Mother should I build the wall?

Mother should I run for president?

Mother should I trust the government?1

Recently elected president of the US, Donald Trump, campaigned on a platform promising radical change within the first 100 days of his presidency. Approximately two weeks into this period it may be instructive to review changes to date and consider their implications for the future, with a particular focus on international health.

Examining domestic health issues within the US first, the new regime’s attacks on the Patient Protection and Affordable Care Act (aka ‘Obamacare’, or the ‘ACA’), which extended care to tens of millions of uninsured Americans, are well known. Promises to scrap Obamacare were a central tenet of the Republican agenda since its controversial introduction, as well as being an important element of Trump’s campaign.2 The new Presidential hiring freeze on federal jobs is already having an impact on hiring, adversely impacting agencies such as the Centers for Disease Control & Prevention (CDC).3 This type of restriction will in time no doubt have implications for such agencies to effectively commit to international public health operations such as the recent Ebola outbreak in West Africa.4

However, this potential distal impact is minimal compared to recent developments in the US, which seem certain to indicate a radical change in perspectives and priorities. The most important of these cultural changes is undoubtedly crystallised in the recent ‘Muslim Ban’ instigated in the US.5 This executive order, which was signed on January 27th, imposed an immediate ban for 90 days on travelers from Syria, Iran, Sudan, Libya, Somalia, Yemen and Iraq even if they held a valid residence visa, as well as suspending the entire US refugee admissions system for 120 days.6

This executive order, which is just one of many, clearly and definitively demonstrates the insecure and defensive xenophobic attitudes of Trump and the new regime. This order was hastily constructed and implemented, and quickly resulted in the firing of the US Attorney General, who questioned its legality,7 as well as leaving customs officials unsure as to the status of dual nationals and those with permanent residence cards.6 The new President campaigned on an extraordinary combination of uncloaked racism and insular protectionism, which has been demonstrated most strongly in his call, which became a trademark chant at his rallies, to ‘build the wall’ between the US and Mexico.8

We can therefore anticipate a continuation into the future of US policy knee-jerk reactions that are steeped in both racism and demonstrate a developing insular focus. The involvement of the US in international Public Health efforts, such as that demonstrated in response to the Ebola outbreak in West Africa, can no longer be taken for granted.9–10 The current rule of Government by executive order heavily influenced by nationalist and populist politics also has significant implications for international organisations. For example, despite the important role of the United Nations (UN) in responding to the recent Ebola outbreak,11 the UN has already been targeted for criticism by both Trump12 and his recently appointed UN envoy.13

Trump’s impact on global public health can already also be seen across a range of areas, including the removal of funding from non-governmental organisations (NGOs) that provide information on abortion.14 Other impacts include a growing global insecurity,15 the erosion of basic human rights,16 and in examining the longer term, an increasing emphasis on fossil fuels.17

On a practical note, it must also be acknowledged that the focus of the US and many of its citizens, including those that might routinely support (financially or otherwise) international efforts in the field of health promotion, may be firmly focused internally over the next four or eight years. Many US citizens may simply have little time for international issues given their immediate focus on significant internal domestic changes. The Presidential election result came after both a bitter and divisive campaign,18 followed by a contested election result.19–20

To date the Trump presidency has been marked by controversy and clear demonstrations of populist engagement with racist sentiment. From examples in policies and commentaries so far we can expect a continuing decline in US support for international organisations such as the UN, as well as a growing isolationism. Knee-jerk policies using executive orders, with or without the support of Congress, will undoubtedly continue. US national and international health policies will increasingly be driven by right-wing capitalist and Christian principles. We can anticipate short-term and ongoing global inter-state instability, as well as longer-term implications for global warming based on a renewed emphasis on fossil fuels.

‍

Mother should I build the wall?

Mother should I run for president?

Mother should I trust the government?1

Recently elected president of the US, Donald Trump, campaigned on a platform promising radical change within the first 100 days of his presidency. Approximately two weeks into this period it may be instructive to review changes to date and consider their implications for the future, with a particular focus on international health.

Examining domestic health issues within the US first, the new regime’s attacks on the Patient Protection and Affordable Care Act (aka ‘Obamacare’, or the ‘ACA’), which extended care to tens of millions of uninsured Americans, are well known. Promises to scrap Obamacare were a central tenet of the Republican agenda since its controversial introduction, as well as being an important element of Trump’s campaign.2 The new Presidential hiring freeze on federal jobs is already having an impact on hiring, adversely impacting agencies such as the Centers for Disease Control & Prevention (CDC).3 This type of restriction will in time no doubt have implications for such agencies to effectively commit to international public health operations such as the recent Ebola outbreak in West Africa.4

However, this potential distal impact is minimal compared to recent developments in the US, which seem certain to indicate a radical change in perspectives and priorities. The most important of these cultural changes is undoubtedly crystallised in the recent ‘Muslim Ban’ instigated in the US.5 This executive order, which was signed on January 27th, imposed an immediate ban for 90 days on travelers from Syria, Iran, Sudan, Libya, Somalia, Yemen and Iraq even if they held a valid residence visa, as well as suspending the entire US refugee admissions system for 120 days.6

This executive order, which is just one of many, clearly and definitively demonstrates the insecure and defensive xenophobic attitudes of Trump and the new regime. This order was hastily constructed and implemented, and quickly resulted in the firing of the US Attorney General, who questioned its legality,7 as well as leaving customs officials unsure as to the status of dual nationals and those with permanent residence cards.6 The new President campaigned on an extraordinary combination of uncloaked racism and insular protectionism, which has been demonstrated most strongly in his call, which became a trademark chant at his rallies, to ‘build the wall’ between the US and Mexico.8

We can therefore anticipate a continuation into the future of US policy knee-jerk reactions that are steeped in both racism and demonstrate a developing insular focus. The involvement of the US in international Public Health efforts, such as that demonstrated in response to the Ebola outbreak in West Africa, can no longer be taken for granted.9–10 The current rule of Government by executive order heavily influenced by nationalist and populist politics also has significant implications for international organisations. For example, despite the important role of the United Nations (UN) in responding to the recent Ebola outbreak,11 the UN has already been targeted for criticism by both Trump12 and his recently appointed UN envoy.13

Trump’s impact on global public health can already also be seen across a range of areas, including the removal of funding from non-governmental organisations (NGOs) that provide information on abortion.14 Other impacts include a growing global insecurity,15 the erosion of basic human rights,16 and in examining the longer term, an increasing emphasis on fossil fuels.17

On a practical note, it must also be acknowledged that the focus of the US and many of its citizens, including those that might routinely support (financially or otherwise) international efforts in the field of health promotion, may be firmly focused internally over the next four or eight years. Many US citizens may simply have little time for international issues given their immediate focus on significant internal domestic changes. The Presidential election result came after both a bitter and divisive campaign,18 followed by a contested election result.19–20

To date the Trump presidency has been marked by controversy and clear demonstrations of populist engagement with racist sentiment. From examples in policies and commentaries so far we can expect a continuing decline in US support for international organisations such as the UN, as well as a growing isolationism. Knee-jerk policies using executive orders, with or without the support of Congress, will undoubtedly continue. US national and international health policies will increasingly be driven by right-wing capitalist and Christian principles. We can anticipate short-term and ongoing global inter-state instability, as well as longer-term implications for global warming based on a renewed emphasis on fossil fuels.

‍