SUMMARY
Donald Trump’s own administration knew the danger a pandemic would hold soon after he was sworn into office. The failure to prepare shows the depths of incompetence and lack of concern that has already contributed to tens of thousands of deaths.
Multiple administration officials acknowledged the likelihood of a pandemic:
Trump and his administration were warned of the dangers a pandemic would hold. Leaders who warned Trump included:
The 2017 National Defense Authorization Act required the administration prepare a biodefense report, commenting on the administration’s ability to respond to, among other things, an infectious disease crisis. The report specifically called for studying the administration’s strategy to release ventilators and increasing testing capacity in event of a pandemic.
Trump failed to put essential personnel into pandemic response positions for months after his inauguration. His failure to do so led to the Washington Post to declare that “The Trump Administration Is Ill-Prepared For A Global Pandemic.”
Trump’s “America First” foreign policy increased the chances of a pandemic developing abroad. In the first few weeks of his presidency, Trump announced plans to slash funding that was used to prevent pandemics abroad. Trump’s cuts caused over 120 retired generals and admirals to call for the funding to be restored, specifically citing pandemic prevention as an area that would be harmed.
In March 2017, Senators Warren and Murray questioned the Trump Administration’s ability to respond to a pandemic. The senators questioned the lack of hiring for key personnel, cuts to the CDC, and Trump’s anti-vaxer tendencies. The administration refused to respond to the letter.
While Trump’s cuts for the CDC have been widely reported – his cuts to the National Institute of Health have been less explored. In three of his four proposed budgets, Trump tried to cut NIH funding, including funding used to develop new vaccines.
In A 2018 Op-Ed, HHS Secretary Alex Azar Recounted The Deadliest Global Health Disaster Of The 20th Century -- 1918 Spanish Influenza Pandemic. According to a Real Clear World op-ed by Secretary Azar, “Each year in April, the World Health Organization celebrates World Health Day, an opportunity to raise awareness of global health issues. This year, it is also a chance to observe the centennial of the deadliest global health disaster of the 20th century—and the deadliest event of the century, period. One hundred years ago, on March 11, 1918, at Camp Funston, Kansas, a U.S. Army cook by the name of Albert Gitchell fell ill as he and his fellow soldiers prepared to go to war in Europe. He thought he had a bad cold. Soon after, Corporal Lee Drake went to the infirmary showing the same symptoms. By that afternoon over a hundred others joined them, and eventually, this influenza virus would circle the globe. Over the next two years, the 1918 influenza pandemic, also known as the Spanish flu, infected nearly a third of the global population, killing more than 50 million people worldwide. At the time, the United States and the world were ill-prepared to combat a pandemic. Influenza viruses had not yet been discovered, there were no vaccines to prevent infection and no medicines to treat it, and the field of public health was in its infancy.” [Alex Azar – Real Clear World, 4/11/18]
Azar Highlighted The Importance Working Alongside The WHO To Address Global Pandemics Because ‘Preparedness Cannot Be Confined Within Borders.’ According to a Real Clear World op-ed by Secretary Azar, “Today, influenza pandemics remain one of our top infectious disease threats. We have a growing set of increasingly advanced tools to detect the emergence of a new strain of influenza virus domestically and abroad, but much work remains to be done. When it comes to the threat of pandemic flu, as well as other infectious threats, preparedness cannot be confined within borders. The world must work together to focus on the prevention and mitigation of pandemics that pay no mind to borders, and focus the work of institutions like the World Health Organization (WHO) on that threat. Our almost universally interconnected world makes it easier for serious illnesses to spread faster than ever before, and we saw this threat when the 2014 Ebola outbreaks that threatened to spread that illness throughout and beyond West Africa. That is why the Trump Administration strongly supports the Global Health Security Agenda to prevent, detect, and respond to infectious disease threats in collaboration with our partner countries.” [Alex Azar – Real Clear World, 4/11/18]
Azar: We Are Committed To Investing In Infectious Disease Preparedness At Home And Across The Globe…These Tasks Must Be The Focus Of Our Global Health Work. According to a Real Clear World op-ed by Secretary Azar, “The United States also supports reforms to WHO to ensure that future epidemics are handled more effectively than Ebola was. We are committed to investing in infectious disease preparedness at home and across the globe, including through the Global Health Security Agenda, and these tasks must be the focus of our global health work. On flu, for instance, the Centers for Disease Control and Prevention (CDC), in collaboration with WHO and the National Institutes of Health (NIH), has built global flu surveillance networks with partner countries that help to detect and respond to new and known influenza viruses. This network provides an early warning system to detect new flu strains and increases the likelihood that partner countries can effectively combat and contain the virus before it spreads to our shores.” [Alex Azar – Real Clear World, 4/11/18]
Azar: We Are Still Vulnerable, Not Just To The Flu But To A Range Of Infectious Diseases. According to a Real Clear World op-ed by Secretary Azar, “The world has come a long way since 1918, but we are still vulnerable, not just to the flu but a range of infectious threats. The United States will continue to work with our partners around the globe to build preparedness for these threats and to strengthen our preparedness at home. Infectious diseases remain a serious threat, but with the right level of cooperation and focus, we can look forward to marking many more World Health Days before we see another pandemic like the Spanish flu.” [Alex Azar – Real Clear World, 4/11/18]
Dr. Anthony Fauci: “If There’s One Message That I Want To Leave With You Today Based On My Experience, It Is That There Is No Question That There Will Be A Challenge To The Coming Administration In The Arena Of Infectious Diseases” According To A Press Release From Georgetown University Medical Center, “As director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, Anthony S. Fauci, MD, has worked with five presidents who all faced pandemics early in their presidencies. At ‘Pandemic Preparedness in the Next US Presidential Administration,’ a gathering of students and global health experts from academia, government and advocacy at Georgetown on Tuesday, Fauci and other global health leaders encouraged the incoming Trump administration to plan accordingly. ‘If there’s one message that I want to leave with you today based on my experience, it is that there is no question that there will be a challenge to the coming administration in the arena of infectious diseases,’ Fauci said. ‘If there’s one message that I want to leave with you today based on my experience, it is that there is no question that there will be a challenge to the coming administration in the arena of infectious diseases,’ Fauci said.” [Georgetown University Medical Center, 1/12/17]
