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"This isn't fiscal responsibility. It's a political decision to let preventable diseases spread—to ignore science, lend legitimacy to anti-vaccine extremism, and dismantle the infrastructure that protects us all."
Public health experts and other critics on Wednesday condemned the Trump administration's decision to cut off funding to the global vaccine alliance Gavi, which the organization estimates could result in the deaths of over 1 million children.
"Abhorrent. Evil. Indefensible," Atlantic staff writer Clint Smith said on social media in response to exclusive reporting from The New York Times, which obtained documents including a 281-page spreadsheet that "the skeletal remains" of the United States Agency for International Development (USAID) sent to Congress on Monday.
The leaked materials detail 898 awards that the Trump administration plans to continue and 5,341 it intends to end. A spokesperson for the U.S. State Department, which runs the gutted USAID, confirmed the list is accurate and said that "each award terminated was reviewed individually for alignment with agency and administration priorities."
The United States contributes 13% of Gavi's budget and the terminated grant was worth $2.6 billion through 2030, according to the Times. Citing the alliance, the newspaper noted that cutting off U.S. funds "may mean 75 million children do not receive routine vaccinations in the next five years, with more than 1.2 million children dying as a result."
"The administration's attempt to unilaterally walk away from its Gavi commitment raises serious legal questions and should be challenged."
Responding to the Trump administration's move in a social media thread on Wednesday, Gavi said that U.S. support for the alliance "is vital" and with it, "we can save over 8 million lives over the next five years and give millions of children a better chance at a healthy, prosperous future."
"But investing in Gavi brings other benefits for our world and the American people. Here's why: By maintaining global stockpiles of vaccines against deadly diseases like Ebola, mpox, and yellow fever, we help keep America safe. These diseases do not respect borders, they can cross continents in hours and cost billions of dollars," Gavi continued.
The alliance explained that "aside from national security, investing in Gavi means smart economics too. Every dollar we invest in lower income countries generates a return of $54. This helps countries develop and communities thrive, taking away pressure to migrate in search of a better life elsewhere."
"The countries Gavi supports, too, see the benefit in our model: Every year they pay more towards the cost of their own immunisation program, bringing forward the day when they transition from our support completely," the group noted. "Our goal is to ultimately put ourselves out of business."
"For 25 years, the USA and Gavi have had the strongest of partnerships," the alliance concluded. "Without its help, we could not have halved child mortality, saved 18 million lives or helped 19 countries transition from our support (some becoming donors themselves). We hope this partnership can continue."
Many other opponents of the decision also weighed in on social media. Eric Reinhart, a political anthropologist, social psychiatrist, and psychoanalytic clinician in the United States, said, "A sick country insists on a sick world."
Dr. Heather Berlin, an American neuroscientist and clinical psychologist, sarcastically said: "Oh yes, this will surely end well. Good thing the U.S. has an invisible shield around it to protect us from 'foreign' diseases."
Some Times readers also praised the reporting. Dr. Jonathan Marro—a pediatric oncologist, bioethicist, health services researcher, and educator in Massachusetts—called the article "excellent but appalling," while Patrick Gaspard, a distinguished senior fellow at the Center for American Progress and its action fund, said that it was "crushing to read this important story."
The newspaper noted that "the memo to Congress presents the plan for foreign assistance as a unilateral decision. However because spending on individual health programs such as HIV or vaccination is congressionally allocated, it is not clear that the administration has legal power to end those programs. This issue is currently being litigated in multiple court challenges."
Liza Barrie, Public Citizen's campaign director for global vaccines access, also highlighted that point in a Wednesday statement. She said that "the Trump administration's decision to end U.S. funding for Gavi will cost more than a million children's lives, make America less secure. It abandons 25 years of bipartisan commitment to global immunization and undermines the very systems that help prevent deadly outbreaks from reaching our own doorsteps."
"Vaccines are the most cost-effective public health tool ever developed," Barrie continued. "This isn't fiscal responsibility. It's a political decision to let preventable diseases spread—to ignore science, lend legitimacy to anti-vaccine extremism, and dismantle the infrastructure that protects us all. In their shocking incompetence, the Trump administration will do it all without saving more than a rounding error in the budget, if that."
"Congress has authority over foreign assistance funding," she stressed. "The administration's attempt to unilaterally walk away from its Gavi commitment raises serious legal questions and should be challenged. Lawmakers must stand up for the rule of law, and for the belief that the value of a child’s life is not determined by geography."
Although the move was "largely symbolic" due to lack of such mandates, one expert still warned it is "legitimization of anti-science and anti-vax noise."
Amid fears of what U.S. President Donald Trump's second term will mean for global health and public education, the Republican on Friday signed an executive order to defund schools that require Covid-19 vaccination for students.
Trump's order bars federal funding "from being used to support or subsidize an educational service agency, state education agency, local education agency, elementary school, secondary school, or institution of higher education that requires students to have received a Covid-19 vaccination to attend in-person education programs," according to a White House fact sheet.
The order, first reported by Breitbart News, also directs the secretaries of education and health and human services (HHS) to develop a plan "to end coercive Covid-19 vaccine mandates, including a report on noncompliant entities and a process for preventing federal funds from supporting educational entities that impose Covid-19 vaccine mandates."
While signing the order in the Oval Office, Trump—who was president during the onset of the pandemic and has received intense criticism for his handling of the public health crisis—said, "OK, that solves that problem."
The White House claimed that "parents are being forced into a difficult position: comply with a controversial mandate or risk their child's educational future." However, according toABC News, Trump's move was actually "largely symbolic" considering that no states currently require K-12 students to have the Covid shots.
