The health implications of the shocking developments in the United States, for the world in general and Australia in particular, need to be clearly articulated. Who will speak up? We certainly are not hearing much on the subject from our political leaders.
The column this week links readers into new resources and developments in Aboriginal and Torres Strait Islander health, documents wide-ranging concerns about failing justice across multiple jurisdictions, and brings interesting news from Nigeria about the integration of journalism roles into primary healthcare.
The quotable?
One month into the new Administration – it feels like a hundred years. The damage to public health, national security, and global stability will be felt for generations.”
System collapse?
Communities should prepare for the possibility of systemic collapse in the United States, warns George Monbiot in an article in The Guardian, ‘There are many ways Trump could trigger a global collapse. Here’s how to survive if that happens’.
The degradation of the US Federal Government by Trump et al could trigger a series of converging and compounding crises, leading to social, financial and industrial failure, he says, noting that “because there is little public understanding of how complex systems operate, collapse tends to take almost everyone by surprise”.
“Every government should hope for the best and prepare for the worst,” Monbiot says, adding that we can’t, however, rely on governments to act so “must seek to create our own backup systems”.
Political anthropologist Dr Eric Reinhart says American medicine and public health are at a crossroads, and must choose whether to become “collaborators or resisters”.
Writing in STAT, he gives many examples of how some of the most prestigious hospitals, universities, and research foundations in the US are complying with the “creeping authoritarianism”.
“History teaches us that anticipatory obedience and appeasement in response to fascist regimes are not only ethical travesties that sacrifice the vulnerable for the convenience of well-protected elites; they are also profoundly naive,” he says.
“Rather than protect their institutions, attempts at strategic collaborationism by hospital and university administrators will only accelerate the destruction of the ideals upon which their organisations are supposedly based. And, as we are already seeing, they will also embolden Trump’s attempts to exert yet further control over medical practice, academic research, university policies, and public discourse.”
Meanwhile, there are widespread concerns that Native Americans will be disproportionately affected.
And speaking of collaborators…
The European Federation of Academies of Sciences and Humanities has issued a statement expressing grave concern over the escalating threats to academic freedom, in the US and beyond.
“Recent developments regarding science and scholarship in the US, including executive orders freezing billions in federal research funding and censorship around topics such as climate change and gender, are forcing many US science agencies and research organisations to abruptly suspend normal operations. Such censorship and political suppression of language, research topics, and methodologies – whether through funding restrictions, legislative control, or institutional interference – fundamentally compromise the integrity of scientific and scholarly endeavours not just in the US but around the world due to the global nature of the research ecosystem.”
The Federation “is deeply concerned that the actions of the US administration could have far-reaching and devastating consequences for essential (global) research programmes, particularly in fields such as health, climate, gender, and the social sciences. These new restrictions also threaten the careers of the younger generation of scholars, engineers, and health professionals, and may cause lasting harm to the fundamental research that underpins most scientific breakthroughs, as well as efforts to secure a healthy, just, and safe world for all. For instance, restricting transatlantic data sharing jeopardises research on both sides of the Atlantic, putting at risk decades of collaboration that have led to groundbreaking discoveries.”
Nature has catalogued the Trump Administration’s assaults on science in its first month and the wide-ranging actions that have shocked and devastated the scientific community. “Although US courts have intervened in some cases, Republicans in both chambers of the US Congress – which largely blocked Trump’s efforts to cut science funding during his first term as president from 2017 to 2021 – have mostly fallen in line with the agenda for Trump 2.0. For many researchers, this first month signals a realignment of priorities that could affect science and society for decades to come,” the journal reports.
The BMJ has published an article titled ‘Anger, despair, and defiance from a voice within the US federal research system’, by a researcher within the federal system who explains their need to remain anonymous: “…we are terrified of the response – not just having our research cancelled and being summarily dismissed, but also set upon by the 250 million followers of Elon Musk on X.