Fauci: “"If History Has Taught Us Anything, It Is That The New Administration Is Likely To Experience At Least One Infectious Disease Crisis Of Significance.” According to a article by Anthony Fauci in Health Affairs, “If history has taught us anything, it is that the new administration is likely to experience at least one infectious disease crisis of significance.” [Anthony Fauci – Health Affairs, 2/9/17]
Trump Beachhead Staffer Bill Steiger Said HHS Would Need To Accept That Some International Global Health Crisis Will Occur.” According to a Press Release From the American Association for the Advancement of Science, “On 10 January, Steiger spoke at a conference held at Georgetown University in Washington, D.C., that focused on pandemic preparedness in the incoming Trump administration. Steiger noted that he wasn’t ‘officially’ part of the transition team at that point, but had shared his No. 1 piece of advice. ‘There’s absolutely no way to keep HHS in particular on a purely domestic track through 4 years of a presidential term,’ Steiger said. ‘Some international global health crisis will occur that will divert that attention.’” [Press Release - American Association for the Advancement of Science, 3/27/17]
March 17, 2017: Trump Met With German Chancellor Angela Merkel In The United States. According to the New York Times, “President Trump criticized Germany on Saturday for paying too little to both NATO and the United States for security support, a day after he held a chilly meeting at the White House with Chancellor Angela Merkel that showcased the two leaders’ disagreements.” [New York Times, 3/18/17]
German Chancellor Angela Merkel Spoke To Trump About Global Pandemics During Her Visit To The United States.According to NPR, “And you saw Angela Merkel, the host of this - she does not want a full-on confrontation with the United States. She has people in Germany, voters who are very, very hostile to him - would like to see her, you know, publicly rebuke him and pick a fight with him. She's not going to do that. That's not her style. Before this summit, she actually tried directly to engage him in kind of smart ways. When she saw him in Washington, she talked about things like global pandemics and bird flu and tried to get him kind of intellectually curious about complicated global problems with global solutions. But the truth is that the last few weeks have seen more and more open hostility.” [NPR, 7/7/17]
Susan Rice: “Pandemic Flu […] I Think It`s A Real Risk. It`s A Fact. It Will Happen.” According to a transcript of the Charlie Rose Show CHARLIE ROSE: I notice that in what you have been saying. How serious do you see that? SUSAN RICE: Pandemic flu? CHARLIE ROSE: Yes.SUSAN RICE: I think it`s a real risk. It`s a fact. It will happen. We have seen it historically over periods of years going back -- the most grave instance was in 1918, where, you know, many, many people died. Hundreds of thousands, millions had the potential to die from something like this because now our world is that much more interconnected through trade, through commerce, through air connectivity. And therefore, what happens in one part of the world can quickly spread to another.” [Charlie Rose Show, 1/17/17]
When Asked “What Scares You The Most, Obama’s Retiring CDC Director Said “Influenza Pandemic.” According to the Washington Post, “TWP: What scares you the most? What keeps you awake at night? Frieden: The biggest concern is always for an influenza pandemic. Even in a moderate flu year, [influenza] kills tens of thousands of Americans and sends hundreds of thousands to the hospital. And a pandemic really is the worst-case scenario. If you have something that spreads to a third of the population and can kill a significant proportion of those it affects, you have the makings of a major disaster.” [Washington Post, 1/16/17]
Former Homeland Security Advisor Lisa Monaco: “I Told My Successor In The Transition, That He Has To Focus On And Because It`s What Has Kept Me Up At Night, Is The Third Pillar Of Threat Which I Feel Is Ever Present Will Be A Focus Going Forward Is Emerging Infectious Diseases.” According to a transcript of The Charlie Rose Show, former Homeland Security Advisor Lisa Monaco said, “The third thing I told my successor in the transition, that he has to focus on and because it`s what has kept me up at night, is the third pillar of threat which I feel is ever present will be a focus going forward is emerging infectious diseases. And what do I mean by that? Not any pathogen that has a malicious origin.” [Charlie Rose Show, 2/2/17]
Monaco: “And I Firmly Believe The Next Administration Will Confront A Challenge From That.” According to a transcript of The Charlie Rose Show, former Homeland Security Advisor Lisa Monaco said, I`m talking about things like Ebola, like Zika. And the concern is that because of globalization, because of climate change, because of the fact that human beings are now living a lot closer to formally developed areas and there is a lot more travel to urban centers as we saw with the development of Ebola, that the threat of emerging infectious diseases is much greater than it was before.” [Charlie Rose Show, 2/2/17]
Monaco Ran Exercise Handing Off Crisis Response To Trump Administration. According to the White House, “The White House on Friday afternoon convened a transition exercise with members of the President-Elect's team and Cabinet designees together with current senior White House, Cabinet, and agency leaders. The exercise provided a high-level perspective on a series of challenges that the next administration may face and introduced the key authorities, policies, capabilities, and structures that are currently in place to respond to major domestic incidents. Members of President Obama's team shared experiences and lessons from incident responses they experienced, and both sides discussed a number of response scenarios together. Participants agreed that the exercise was productive and advanced the shared goal of conducting the most professional and seamless transition possible. Obama Administration Participants Included: Chair Lisa Monaco, Assistant to the President for Homeland Security and Counterterrorism” [White House, 1/14/17]