The Associated Pressreported that "some colleges started requiring students to be immunized against Covid-19 during the pandemic, but most have dropped the requirements. A few continue to require vaccines at least for students living on campus, including Swarthmore and Oberlin colleges. Most of those colleges allow medical or religious exemptions."
As ABC noted:
One open question is whether the new administration could opt to go beyond Covid vaccines and put pressure on schools to drop requirements for other vaccines.
Currently, all 50 states mandate that students receive certain vaccinations, including to prevent the measles. Many states, however, offer religious exemptions.
"This is anti-vax pandering," Timothy Caulfield, a professor focused on public health and law at Canada's University of Alberta, said of Trump's order. "Still worrisome, however. It is yet more normalization and legitimization of anti-science and anti-vax noise."
The new measure came a day after Senate Republicans voted to confirm vaccine conspiracy theorist Robert F. Kennedy Jr. as HHS secretary and Trump signed another executive order establishing the Make America Healthy Again Commission.
Also on Thursday, the Senate Committee on Health, Education, Labor, and Pensions held a confirmation hearing for Linda McMahon, the billionaire GOP megadonor and former World Wrestling Entertainment CEO nominated to serve as education secretary, even though Trump has signaled that he ultimately intends to fully dismantle the department.
"No senator should have voted to confirm Robert F. Kennedy Jr.," said one consumer advocate.
The U.S. Senate on Thursday voted to confirm vaccine conspiracy theorist Robert F. Kennedy, Jr. to lead the nation's health policy, a move that one advocate said puts "our entire healthcare system and countless patient lives in jeopardy."
"This is a shameful day for the U.S. Senate, an institution that likes to laud itself for its careful deliberation and seriousness of purpose," said Robert Weissman, co-president of government watchdog Public Citizen. "No senator should have voted to confirm Robert F. Kennedy Jr. Every single senator knows he's not just profoundly unqualified to head the nation's health agency but a threat to public health in the nation."
Every Democratic senator voted against Kennedy's confirmation to lead President Donald Trump's Department of Health and Human Services (HHS), while Sen. Mitch McConnell (R-Ky.) was the only Republican to oppose Kennedy. McConnell survived polio as a child and said Kennedy's "record of trafficking in dangerous conspiracy theories" about vaccines influenced his decision.
The confirmation followed Senate hearings in which Kennedy had nothing negative to say about the country's for-profit health insurance system, which has made insurers increasingly wealthy as patients' healthcare treatments are denied and delayed.
He insisted that Americans "would prefer to be on private insurance" and displayed a lack of knowledge about Medicaid and Medicare, appearing to confuse the two. He also denied being anti-vaccine while refusing to reject the debunked claim that vaccines cause autism, a failure that Sen. Bill Cassidy (R-La.), who is a physician, claimed to be troubled by—but Cassidy went ahead with his vote for Kennedy nonetheless.
"Senators who rubber stamp this dangerous nomination in fear of an angry tweet from President Trump cannot later feign concern and surprise when Kennedy's actions end up harming everyday Americans. They, too, will own the consequences."
"Any vote to confirm Kennedy to lead HHS is a vote to put our public health at risk, and senators know it," said Tony Carrk, executive director of government watchdog Accountable.US. "The war Kennedy is itching to wage against vaccines and scientific research will undoubtedly cost lives and could lead to the resurgence of diseases once thought dormant."
"Among the last people who should be overseeing our public health is Kennedy, with his non-existent health policy credentials, embrace of ludicrous conspiracies, and judgment so lacking that he potentially committed felony voter fraud despite courts warning him not to," Carrk added, referring to Accountable's accusation that Kennedy cast a ballot last year from an address that wasn't his. "Senators who rubber stamp this dangerous nomination in fear of an angry tweet from President Trump cannot later feign concern and surprise when Kennedy's actions end up harming everyday Americans. They, too, will own the consequences."
During his confirmation hearings, Kennedy angered officials in Samoa, where he spread anti-vaccine conspiracy theories just before 83 people died of measles in a 2019 outbreak. Samoa's director-general of health, Alec Ekeroma, accused Kennedy of "a total fabrication" when he told senators many of the people who died didn't have measles.
Before the Senate voted on Thursday, Ekeroma said Kennedy's confirmation to lead U.S. health agencies, which control funding for international health and vaccine initiatives as well as domestic policy, would be "a danger to us, a danger to everyone."
Weissman credited many Democratic senators for their "truly heroic efforts... to rally opposition against this dangerous nominee," and warned that "it will fall on the American people to confront his lies and policies and to defend basic public health principles and institutions."
"We should expect Robert F. Kennedy to continue spreading his conspiracies, anti-vaccine propaganda, and anti-science crusade," said Weissman. "We should expect him to deliver on his promises to sabotage our public health institutions. And we should expect him to enable and facilitate the effort to slash health care coverage for lower-income people, privatize Medicare, and undermine the subsidies and consumer protections on the Affordable Care Act exchanges."
Kennedy has claimed that he has "often disturbed the status quo by asking uncomfortable questions," but advocacy group Patients for Affordable Drugs noted that he provided little information in his confirmation hearings about how he would challenge Big Pharma by lowering drug prices and defending the Medicare negotiations introduced by former President Joe Biden.
"Secretary Kennedy has a critical opportunity—and responsibility—to build on existing measures to rein in Big Pharma's price-gouging and lower drug costs for patients," said Merith Basey, the group's executive director. "We are ready to work with him to ensure Medicare drug price negotiations continue, out-of-pocket costs are reduced, and competition in the marketplace is increased through reforms to end abusive pharmaceutical monopolies that harm patients."
"But make no mistake," added Basey. "Patients fought hard to secure the 2022 prescription drug law, and we will fiercely oppose any efforts to weaken it."