The British Infection Association is a charitable organisation that aims to improve patient care by supporting infection professionals with clinical guidance, education and research funding. We are concerned that recent changes to public health policy and funding in the US will adversely impact the global management and control of infectious disease with low- and middle-income countries bearing the greatest consequences. These changes are as follows:

Suspending US foreign aid:   

The 90-day freeze of the US Agency for International Development has had significant impact on public health initiatives and research. This funding included HIV treatment for 20 million individuals, monitoring of avian influenza in 49 countries, efforts to diagnose and eradicate neglected tropical diseases that cause significant morbidity worldwide, malaria vaccine research, and the provision of low-cost vaccines for children and contraception for women.

Centres for Disease Control (CDC) Communications freeze, guidelines alterations and deletion of health data:

The pause on all health communications by Federal agencies includes the Morbidity and Mortality Weekly Reports, which provides vital updates on global public health matters such as emerging infectious disease threats and vaccination. This regular communication contains information about the highly pathogenic avian influenza which has already claimed one life in the US. Several guidelines have been removed from the CDC pages. These guidelines are accessed by clinicians in the US and around the world. Guidelines removed include those that support treatment of specific groups who are most impacted by infections such as HIV and mpox.

Cancelling National Institutes of Health (NIH) grant reviews:

The NIH is the largest public funder of health research in the US. NIH funding has contributed to significant advances in vaccines and therapeutics used to treat infectious diseases.

Ending of policies to prevent climate change:

Increasing global temperatures mean changes in the distribution of vectors that transmit infectious diseases such as dengue, zika and malaria. Warmer waters are more likely to propagate.

Intention to withdraw from the World Health Organisation (WHO):

The USA is the largest funder of WHO and its withdrawal will have a significant impact on the global response to pandemics and emerging infectious diseases threats. This includes current threats such as the Marburg virus in Tanzania.

Conclusion:

These changes will directly affect the lives of those who suffer from an infectious disease by reducing access to treatments and vaccines, restricting guidance for specific groups and limiting future research. Globally, these changes threaten to undermine our ability to respond to pandemics, eradicate vaccine preventable infections and prevent further global warming and its disease associations.