Bill Gates Discussed How To Prevent Pandemics In West Africa With Trump. According to the Guardian, “Bill Gates said their foundation would not be able to bridge the potential funding gap. ‘The US is the No 1 donor in the work that we do. Government aid can’t be replaced by philanthropy. When government leaves an area like that, it can’t be offset, there isn’t a real alternative. This expansion of this policy, depending on how it’s implemented, could create a void that even a foundation like ours can’t fill.’ He had an early phone call with Trump in November and then a meeting in December with the president-elect in New York, he told the Guardian. They talked about the eradication of polio, which Gates hopes could come as early as this year, and the research his foundation is supporting towards an AIDS vaccine and ways to protect people from pandemics such as Ebola in west Africa.” [The Guardian 2/14/17]
During Meeting With Trump, Gates Emphasized That The U.S. Does Not ‘Have The Tools, The Preparedness, The Capacity To Deal With [Pandemics.] According to Politico Power Briefing, “Good Thursday afternoon. A RECAP OF OUR CONVERSATION WITH BILL GATES ... What he'll talk about in his meeting with President Trump: ‘I have two clear messages. One is about foreign aid, where we're partnered with the government, to help articulate why -- even if you just look at the benefit to America of stability, disease being less likely to come here -- that this is very beneficial; that having those strong relationships, maintaining that commitment, continuing to tune it; that there's great things that are coming out of that. ‘And that's been my primary message. Because of this budget increase, a second message for me will be that there's an opportunity to take on some tough unsolved problems. One that I would highlight is that the preparedness we have for a pandemic, either a naturally caused pandemic or a bioterrorism intention caused pandemic, we don't have the tools, the preparedness, the capacity to deal with that.’” [Politico Playbook Power Briefing, 3/15/18]
Gates: There Is A Significant Probability Of A Large And Lethal, Modern-Day Pandemic Occurring In Our Lifetimes. According to U.S. News and World Report, “‘The world needs to prepare for pandemics the way the military prepares for war,’ Gates said. Speaking to The Washington Post this week ahead of the announcement, Gates said he had encouraged President Donald Trump to take proactive steps to prepare for pandemic threats and, with Trump's encouragement, had spoken several times with former national security adviser H.R. McMaster on the issue. ‘Given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and how connected our world is through air travel, there is a significant probability of a large and lethal, modern-day pandemic occurring in our lifetimes,’ Gates said in his speech.” [U.S. News and World Report, 4/27/18]
Then Director-General Of WHO Tedros Ghebreyesus Stated That Threat Of Epidemics And Pandemics Keep Him Up At Night. According to Foreign Policy interview with WHO Director General Tedros Ghebreyesus, “What keeps you up at night? Epidemics or pandemics. Immediately after the First World War, in 1918, the world encountered the Spanish flu. It was airborne and killed more than 50 million people. Ebola is lousy compared to that. That sometimes keeps me awake at night, because we have to do a lot, especially considering the serious gaps we have. I think the world should unite and focus on strong health systems to prepare the whole world to prevent epidemics-or if there is an outbreak, to manage it quickly-because viruses don't respect borders, and they don't need visas.” [Foreign Affairs, 8/21/17]
Global Preparedness Monitoring Board: Outbreaks Have Been On The Rise For Decades And The World Is Not Prepared. According to the Global Preparedness Monitor, “While disease has always been part of the human experience, a combination of global trends, including insecurity and extreme weather, has heightened the risk. Disease thrives in disorder and has taken advantage--outbreaks have been on the rise for the past several decades and the spectre of a global health emergency looms large. If it is true to say ‘what’s past is prologue’, then there is a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people and wiping out nearly 5% of the world’s economy. A global pandemic on that scale would be catastrophic, creating widespread havoc, instability and insecurity. The world is not prepared.” [Global Preparedness Monitoring Board, September 2019]
Rep Tom Cole: “You're Much More Likely To Die In A Pandemic Than A Terrorist Attack.” According to a transcript of MSNBC, “COLE: Oh, it's an overwhelmingly good case. Look, I don't favor cutting NIH or Center for Disease Control. You're much more likely to die in a pandemic than a terrorist attack. And so that's part of the defense of the country as well. The CDC is what protects you from things like Ebola and Zika. The NIH, we have 1.6 million Americans a year that contract cancer. About 600,000 die.” [MSNBC, 2/17/17]
2017 National Defense Authorization Act Required Administration To Write National Biodefense Strategy. According to The Bulletin Of the Atomic Scientists, “By 2015, with the Bush- and Obama-era policies still in effect, some form of responsibility for biodefense had been assigned to at least 19 departments or agencies, three executive offices, 50 political appointees, and all state, local, tribal, and territorial governments. Partly as a result, the 2015 bipartisan report of the Blue Ribbon Study Panel on Biodefense warned that despite “a decade of profusion of policy directives,” the United States had failed to produce a comprehensive biodefense strategy spanning prevention to recovery.Lawmakers took notice, and the National Defense Authorization Act for Fiscal Year 2017 required the secretaries of Defense, Health and Human Services, Homeland Security, and Agriculture to produce a comprehensive strategy. Thus the National Biodefense Strategy of 2018 was born. But the profusion of policy directives remains.” [The Bulletin Of the Atomic Scientists,, 1/18/19]
2018: Trump Directed That A National Biodefense Strategy Be Implemented Because “Biological Threats Know No Borders And Have The Potential To Disrupt The Economy, And Impact Travel And Trade.’ According to a White House Fact Sheet, “NATIONAL BIODEFENSE STRATEGY: President Donald J. Trump is directing the implementation of a National Biodefense Strategy to more effectively prepare for and combat biological threats […] Biological threats are a distinct aspect of national security. Biological threats arise from many sources and require a deliberate and systematic approach to reduce their risks. Biological threats know no borders and have the potential to disrupt the economy, and impact travel and trade.” [Fact Sheet: President Donald J. Trump is Strengthening America’s Biodefense – White House, 9/18/18]
National Biodefense Strategy Cited SARS And Pandemic Influenza As Reasons To Improve Nation’s Pandemic Response. According to the National Biodefense Strategy, “Health security means taking care of the American people in the face of biological threats to our homeland and to our interests abroad. The significant infectious disease outbreaks of recent decades, including Severe Acute Respiratory Syndrome (SARS), pandemic influenza, Ebola virus disease, and Zika virus disease, have revealed the extent to which individual countries and international communities need to improve their preparedness and biosurveillance systems to detect and respond to the next health crisis.” [National Biodefense Strategy, 9/8/18]
