MARY LOUISE KELLY, HOST:
Just three days to go until Donald Trump moves back into the White House. His return to power has the potential, among other things, to reshape the global health landscape. NPR's Gabrielle Emanuel joins me to walk through what might be in store. Hi there.
GABRIELLE EMANUEL, BYLINE: Hi.
KELLY: So I think it might be helpful to set the stage here. Just how big a role does the U.S. play right now in global health?
EMANUEL: So simply put, the U.S. is a huge force in global health. The country spends more than $10 billion a year on it, and that money has bought some big successes. Take HIV/AIDS. The U.S. started focusing on the AIDS epidemic some 20 years ago, under a Republican president, George W. Bush. And since then, the U.S. effort has saved 26 million lives around the world. Another example - vaccines - the U.S. helps underwrite the development of many vaccines. Like, it helped with the Ebola vaccine. There's malnutrition programs, maternal and child health. I can go on and on and on.
KELLY: OK, so Trump moving back into the White House - what kind of things are you watching that could change and change potentially quickly?
EMANUEL: Yes. So some Washington insiders say that, pretty soon after the inauguration, Trump plans to pull the U.S. out of the World Health Organization.
KELLY: Which he did before - right? - last time?
EMANUEL: Yes, he tried to, but Biden reversed it before it took effect. So technically, there's this one-year notification period. But Trump could start the process this time on Day 1. The other possibility is he insists the WHO make changes - things like how it spends its money or its abortion policy.
KELLY: OK. What does he not like about the WHO?
EMANUEL: Let's hear from Brett Schaefer of The Heritage Foundation on that.
BRETT SCHAEFER: I expect the Trump administration to take a very tough line with the World Health Organization, saying that we were deeply dissatisfied with your response to COVID-19, particularly your relationship with China in regard to its role in potentially creating the outbreak in the first place.
EMANUEL: But, Mary Louise, you know, the idea of leaving the WHO has a lot of people worried. Here is Elisha Dunn-Georgiou. She heads the Global Health Council.
ELISHA DUNN-GEORGIOU: It would be really bad for the U.S. to withdraw, in terms of the U.S. having access to data, to the surveillance, to being at the table to negotiate and hold other countries accountable when there is an epidemic or pandemic.
EMANUEL: So she worries that other countries, like China, will step in and try to reshape the WHO in a way that is more favorable to them.
KELLY: OK. Gabrielle, beyond the WHO, what else are you watching for on this front?
EMANUEL: Well, Trump is very likely to reinstate something that's called the Mexico City Policy. This policy says no federal funding can go to foreign organizations that provide abortions or even talk about them. There is a sense that Trump might expand this policy, possibly to include all foreign aid, not just global health funding. Now, those opposed to abortion say that's a good thing and that this policy places a focus on supporting the health of pregnant moms. But critics point to studies showing abortions actually have gone up under the policy, and that's likely because family planning programs have lost funding and had to scale back services. So it is all very fraught. And given that it is global health, what happens here in the U.S. will affect people all over the world.
KELLY: NPR's Gabrielle Emanuel covers global health and development. Thank you.
EMANUEL: Thank you.
(SOUNDBITE OF 9TH WONDER SONG, "SEASON COURAGE") Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
