products and making a shift to non-US alternatives as a matter of urgency, according to a senior health systems expert.
The Government should also be urgently eliminating any dependencies upon US regulatory agencies such as the Food and Drug Administration and the Environmental Protection Agency, Professor Martin Hensher told Croakey.
He urged the Government to take rapid action to allow US health professionals to emigrate to Australia and “provide us with an important new supplement to our workforce”.
Hensher, the Henry Baldwin Professorial Research Fellow in Health Systems Sustainability at the Menzies Institute for Medical Research at the University of Tasmania, also called on the Australian Government to step in to support the World Health Organization (WHO) and associated multilateral health programs “to the greatest extent possible”.
He was responding to the results of a Croakey Health Media inquiry to multiple federal departments asking whether they had examined the risks to Australians’ health arising from the Trump Admininstration’s actions in a variety of areas.
Our inquiries – to Health, the Department of Foreign Affairs and Trade (DFAT), Prime Minister & Cabinet, and Climate Change – received responses from three agencies, but none confirmed whether any formal assessments of health impacts had been conducted.
The responses leave open questions about whether the Government has examined the risks posed by the US Administration’s cuts to international health funding, its freeze on healthcare regulations, and the breakdown of global health cooperation.
Concerns
Asked to comment on the Government’s silence on associated health issues, experts contacted by Croakey expressed concern.
“I would like to see an acknowledgement of the importance of the US Administration’s actions, and that what happens in the US will have global effects, including in Australia, and that sitting back and waiting to see what happens isn’t a reasonable approach to mitigation,” said Adjunct Professor Virginia Barbour, Editor in Chief of The Medical Journal of Australia.
If the Government remains silent on the health concerns at stake, Barbour said “it would be helpful to have questions raised in the Senate, for example”.
Professor Scott Wilson, CEO of the Aboriginal Drug and Alcohol Council South Australia, said he was very concerned about the silence from the Australian and other governments on health concerns arising from the Trump Administration’s actions.
Australia should be asking for all travellers from the United States for proof of vaccination for diseases such as measles and polio, Wilson said.
“We are already seeing major outbreaks of measles, for example in some states in the US, with little or no reporting as to what’s happening due to restrictions on reporting from organisations such as the Centers for Disease Control,” he said.
Dr Kate Wylie, Executive Director of Doctors for the Environment Australia, said it had been heartening to see many examples of leadership within the health community, including the MJA, the Lancet, the NEJM and the JAMA, all raising concerns about the harms caused by Trump’s policies for public health.
These included the US withdrawal from the WHO and the Paris Agreement, budget cuts to Medicaid, taking down 3,000 web pages from the Centers for Disease Control and Prevention, pausing activity at the National Institutes of Health, denying gender diversity and appointing an anti-vaxxer as Health Secretary.
“I would also like to hear our nation’s politicians loudly decrying these activities as damaging to community health and assuring the people of Australia that we would not follow the US down that road,” Wylie said.
Health and Aged Care Minister Mark Butler “has an opportunity here to remind the community of the importance of his portfolio for the health and wellbeing of the nation, to reassure us on the importance of medical research, immunisation and equitable access to healthcare for all people”, Wylie said.
Shadow Minister Senator Anne Ruston “has an opportunity to do the same and reassure the community that Australians would still enjoy high quality health care should the next government be led by the LNP,” Wylie said, “This opportunity of course extends to the Greens health spokesperson Jordan Steele-John and the cross bench.
“One wonders about this silence on the health harms of the Trump presidency by our politicians and what this says about their conviction and intentions. Surely now is the time to dispel any fears in the community that Australia values all members of the community and recognises the value of public health?”
Professor Martin Hensher said he did not expect the Government to share the details of risk and threat assessments and contingency plans, “but I would find it reassuring to know that such assessments are being made in real time”.
“I would also suggest that these Departments might benefit from bringing in experts who are less professionally invested in the old world order which has clearly now been upended,” Hensher said.
“I would like to hear a clearer acknowledgement from the Australian Government – ministers and officials – that they recognise that everything has changed, and that no one can rely on the USA.
“But I don’t think it’s reasonable to expect that their detailed planning to respond to this new reality take place in real time in public view.”
Global health implications
Since returning to the White House, the Trump Administration has enacted several significant policy changes that could have global health implications, including for Australia – as Croakey has been reporting.
The Administration has announced plans to slash 92 percent of foreign assistance, amounting to nearly US$60 billion, and eliminate 10,000 contracts and grants.
Nicholas Enrich, the acting Assistant Administrator for Global Health at USAID, warned that these cuts would result in severe human costs, including increased preventable deaths, disabilities, destabilisation, and heightened national security risks.
Global health programs targeting HIV treatment, malaria services, and maternal and child care are expected to be severely affected. The termination of longstanding programs like the President’s Emergency Plan for AIDS Relief (PEPFAR), credited with saving 25 million lives, could lead to increased drug resistance and a spike in HIV and malaria cases.