September 18, 2018: Giving Remarks For A Biodefense Briefing At The White House, Azar Stated That ‘Biological Threats, Of A Man-Made, Accidental, Or Naturally Occurring Nature, Are Real And Growing. According to Alex Azar, “So first of all, why a biodefense strategy? The simple answer is that biological threats, of a man-made, accidental, or naturally occurring nature, are real and growing. There are several factors driving their growth: As the world grows more urbanized and interconnected, infectious threats can spread more rapidly and easily than ever before. Think about one of the threats HHS is monitoring right now, the Ebola outbreak in the eastern part of the Democratic Republic of the Congo. Such is the ease of mobility between countries now that, just in the DRC, more than 100,000 people are being screened at border crossings every day.” [Azar Remarks for Biodefense Briefing at the White House – HHS, 9/18/18]
Azar: Trump Has A Strong Commitment To Defending The Health And Well-Being Of The American People, It’s Going To Get That Much Harder For Any Threat […] To Blindside Us. According to Alex Azar, “Before 9/11, a future president understood this and recommended that we do a much better job of preparing for the possibility of a biological attack. ‘Our adversaries understand that if they are able to blindside us,’ he wrote, ‘they will be much more likely to succeed in blackmailing us.’ That future president was Donald Trump, writing in the year 2000. With this strategy and President Trump’s strong commitment to defending the health and well-being of the American people, it’s going to get that much harder for any threat or any of our adversaries to blindside us.” [Azar Remarks for Biodefense Briefing at the White House – HHS, 9/18/18]
Nicole Lurie, Former HHS Assistant Secretary Of Preparedness And Response Under Obama, Criticized Trump’s Plan For Failing To Include An Implementation Plan ‘That Spells Out Who’s Doing What When And Who Has The Lead.’ According to Science Magazine, “Nicole Lurie, who worked at HHS in former President Barack Obama’s administration as the assistant secretary for preparedness and response, says it’s always a good idea to try and ‘connect the dots’ in the sprawling, complex U.S. government. But, she notes, her former HHS division already has the Public Health Emergency Medical Countermeasures Enterprise which specifically coordinates federal preparedness for biological threats, including emerging infectious diseases. ‘This largely looks to me like a repackaging of what’s been going on,’ says Lurie, who now is a strategic adviser to the Coalition for Epidemic Preparedness Innovations, a nonprofit based in Oslo. Lurie says she was surprised the new strategy leaves many important questions up in the air. ‘What puzzled me is usually if you have a strategic plan there’s an implementation plan that spells out who’s doing what when and who has the lead and who is helping,’ Lurie says. ‘I didn’t see any of that, and I didn’t see intended outcomes.’” [Science Magazine, 9/19/18]
The 2018 National Biodefense Strategy Called For Promoting Measuring To Prevent The Spread Of Naturally Occurring Infectious Diseases. According to the 2018 National Biodefense Strategy, “Using a multidisciplinary approach, strengthen medical, public health, animal health, and plant health capacities to improve infection prevention and control. Strengthen vaccination and other health intervention activities […] Identify the risk of the vectors transmitting disease to humans, animals, and plants. Develop and disseminate, as appropriate, measures that will safely limit the exposure of humans, animals, and plants to disease vectors and the ability of vectors to transmit disease to humans and animals. Address resistance of vectors to vector control or mitigation measures.” [2018 National Biodefense Strategy, September 2018]
The National Biodefense Strategy Also Called For Strengthening Animal And Zoonotic Disease Detection And Prevent Capacity. According to the 2018 National Biodefense Strategy, “Strengthen capacity to detect and prevent the spread of animal and zoonotic diseases. Support the development and deployment of diagnostics and countermeasures for use in animals as well as the development of disease-resistant animals. Strengthen international partnerships regarding awareness, detection and control, and eradication of animal diseases before they reach the United States.” [2018 National Biodefense Strategy, September 2018]
The National Biodefense Strategy Also Called For Strengthening Global Health Security Capacities And Preventing Local Bioincidents From Becoming Epidemics. According to the 2018 National Biodefense Strategy, “Promote the development and implementation of national legal frameworks adequate to support and enable the implementation of the World Health Organization’s International Health Regulations (2005) and the World Organisation for Animal Health reporting requirements. Promote transparent, independent, and objective assessments of country capacity to prevent, detect, and respond to bioincidents. Strengthen timely surveillance and monitoring for core syndromes and confirmed reportable infections as outlined by international bodies to ensure quick identification and reporting of bioincidents […] Promote a prepared public health and animal health workforce appropriate for the population. Strengthen capacity and promote policies and best practices to minimize transmission of disease between humans and animals. Promote incident management systems capable of activating an emergency operations system in response to public health emergencies.” [2018 National Biodefense Strategy, September 2018]
Trump’s 2018 National Biodefense Strategy Called For The Effective Deployment Of MCM Stockpiles. According to the 2018 National Biodefense Strategy, “Conduct pre-incident planning for distribution and dispensing of the MCM stockpiles to ensure such activities can be accomplished in a timely manner, are informed by appropriate guidance, and can be supported operationally by federal and SLTT agencies during a bioincident. Ensure plans consider the provision of MCMs to personnel performing mission-essential functions to help ensure that mission-essential functions continue to be performed after a bioincident. Ensure the safety, security (including cybersecurity), and reliability of supply chains to provide necessary MCMs and other materiel support during bioincidents. Ensure the capability to monitor the safety and effectiveness of deployed MCMs. Integrate the access and functional needs of at-risk individuals in planning for MCM distribution and dispensing. Ensure that operational plans, clinical guidance, regulatory mechanisms, and operational capacity are in place to administer stockpiled MCMs effectively.” [2018 National Biodefense Strategy, September 2018]
