The United States now has more COVID-19 cases than any other country, and it’s increasing its lead. This outcome is due largely to the government’s massive failure to prepare for and respond appropriately to the spreading contagion. A lot of attention in the media has been devoted to President Trump’s cluelessness, the Center for Disease Control’s (CDC’s) wrongheaded approach to testing, and the critical shortage of personal protective equipment and ventilators. Less attention has been paid to actions by the Trump administration over more than three years that hobbled the country’s preparedness for the pandemic. In a nutshell, Trump’s reflexive nationalism led his administration to assail global health efforts; his resentment of Barack Obama led him to dismantle programs the former president had created in the wake of previous epidemics; and his disregard for science led him to cut funding for research in public health.
Here’s a chronology of the Trump administration’s actions related to global health and pandemics, leading up to the COVID-19 outbreak:
January 2017. Shortly before Trump’s inauguration, Obama administration officials warn his transition team of the danger posed by global pandemics. The briefing includes a “Facilitated Group Discussion [on] Pandemic Response,” based on a contagion model similar to the COVID-19 pandemic in the U.S. Some transition team members pan the presentation; an Obama official says future Commerce Secretary Wilbur Ross and Education Secretary Betsy De Vos are “especially dismissive;” and Ross reportedly dozes off. Politico, March 16, 2020
February 2017. Trump’s FY 2018 budget request to Congress decreases the Centers for Disease Control’s (CDC’s) funding by $1.2 billion, a 17 percent reduction from the previous year. Among the cuts are those to Global Health (-$76.3 M), Emerging and Zoonotic Infections (-$64.9), Immunization and Respiratory Diseases (-$82 M), and Public Health Scientific Services (-$30.7 million). A zoonotic infection is one transmitted from animals to humans, such as the bat virus that probably started the COVID-19 pandemic in Wuhan, China. Overview of CDC FY 2018 Budget Request
These proposed cuts to public health and pandemic prevention and response will be repeated each year, and each year Congress will reject them on a bipartisan basis.
February 2018. The Trump administration forces CDC to reduce its global epidemic prevention activities by 80 percent, because Obama-era funding is running out and no new funds will be available. These programs train front-line workers to detect outbreaks and strengthen laboratory and emergency response systems in epidemic hotspots in order to stop future outbreaks at their source. Countries where the CDC is scaling back include China, Pakistan, Haiti, Rwanda and Congo. Admiral Tim Ziemer, Senior Director for Global Health Security and Biodefense at the National Security Council (NSC), writes that “the world remains under-prepared to prevent, detect, and respond to infectious disease outbreaks… “ Washington Post, February 1, 2018
April 2018. The Trump administration’s National Security Advisor, John Bolton, pressures Department of Homeland Security (DHS) advisor, Tom Bossert, to resign, along with his team. Bossert’s job included coordinating the United States’ response to global pandemics. This was one of several programs Obama created after fighting to contain several world health crises, including the Ebola epidemic. New York Times, April 10, 2018
April-May 2018. The Trump administration eliminates the State Department’s Complex Crises Fund, a $30 million emergency response pool that enabled the Secretary to deploy “diplomats, disease experts, famine relief supplies, and disaster programs to de-escalate crisis situations that threaten to blow up into all-out wars or mass catastrophes. The intent is to spend a little money today to offset cataclysm tomorrow.Created at the behest of former Secretary of State Hillary Clinton, the CCF appears to be targeted by Trump because of personal animus.” Foreign Policy, May 9, 2018
May 2018. “I herewith report 38 rescissions of budget authority, totaling $15.4 billion,” President Trump decrees. This is his effort to claw back funds already appropriated in the FY 2018 budget. Included are his previously proposed reductions in funding for CDC (-$1.2B). The Republican-controlled House approves the rescission, but the Senate narrowly rejects it. President’s Rescission Package, 2018; Foreign Policy, May 9, 2020
May 2018. The President eliminates the position of the Senior Director for Global Health Security and Biodefense at the NSC, held by Admiral Ziemer. His unit, an Obama creation, is subsequently disbanded. Washington Post, May 10, 2018
October 2019. The Trump Administration closes the U.S. Agency for International Development’s (USAID’s) PREDICT unit, formed for “the detection and discovery of zoonotic viruses with pandemic potential.” Vox, October 29, 2019
October 2019.The Trump administration suppresses “Crimson Contagion,” a draft report by the Department of Health and Human Services on a computer simulation of a pandemic that describes clearly what the COVID 19 contagion will look like six months later. The team that worked on the simulation from January through August 2019 collected epidemiological data on contagion and data on response capabilities of state and local governments. New York Times, March 19, 2020
January-February 2020. In public statements, Trump repeatedly dismisses the threat posed by the virus. Weeks of valuable time to prepare for and respond to the disease are lost. The cumulative number of COVID-19 cases is doubling every two days. Business Insider, March 12, 2020; Financial Times, Continuous Coverage
February, 2020. Trump postpones the Director of National Intelligence’s annual report to Congress. The report again warns, as it did in 2019, that the United States continues to be vulnerable to global pandemics. Time, March 9, 2020
February 2020. Trump’s FY 2021 budget proposes to cut U.S. funding for the World Health Organization in half and to eliminate $3 billion from global health programs altogether. Proposed cuts to CDC total $1.2 billion (again); those to the National Institute for Allergies and Infectious Diseases (NIAID), headed by Dr. Anthony Fauci, total $451 million. A month later, the Trump administration rescinds these cuts under extreme public pressure. The Hill, March 19, 2020
The actions chronicled above focus on the damage done to the nation’s pandemic prevention and response infrastructure. However they occurred in the context of Trump and Republican antipathy to public health programs in general and to publicly funded health insurance, including Obamacare, Medicare, Medicaid, Children’s Health Insurance (CHIP), and related scientific research. And of course, they occurred in the context of Trump’s personal antipathy toward President Obama and his accomplishments.
David Boesel is a Ph.D. political scientist, political activist, and martial arts instructor.
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