The Administration’s budget proposal includes potential cuts of US$800 billion from Medicaid, alongside US$4.5 trillion in tax cuts and US$2 trillion in spending reductions over a decade. These measures could significantly impact healthcare access for low-income Americans and reshape the global pharmaceutical market, potentially affecting Australia.
Additionally, a government-wide regulatory freeze has been implemented, halting the progress of healthcare regulations. This freeze affects the Department of Health and Human Services’ ability to issue new healthcare regulations, pending a 60-day review of existing rules.
Recent executive orders have also reshaped the healthcare landscape:
- Enforcing the Hyde Amendment: Ends federal funding for elective abortions and revokes prior related orders, reinforcing the prohibition of using federal taxpayer dollars for such procedures.
- Protecting Children from Chemical and Surgical Mutilation: Prevents gender-affirming care for minors by withholding federal funding and directing agencies to take steps against surgeries, hormone therapy, and related treatments for individuals under 19 years old.
Questions for the Federal Government
Croakey Health Media sought to clarify whether the Commonwealth had examined the risks posed to the country’s health system, international research collaborations, and pandemic preparedness.
Requests for information were sent to four key agencies:
- The Department of Health and Aged Care, to determine whether an assessment was conducted on the impact on Australia’s health system and research sector.
- The Department of Foreign Affairs and Trade (DFAT), to ask whether there was diplomatic engagement on the US decisions and their broader implications.
- The Department of the Prime Minister and Cabinet (PM&C), to find out whether a whole-of-government analysis was undertaken on the risks posed by the US disengagement from global health governance.
- The Department of Climate Change, Energy, the Environment and Water, to explore whether the administration’s approach to international cooperation extended beyond health to environmental and pandemic-related responses.
Croakey asked whether the Government had conducted any analysis or received ministerial advice on the implications of these Trump-era policies for Australia.
Of the four departments contacted, three responded, but none confirmed whether any formal risk assessment had been conducted.
The Department of Health and Aged Care provided the following statement: “The US Administration’s recent policy changes are decisions for the US Government. Australia remains committed to supporting global health initiatives and will continue to work with international partners, including the US, to strengthen global health cooperation and prepare for future health emergencies.”
The Department of the Prime Minister and Cabinet (PM&C) said: “Australia remains committed to global health cooperation and to the World Health Organization and Paris Agreements.”
The Department of Foreign Affairs and Trade (DFAT) responded: “Australia’s development program is focused on being a partner of choice for our neighbours. This is fundamental to our region’s prosperity, stability and security. The decision to pause United States foreign aid for policy review is a matter for the US Administration.”
No response was received from the Department of Climate Change, Energy, the Environment and Water, leaving unanswered questions about whether Australia has considered the environmental or broader international implications of these US decisions.
The limited responses raise broader questions about whether the Commonwealth planned for the consequences of Trump Administration policies or simply reacted as events unfolded.
Without a detailed response from DFAT, PM&C, or other relevant agencies, it remains unclear whether:
- Australian researchers faced funding shortfalls due to National Institutes of Health cuts and whether contingency plans were considered.
- Australia worked diplomatically to mitigate the impact of reduced US engagement in global health cooperation.
- There was an internal risk assessment of how the US’s shifting position on multilateral health efforts could affect Australia’s pandemic preparedness.
While some nations have historically stepped in to fill funding gaps left by US foreign aid reductions, the global trend is shifting.
Recent reports indicate that several European governments, including France, Germany, Sweden, and Finland, are now also cutting foreign aid budgets. Instead of increasing their contributions to global health initiatives, many major donor countries are scaling back their commitments in line with broader fiscal tightening.
Organisations in some low- and middle-income countries that depended on US health aid implemented emergency strategies to replace lost funding. Australia’s approach, however, remains unclear.
This trend suggests that rather than relying on other countries to counterbalance the US aid reductions, nations – including Australia – may need to take a more proactive role in sustaining global health efforts.
Croakey Health Media will continue seeking responses from government agencies to clarify whether any assessments have been made.
Seize the moment
Professor Martin Hensher said Australia had an opportunity to seize three opportunities in global health leadership “if we are willing to move rapidly and with determination”.
He said these are:
1. The health-damaging regime of global intellectual property rights and Investor State Dispute Settlement mechanisms – frequently used by US corporations to prevent action to protect health – can now be neutralised and dismantled if Trump goes through with tariffs that violate the free trade agreements underpinning them. This would be greatly to the advantage of Australia and much of the rest of the world.
2. US intellectual leadership in global health (especially that of the US CDC) is already lost; Australia has the capability to step up and co-lead with others for the global public good.
3. Rapid action to allow US health professionals to emigrate to Australia can provide us with an important new supplement to our workforce.
• See the full responses from Professor Hensher, Professor Barbour, Professor Wilson and Dr Wylie here.
See Croakey’s archive of articles on the Trump Administration