MCMs Were Defined As Products That May Be Used To Prevent, Mitigate, Or Treat The Adverse Effects From A Bioincident, Including Ventilators. According to the 2018 National Biodefense Strategy, “Medical Countermeasures (MCMs): Pharmaceutical products, such as vaccines, antimicrobials, and antitoxins, and nonpharmaceutical products, such as ventilators, diagnostic tests, PPE, and patient decontamination materials, that may be used to prevent, mitigate, or treat the adverse health effects from a bioincident.” [2018 National Biodefense Strategy, September 2018]
The Strategy Called For Developing Stronger Diagnostic Test Capabilities. According to the 2018 National Biodefense Strategy, “Advance diagnostic capabilities, including for plants and animal diseases, to enable timely and accurate biohazard and disease detection. Develop instructions for public health and medical stakeholders regarding the use of Food and Drug Administration (FDA)-authorized or -cleared diagnostic tests, if available. Enhance capability to rapidly characterize bioincidents to help inform ongoing or future response to biothreats and bioincidents. Establish standardized Material Transfer Agreements for sample sharing.” [2018 National Biodefense Strategy, September 2018]
The Plan Also Called For The Establishment Of Mechanisms To Aid The Development Of Diagnostic Testing And A Regional Aid System To Improve National Healthcare Readiness. According to the 2018 National Biodefense Strategy, “ Establish mechanisms for the collection and sharing of clinical samples to support development of diagnostic tests. Establish a regional aid system that will improve national healthcare readiness and medical surge for bioincidents.” [2018 National Biodefense Strategy, September 2018]
Washington Post Headline: “The Trump Administration Is Ill-Prepared For A Global Pandemic.” [Headline, Washington Post, 4/8/17]
11 Weeks Into Administration Essential Pandemic Response Roles Remained Unfulfilled. According to the Washington Post, “But after 11 weeks in office, the Trump administration has filled few of the senior positions critical to responding to an outbreak. There is no permanent director at the CDC or at the U.S. Agency for International Development. At the Department of Health and Human Services, no one has been named to fill sub-Cabinet posts for health, global affairs, or preparedness and response. It's also unclear whether the National Security Council will assume the same leadership on the issue as it did under President Barack Obama, according to public health experts.” [Washington Post, 4/8/17]
Trump Administration Failure To Fill Public Health Roles Left It “Ill-Prepared To Face Pandemic. According to the Washington Post “The Trump administration has failed to fill crucial public health positions across the government, leaving the nation ill-prepared to face one of its greatest potential threats: a pandemic outbreak of a deadly infectious disease, according to experts in health and national security.” [Washington Post, 4/8/17]
Health Technology CEO: We Need People In Position To Help Steer The Ship, […] We Are Actually Very Concerned.” According to the Washington Post “‘We need people in position to help steer the ship,’ said Steve Davis, the chief executive of PATH, a Seattle-based international health technology nonprofit working with countries to improve their ability to detect disease. ‘We are actually very concerned.” [Washington Post, 4/8/17]
Trump Admin “Displayed Little Interest” In Pandemic Response And “Has “Has Yet To Build The International Relationships That Are Crucial For Responding To Global Health Crises.” According to the Washington Post “In addition to leaving key posts vacant, the Trump administration has displayed little interest in the issue, health and security experts say. The White House has made few public statements about the importance of preparing for outbreaks, and it has yet to build the international relationships that are crucial for responding to global health crises. [Washington Post, 4/8/17]
May 2017: 700 CDC Positions Were Vacant Due To Hiring Freeze. According to the Washington Post, “Nearly 700 positions are vacant at the Centers for Disease Control and Prevention because of a continuing freeze on hiring that officials and researchers say affects programs supporting local and state public health emergency readiness, infectious disease control and chronic disease prevention.” [Washington Post, 5/19/17]
HHS Kept Hiring Freeze In Place Despite Government-Wide Restrictions Being Lifted. According to the Washington Post, “The same restriction remains in place throughout the Health and Human Services Department despite the lifting of a government-wide hiring freeze last month. At the National Institutes of Health, staff say clinical work, patient care and recruitment are suffering.” [Washington Post, 5/19/17]
Some HHS Positions Were Exempt From Hiring Freeze Including Pandemic Response. According to The Pink Sheet, “President Trump's 90-day federal hiring freeze appears to offer some broad exemptions for key positions at the US FDA. An internal Department of Health and Human Services (HHS) memo memo dated Feb. 6 contains a list of specific HHS positions that meet criteria outlined in the presidential memorandum that are exempt from the hiring freeze. Among the listed FDA positions are biologist, microbiologist, pharmacology, physiology, toxicology epidemiologist, medical officer and chemist. The hiring freeze memorandum - effective as of Jan. 23 - contains several criteria for exemption, such as national security considerations, conflicts with applicable laws and positions that require presidential appointment. HHS identified four broad areas of positions that are exempt from the hiring freeze based on the memorandum’s criteria: patient care and health related research, public health safety and emergencies, national security and critical infrastructure. The aforementioned FDA positions appear to fall under the category of public health safety and emergencies, which specifically mentions the Federal Food, Drug and Cosmetic Act. ‘Such public health emergencies might include responses to pandemic influenza, Ebola, and the Zika outbreak,’ the memo states.” [The Pink Sheet, 2/9/17]
Exclusion List Was “Arcane And Complex.” According to The Pink Sheet, Steven Grossman of the Alliance for a Stronger FDA, however, said he is being ‘cautious’ about how the memo reads, noting that ‘this area is arcane and complex.’ ‘Without expert knowledge, there may well be distinctions that we might not recognize in reviewing a list,’ Grossman told the Pink Sheet in an email. ‘For example, I am not positive that a series 401 biologist (listed in the HHS memo) would cover all, some, or none of the biologist vacancies at FDA. I am hopeful, but do not consider this definitive.’” [The Pink Sheet, 2/9/17]
