Sam Friedman
Posted March 30, 2025
AS SHOULD BE evident by now, the Trump administration has begun a full-scale attack on much of public health in the United States and globally.
Some of this is ideological — for example, when Kennedy, the United States Secretary of Health and Human Services, attacks vaccines as dangerous and ignores the millions of lives they save. This has been covered extensively in the non-reactionary media.
I want to present here some of the less-obvious implications of what the Trumpires are doing.
Cuts to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the President’s Emergency Plan for AIDS Relief (PEPFAR), and related programs will reverse our progress in reducing these diseases globally. The Director General of the World Health Organization recently described some of them including:
* If disruptions continue we could see an additional 15 million cases of malaria and 107,000 deaths this year alone, reversing 15 years of progress.
* Disruptions to HIV programs could undo 20 years of progress, leading to more than 10 million additional cases of HIV and three million HIV-related deaths — more than triple the number of deaths last year.
* On tuberculosis, 27 countries in Africa and Asia are facing crippling breakdowns in their response, with shortages of human resources, disruptions to diagnosis and treatment, data and surveillance systems collapsing, and vital community engagement work deteriorating.
As of this writing, it is unclear what cuts may be forthcoming to U.S. HIV/AIDS prevention and care. Dozens of National Institute of Health (NIH) research grants focusing on these topics have received termination letters meaning that all research under them has had to stop immediately. This leaves both research staff unemployed and people who are participants in studies cut off from medicines or services that the studies may have funded.
Potential cuts to Medicaid may also deprive people with HIV and others of access to medicine.
Very importantly: Millions of people living with HIV in the United States and elsewhere are taking medicines that are very good at holding the disease in check. What they do is reduce the number of virus particles in the body to such low levels that patients stay healthy for decades –and in addition, these levels are usually so low that infected people stop being able to infect other people.
When access to these medicines stops, or becomes stop-and-go, these numbers (called “viral loads”) increase. Patients get sick, and in time die. They also become highly infectious, so new infections start increasing fairly rapidly.
In addition, the total “Global Viral Load” (number of HIV particles) will increase rapidly — possibly to hundreds of times current levels — and each new particle produces a risk of being a dangerously mutated strain of the virus.
As the Director General of WHO said, millions will die. And the AIDS pandemic will re-ignite. In the United States, these deaths and new infections will likely concentrate among those the Trumpires are quite willing to see suffer and die: Black people, Latino/a people, Native Americans, and the employed and unemployed poor. Men who have sex with men, people who inject drugs, and members of the sexual networks of these people will suffer most — which is likely to be quite acceptable to the Trumpires.
New Pandemics and More Deaths
The attacks also may lead to a massive increase in other infectious diseases and to new mega-pandemics. The world is facing many potential pandemics, some of which have received considerable media attention like avian flu and MPOX — but there are a host of other infectious agents that may mutate into pandemic form, and the normal actions of capitalism and imperialism have increased the risk of devastating pandemics enormously over the last generation.
I will not go into the details on this here, since I recently co-authored an easily-accessible article on Pandemic Futures that does this.
As I write this article, I just got an email telling me that “the Department of Health and Human Services has abruptly canceled more than $12 billion in federal grants to states that were being used for tracking infectious diseases, mental health services, addiction treatment and other urgent health issues.”
This means that many more people will die of suicide and overdose deaths, that sexually transmitted diseases will spread rapidly, that people who face emotional difficulties in accessing medical care will get sick and die — including a great many people with HIV/AIDS and with Long COVID.
Also in regard to COVID and Long COVID, the administration is eliminating many services, much research, and much support for testing and treatment. The upshot of this will be more people will get Long COVID that debilitates them for years, and that the odds will increase that COVID will generate a new strain that kills millions of people.
I suppose their slogan now that they are in office again is Make America Sick Again. Even the Biden administration, with its pathetic COVID performance, at least pretended to care.
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