“Our homes, salaries, families, and even our lives are at risk….I never thought that in the US we would come to fear the knock on the door as so many have feared in unfree countries. The fear of speaking about this to friends and close colleagues because we do not know who believes what. Free speech and the rule of law have been central to what the US stands for and what it has achieved, but both now are being eroded.”
The American Public Health Association’s Public Health Newswire reports that the Trump Administration’s purge of federal workers will leave the US unprepared to face public health threats such as infectious disease, foodborne illness, energy security and more.
The article documents mass firings across multiple agencies, including the Department of Health and Human Services, the National Institutes of Health, Food and Drug Administration and the Centers for Disease Control and Prevention. Nearly half of CDC’s Epidemic Intelligence Service were fired despite their vital role in monitoring, tracking and tracing emerging disease outbreaks (other reports suggest the service is being closed).
“These actions will not make America healthy,” said APHA Executive Director Dr Georges Benjamin. “Firing thousands of federal health workers who are dedicated to minimising threats to the nation’s health will jeopardise the health of communities across the US.”
UNAIDS has released data on the impact of the freeze on US foreign assistance.
As of 17 February 2024, UNAIDS had received at least one status report from 52 countries (39 PEPFAR-funded and 13 countries that receive some US support). PEPFAR is the US President’s Emergency Plan for AIDS Relief. The 39 countries represent 71 percent of all PEPFAR-funded countries.
Collectively, these status reports reveal a range of significant impacts, although the situation is changing quickly. More details are in this story.
Hilda Bastian has examined the risks to PubMed and looks at alternatives and work-arounds if the worst happens.
Meanwhile, the continuing attacks on media that are not perceived as Trump supporters come straight from the authoritarian playbook.
Other global health news
Marking the 80th anniversary of the United Nations, Secretary-General António Guterres calls for reforms to ensure it is more representative. He calls for global solidarity and multilateral solutions to address the “raging” climate crisis, growing inequalities, the potential for AI “to undermine and even replace human thought, human identity and human control”, and wide-ranging threats to peace.
https://healthpolicy-watch.news/with-10-days-of-talks-left-its-now-or-never-for-pandemic-agreement/
Amnesty International said in a statement that: “Leonard Peltier’s release is the right thing to do given the serious and ongoing human rights concerns about the fairness of his trial, his nearly 50 years behind bars, his health and his age. While we welcome his release from prison, he should not be restricted to home confinement.”
Health updates for Aboriginal and Torres Strait Islander people
See the paper: https://www.lowitja.org.au/resource/social-and-emotional-wellbeing-a-review/?hss_channel=lcp-2135262
https://www.gayaadhuwi.org.au/gayaa-dhuwi-proud-spirit-framework-implementation-and-plan-launched/
https://www.justice.org.au/community-led-first-responders-needed-as-an-alternative-to-police/
Justice matters
https://humanrights.gov.au/about/news/explainer-new-national-and-nsw-hate-crime-laws
The NT Chief Justice has blamed increased policing in the Territory for skyrocketing incarceration figures, saying officers were taking a “zero tolerance” approach to crime under the new Country Liberal government, following a spate of violent crime in the nation’s Top End, reports The Australian.
Chief Justice Michael Grant said zero-tolerance stance was a marked shift away from careful discretion to “apprehend, caution and release” alleged offenders in the past, due to the new political imperatives of the recently elected Finocchiaro government.
“This is the new political and operational environment, and there is nothing the courts or the legal profession can do under present conditions to ameliorate the consequences of that environment in terms of workload or remand numbers,” Justice Grant said.
Primary care
More details: https://www.health.gov.au/news/mrff-22-million-for-research-to-improve-primary-care-in-australia
#AusPol
Media matters
From Nieman Reports: “Five years have passed since the beginning of the global pandemic, but Italian journalists still struggle to cope with their trauma, PTSD symptoms, and memories that keep haunting them. As some of the first Western reporters on the frontline of a new story no one knew how to cover, many are dismayed to see how fast the world has moved on from a tragic news event that has impacted their mental health forever.”
Meanwhile, from Nigeria comes an interesting report about the integration of journalism roles into primary healthcare. Watch and learn, Australia!
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