2017: Trump Proposed Cuts To Foreign Aid, Including That Used For International Health Efforts To Prevent Pandemics. According to CNN, “The icy winds of US President Donald Trump's promise to cut and in some cases freeze US overseas assistance are blowing through the corridors of humanitarian agencies around the world. Trump outlined his first budget proposal Monday, hiking military spending by $54 billion and slashing roughly the same amount from non-defense programs. Foreign aid, which accounts for roughly 1% of the federal budget, is expected to be high on the list of areas to cut. This includes military aid, debt relief, funds for long-term development programs, and also emergency aid. […] Aside from emergencies like earthquakes, war, floods and famine, the US is also the biggest donor by far to global health efforts, contributing roughly $2.6 billion to basic health projects through USAID in 2015 alone. The US was heavily involved in combating the recent Ebola crisis in West Africa. Had there not been the global response there could have been an international pandemic.” [CNN, 3/1/17]
Former USAID Deputy Assistant Administrator Said Foreign Assistance Was Vital To Preventing Pandemics. According to AFP, “ Jonathan Katz, who until recently was deputy assistant administrator of USAID, told AFP that Trump’s proposed cuts could damage US interests and weight on the world stage. Foreign assistance offers ‘great value for money’ and makes a ‘huge contribution to security, the economy and over all safety of Americans’ he said. Katz, now with the German Marshall Fund, said foreign assistance is vital for everything from preventing pandemics to developing economies that eventually become trade partners. ‘If there are no resources to address an Ebola outbreak, how does that help the wellbeing of Americans?’” [AFP, 2/27/17]
Trump Foreign Aid Cut Led To Fears That “United States Will No Longer Be A Reliable Ally In Tackling Major Global Health Challenge.” According to the Chicago Tribune, “But across the world, there are growing fears the United States will no longer be a reliable ally in tackling major global health challenges, including combating HIV/AIDS, malaria and future pandemics such as Ebola, which killed thousands in Liberia.” [Chicago Tribune, 4/10/17]
CSIS Fellow: Trump Will Be Skeptical Of Foreign Aid Spending ‘Until The First Time There’s A Pandemic.’ According to Bloomberg, “While noting that foreign aid has provided life-saving help in crises, such as the West African Ebola outbreak in 2014 and the aftermath of the deadly Asian tsunami in 2004, the report acknowledges that the system is ‘needlessly complicated at best, inefficient and wasteful at worst’ and in need of reform. ‘Should we be thinking about how we do development in a changed world ? Absolutely yes,’ Daniel Runde, a fellow at CSIS who oversaw the writing of the report, said in an interview. He said the Trump administration will be ‘skeptical about it until the first time there's a pandemic -- I don't hope for one -- or when there's a mass forced migration crisis on the border. Then they're going to see the necessity of this.’” [Bloomberg, 7/24/17]
Melinda Gates Criticized Trumps 2019 Budget Proposal, Stating That Cuts To International Health Programs Proposed Would Leave The U.S. Open To Pandemics. According to the Independent, “Melinda Gates has said U.S. President Donald Trump’s budget proposal is a ‘misguided approach to global health and development.’ The philanthropist and co-founder of the Bill and Melinda Gates Foundation said the cuts to international health programmes proposed in the new defence-focused budget would leave the U.S. open to pandemics. ‘ The fact that we already had health workers on the ground in Nigeria fighting polio was a key reason we were able to contain the last Ebola epidemic before it reached our shores…Make no mistake: foreign aid funding protects American lives, too,’ Ms. Gates said in a statement.” [The Independent, 2/13/18]
Trump Attempted To Sever A Commitment To Provide One-Third Of The Global Fund’s Overall Funding – Congress Rejected That Suggestion. According to Devex, “While U.S. President Donald Trump has proposed a contribution that is more than $400 million less than what the fund hopes to receive from the United States — while simultaneously proposing to sever a commitment to provide one-third of the fund’s overall funding — the U.S. Congress has flatly rejected that suggestion. Both the U.S. Senate and House of Representatives have put forward budget bills that include $1.56 billion for the Global Fund — though it appears unlikely those bills will pass before the pledging conference.” [Devex, 9/27/19]
Global Fund Invested In Measures To Address Epidemics. According to the Global Health Fund, “COVID-19 is having a devastating impact on communities and health systems worldwide. As the largest multilateral grant funding mechanism in global health, the Global Fund is taking swift action to respond to the COVID-19 crisis alongside the WHO and global health partners. The Global Fund raises and invests more than US$4 billion a year to support programs to fight AIDS, TB and malaria in more than 100 countries. The infrastructure and capabilities to defeat diseases like AIDS, TB and malaria – medical supply chains, laboratories, community health workers, disease surveillance – are what we need to identify and respond to new outbreaks like COVID-19.” [Global Fund, Accessed 3/27/20]
More Than 120 Retired Generals Attacked Trump’s Budget Cuts To State Department, Specifically Mentioned Threat Of Pandemics Ass Reason For Opposition According to CBS News, “More than 120 retired generals are making what may seem like a surprising defense of government spending on diplomacy. Their unified perspective is expressed in letter to congressional leadership and was prompted by an announcement of major cuts to the non-defense budget and a corresponding increase of $54 billion to defense spending. […] ‘We know from our service in uniform that many of the crises our nation faces do not have military solutions alone -- from confronting violent extremist groups like ISIS in the Middle East and North Africa to preventing pandemics like Ebola and stabilizing weak and fragile states that can lead to greater instability,’ the generals wrote.” [CBS News, 2/28/17]
Trump’s Isolationist Policies Threatened CDC Strategy Of Preventing Pandemics At Source. According to the American Journal of Public Health, “What might not be appreciated, however, is that an isolationist approach presents a public health risk. An isolationist bent may undermine the long-standing strategy of the Centers for Disease Control and Prevention (CDC) to combat pandemics at their source in favor of a restrictive approach meant to safeguard American lives by keeping health care professionals out of infected zones. Ironically, this policy shift would not only increase casualties in the infected zones and risk the global spread of diseases but also hinder disease control measures such as quarantines, separating individuals who have been exposed to an infectious disease but are not symptomatic.” [American Journal of Public Health, June 2017]
