As Donald Trump took the stage declaring victory as the 45th President of the United States and the Leader of the Free World, I had a sudden chilling realisation. This man, who has spent his entire life ignoring or actively working against the dangers of climate change, progressive social policy and a centralised state control healthcare system, now sits at the head of the American government, which sets the trends in policy and action in the Western world.
His often-repeated goal during campaigning was to “repeal and replace” Obamacare by relaxing legislation which prevents exploitation of the injured by private insurance interests, and removing funding for vital infrastructure in hospitals and speciality clinics, as well as sexual health and Planned Parenthood programmes. Although he has, so far, been unsuccessful in repealing Obamacare, he has not given up his crusade against basic healthcare provisions.
Under Trump’s direct guidance, Tom Price, head of the Department of Health and Human Resources, continues to reduce requirements for insurance companies to provide essential benefits, and works towards completely dismantling systems related to women’s or sexual health. Such a removal of support and shift away from women is concerning, as it appears to indicate the return of deep-seated sexism within governmental institutions which sets an example for the wider society.
While Trump has proven time and time again that he has little regard for females, this blatant attack seems like an extreme first step. People have been protesting the numerous unconstitutional and unethical executive orders streaming from the desk of the White House through large organised protests, rallies at offices of local governmental officials and online petitions. It is vital, however, that this momentum does not weaken: accepting this situation as the new ‘normal’ cannot be allowed to happen. Having to fight constantly is exhausting but essential. Without significant resistance, it is likely that Trump will be able push many of these bills through a Republican-dominated congress and into law.
Trump’s executive order to freeze funding and support for global aid serves to reinstate and expand Reagan’s 1984 ban on United States (US) foreign aid. All $9.5 billion USD of American global health funding will be restricted from being available to any non-government organisations providing or even discussing abortion with patients.[1, 2] These cuts will jeopardise the health of the world’s most at-risk individuals by removing access to education and preventative measures against sexually transmitted diseases, as well as all facets of maternal healthcare. The World Health Organization estimated that a total of 225 million women in developing countries were not using contraception, mainly due to lack of access and education. With the implementation of this gag, it is expected that these numbers will rise significantly.
Trump has made it clear that he is committed to the promises he made going into the election – promises which have the potential to jeopardise global health. The next step is likely to be severe cuts or the removal of foreign aid funding entirely, as Trump has expressed on multiple occasions that he has no intention of being “president to the world”. By internalising focus, Trump aims to disconnect America from the rest of the world – a process that has started with reduction and removal of aid and is predicted to continue with taxing of overseas goods.
The impact this will have on global health programs is not to be underestimated. Slashing America’s global aid support will only result in detriment for those people already suffering from the consequences of poor support for health services; a rise in disease, poverty and death are to be expected if this policy is to be implemented.
Australia has an opportunity, and a responsibility here to intervene. As a country with the wealth and resources to help, we would be passively condoning Trump’s gag policy if we do not aim to lessen its blow on developing nations. By increasing our international aid and presence, as well as encouraging other countries to do so, we can hopefully avoid the rise of neoliberalist nationalism we have seen in America, and help prevent its consequences to global health.
Most importantly, Australia needs to stand up against America on this issue. It is time for Australia to take the lead. By changing direction and taking a strong stand on healthcare and foreign aid, Australia could become a rally point for other nations – a model for them to work by and therefore improve the lives of millions of people who have already, and will be, affected by the rise of Trump.
Owen Burton holds degrees of Bachelor of Biomedical Science (Griffith University) and Masters of Orthoptics (University of Technology, Sydney)
Conflict of Interest
|1.||Filipovic J. The Global Gag Rule: America’s Deadly Export. Foreign Policy. 2017 March; 20.|
|2.||Office of the Press Secretary, White House. White House. [Online].; 2017 [cited 2017 May 10. Available from: https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.|
|3.||Singh S, Darroch J, Ashford L. Adding It Up: The Costs and Benefits of Investing in Sexual and Reproductive Health 2014. Guttmacher Institute; 2014.|