Bill Gates: I Don’t Agree With American First Rhetoric And Warned That We Are Not Prepared For A Pandemic. According to Politico, “‘Yeah, I don't agree with the American first rhetoric. That is, I think the alliances that we've built over time and the help we've provided to countries uplifting them ... have made the world a more stable, a richer place,’ Gates said in an interview with POLITICO Playbook authors Anna Palmer and Jake Sherman […] Gates said his message to Trump will be twofold: that foreign aid, which makes up less than 1 percent of the federal budget, has already proven beneficial to U.S. interests, and that a sliver of the increased spending in the upcoming budget dedicated toward readiness for a pandemic could work wonders for national health security. ‘The preparedness we have for a pandemic, either a naturally caused pandemic or a bioterrorism, intention-caused pandemic, we don't have the tools, the preparedness, the capacity to deal with that,’ he said. ‘And yet the science is at a point where for a fairly small portion of that increase, say a few percent a year, you could do something quite miraculous in terms of health security.’” [Politico, 3/15/18]
Foreign Policy Op-Ed: If There Is A Serious Pathogenic Threat To The United States The Response Will Be Driven By ‘The National Security Advisor’s Disdain For Globalism And The President’s Scientific Ignorance.’ According to a Foreign Policy op-ed by Laurie Garrett, “If there is a serious pathogenic threat to the United States, the response will be driven by the national security advisor’s disdain for globalism and the president’s scientific ignorance, coupled with his refusal to turn to genuine expertise for guidance. Some Trump supporters may applaud saving a few million taxpayer dollars by cutting support of global health efforts and believe that other nations can, and should, handle outbreak threats. But America is a safer place precisely because of the depth of experience and wisdom its scientists and public servants have acquired from decades of engagement in health crises overseas. Stepping away from such engagements only signals to the world that the United States no longer cares about the health and survival of non-Americans. Americans should not be surprised if, because of their government’s actions, the leaders of global public health organizations start to care less about them.” [Foreign Policy, 5/21/18]
March 2017: Senators Warren and Murray Asked Trump Administration about its preparedness for flu Pandemic - Trump Refused To Answer. The Democratic Policy and Communications Committee today released a compilation of over 100 oversight letters the Trump Administration has refused to answer in response to congressional inquiries sent since January of this year. This release follows reports that the Trump Administration instructed federal agencies to ignore Democratic oversight requests. It also follows an opinion released by the Department of Justice that reverses previous Executive Branch policy and argues individual Members of Congress do not have the authority to conduct oversight […] A March 13, 2017 letter from Senators Warren and Murray to Secretary of Health and Human Services Tom Price and Acting Director of the Centers for Disease Control and Prevention Anne Schuchat with questions on preparedness to deal with a potential pandemic flu outbreak.” [U.S. Senate Democrats, 6/7/17]
In A Letter To Then HHS Secretary Price, Democrats Criticized Trump’s Failure To Place Permanent Appointees In Public Health Positions Along With His Federal Government Hiring Freeze. According to a letter to Secretary Price and Acting Director Schuchat, “Other actions taken by President Trump could also impair our readiness in the face of a public health crisis, such as a flu pandemic. The President has failed to put in place permanent appointees in key public health positions at the HHS or CDC. He has not nominated a Deputy Secretary, General Counsel, Assistant Secretary for Planning and Evaluation, Assistant Secretary for Health, Assistant Secretary for Global Affairs, or Assistant Secretary for Preparedness and . Response. Further, he has not appointed a CDC Director. President Trump signed a Presidential memorandum on January 23, 2017, that instituted a federal government hiring freeze, stating that ‘no vacant positions existing at noon on January 22, 2017, may be filled and no new positions may be created.’” [Congressional Letter to Secretary Price and Acting Director Schuchat, 3/13/17]
Trump Made Plans To Eliminate The Prevention And Public Health Fund; The PHF Provided Critical Funding To Public Health Programs Including 40 Percent Of The CDC’s Immunization Program.According to President Trump will reportedly propose a $54 billion budget cut on non-defense discretionary spending, which could include CDC, HHS, and other programs that are critical to preventing and responding to a pandemic flu outbreak. A cut of such size could impact our ability to effectively respond to any public health emergency, including a disease outbreak. In addition, the President and congressional Republicans have developed plans to abolish the Prevention and Public Health Fund as part of their efforts to repeal the ACA. The PPHF provides critical funding to public health programs, accounting for more than 12 percent of the CDC's total program funding and 40 percent of the CDC's immunization program.” [Congressional Letter to Secretary Price and Acting Director Schuchat, 3/13/17]
The PPHF Funds 100 Percent Of The Preventative Health And Health Services Block Grant Which Helps State And Local Governments Built Their Public Health Infrastructure.The PPHF also provides 100 percent of the funding for the Preventive Health and Health Services Block Grant, which helps state and local governments build their public health infrastructure and fund immunization and infectious disease programs. Repealing the Prevention and Public Health Fund would deprive federal, state, and local governments of funding needed to fully prepare for and respond to a flu pandemic.”[Congressional Letter to Secretary Price and Acting Director Schuchat, 3/13/17]
President Trump Repeatedly Cast Doubt On The Safety Of Vaccines. According to a letter to Secretary Price and Acting Director Schuchat, “Finally, the President himself- on social media and in other forums has repeatedly cast doubt on the safety of vaccines, falsely claiming that they can cause autism and reportedly promising to convene a ‘vaccine safety’ panel led by Robert Kennedy, Jr., a notorious vaccine safety skeptic. These allegations are both scientifically baseless and potentially dangerous, as the public depends on ‘herd immunity’ to prevent the spread of serious - sometimes deadly - diseases, such as polio and measles. The yearly flu vaccine also curbs the spread of the virus, and we have seen that a widespread outbreak can occur when there is no effective vaccine - as was the case with HI NI.” [Congressional Letter to Secretary Price and Acting Director Schuchat, 3/13/17]
FY2021 Trump Budget Cut 7.2 Percent From Overall NIH Funding. [NIH, FY21 Executive Summary]
FY 2020: Trump Proposed $4.7 Billion 12 Percent Cut To NIH. According to the American Institute of Physics, “Funding for the National Institutes of Health would decline $4.7 billion, or 12 percent, to $34.4 billion under President Trump’s fiscal year 2020 budget request for the agency, close to the level proposed last year. Congress has flatly rejected the Trump administration’s proposals to cut funding for NIH over the past three years, instead providing multi-billion dollar increases each budget cycle.” [American Institute of Physics, 4/11/19]
FY 2019: Trump Proposed Essentially Flat Funding For NIH. According to Science, “Funding for the National Institutes of Health (NIH), initially slated to be slashed by 27%, instead would total $34.7 billion, roughly unchanged from 2017. That level could end up being a cut, however, after Congress completes work on a bill to fund federal agencies through 2018. The House of Representatives has proposed a $1.1 billion increase and the Senate $2 billion; a budget agreement approved last week promises at least $2 billion for NIH over the next 2 years, adding support for a substantial increase this year. In the 2019 proposal, NIH’s budget would go up slightly by $538 million over 2017. But that is because it would absorb three Department of Health and Human Services (HHS) agencies that fund research on health care quality, occupational health, and disabilities.” [Science, 2/12/18]
FY 2018: Trump Proposed Over $5 Billion Cut To NIH. According to the Washington Post, “The Department of Health and Human Services would receive $69 billion under the president’s budget proposal, a reduction of 17.9 percent that would send spending in one of the government’s largest and most sprawling departments to its lowest level in nearly two decades. More than a third of the $15.1 billion in cuts would affect the National Institutes of Health, the government’s main engine of biomedical research, which has long enjoyed strong bipartisan support in Congress.” [Washington Post, 3/16/17]
Rep Tom Cole: “You Can Have The Best People In The World, But If You’re Slashing The NIH Budget By 20 percent […] Then I Don’t Care How Good Your People Are, They’re Not Going To Be Nearly As Effective As They Need To Be.” According to the Washington Post, “‘You can have the best people in the world, but if you’re slashing the NIH budget by 20 percent, and presumably the same thing to CDC, then I don’t care how good your people are, they’re not going to be nearly as effective as they need to be,’ said Rep. Tom Cole, (R- Okla.), who chairs the House Appropriations subcommittee on labor, health and human services, education, and related agencies. The health agencies are ‘the front lines of defense for the American people for some pretty awful things,’ Cole said. ‘If the idea of a government is to protect the United States and its people, then these people contribute as much as another wing on an F-35 [fighter jet], and actually do more to save tens of thousands of lives.” [Washington Post, 4/8/17]
Rep Tom Cole: ‘I Think [CDC Cut] Leaves You Very Vulnerable And The American People Very Vulnerable.’ According to McClatchy Washington Bureau, “Rep. Tom Cole, R-Okla., praised Mulvaney for presenting a plan that tries to balance the budget within 10 years - then criticized the same proposal for cutting the budgets of the National Institutes of Health and the Centers for Disease Control and Prevention. Cole, a close ally of House Speaker Paul Ryan, R-Wis., got dire. He warned of a potential pox on the Trump White House: ‘I'll tell you, sometime in the president's term, you will have a pandemic. You will have a Zika, you will have an Ebola, and cutting the Center (sic) for Disease Control,’ he said, ‘I think, leaves you very vulnerable and the American people very vulnerable.’ Mulvaney calmly responded that ‘despite what you may have read in the press, we wholeheartedly support research in this area.’” [McClatchy, 5/24/17]
National Institute Of Allergy And Infectious Diseases Faced $430 Million Cut. [NIH, FY 21 Supplementary Tables]
NIAID Director Dr .Anthony Fauci Was One Of The Top Officials Overseeing Government COVID-19 Response. According to NBC News, “Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Friday that Americans will most likely have to continue staying at home and practicing social distancing for ‘at least several weeks’ amid the coronavirus outbreak.” [NBC News, 3/20/20]
NIAID Was Funding COVID-19 Vaccine Research. According to the National Institute Of Health, “A Phase 1 clinical trial evaluating an investigational vaccine designed to protect against coronavirus disease 2019 (COVID-19) has begun at Kaiser Permanente Washington Health Research Institute (KPWHRI) in Seattle. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is funding the trial. KPWHRI is part of NIAID’s Infectious Diseases Clinical Research Consortium. [NIH, 3/16/20]
FY 21 Estimated Research Dollars For Emerging Infectious Diseases Was Down By Almost $240 Million. [National Institutes of Health, 2/24/20]
Azar claimed Budget Cuts To NIH And CDC would not harm COVID-19 Response. According to a hearing on Health and Human Service Fiscal Year 2021 Budget Request, “ESHOO: The 200 million dollars in cuts at BARDA, 700 million dollars in cuts at CDC, and $3 billion out of NIH, are you willing to reconsider that given what our country is facing and what the American people need day in and day out from these agencies – they are the essentials AZAR: The proposals to the budget do not impact our ability to do the novel corona response – the CDC budget actually has 135 million dollar increase in the fields of infectious disease - ESHOO: do you think that - in other words they deserve these cuts these are healthy cuts? This is good for them and good for our country AZAR: You asked me about impact related to novel coronavirus these will not impact functioning related to that and of course we have the emergency supplemental request on top of that.” [Energy and Commerce Committee, Hearing on Health and Human Service Fiscal Year 2021 Budget Request -CSPAN, 2/26/20]
Azar Said Budget Written Before COVID-19 Spread Was Sufficient. According to a hearing on Health and Human Service Fiscal Year 2021 Budget Request, “ESHOO: But If you wrote it in December how do you know that? AZAR: Because the changes that we make in the budget are not related to categories that will impact our ability to do the novel coronavirus response.” [Energy and Commerce Committee, Hearing on Health and Human Service Fiscal Year 2021 Budget Request -CSPAN, 2/26/20]
Azar Said There Was Nothing To Reconsider In HHS Budget. According to a hearing on Health and Human Service Fiscal Year 2021 Budget Request, “ESHOO: So there’s nothing to reconsider. AZAR: I don’t believe there is in terms of the existing budget proposal. We have the emergency supplemental adding to accounts that we think are relevant.” [Energy and Commerce Committee, Hearing on Health and Human Service Fiscal Year 2021 Budget Request -CSPAN, 2/26/20]
March 17: Trump Admin Sent Letter Reversing Cuts To NIAID. After weeks of criticism, the Trump administration has reversed course on its request to cut funds for the Centers for Disease Control and Prevention (CDC) and the National Institute of Allergy and Infectious Diseases (NIAID) in its 2021 budget. ‘This FY 2021 Budget amendment increases funding for CDC to ensure that the Agency has the resources beginning October 1, 2020, to continue its critical public health mission,’ White House Budget Chief Russ Vought wrote to Congress in a letter dated Tuesday.” [The Hill, 3/19/20]