What does the cessation of U.S.-funded vaccination initiatives in developing nations signify for their residents—and for Americans?

EXPERT Q&A

Abram Wagner, assistant professor of epidemiology and global public health at the University of Michigan School of Public Health, explores the ramifications of the U.S. possibly ending international vaccine programs.

In your view, should the U.S. finance vaccines for other nations?

There are numerous persuasive arguments for the United States to endorse global vaccination initiatives. First, a significant number of vaccines are designed and produced in the U.S., therefore enhancing international access to vaccines frequently entails augmenting domestic production, bolstering American employment, fostering innovation, and lowering per-dose expenses via economies of scale.

Second, while it is crucial for U.S. taxpayer funds to prioritize the health and welfare of American residents, it is equally vital to acknowledge that the U.S. derives economic and strategic advantages from a healthier global populace. The U.S. is intricately connected to worldwide trade networks, and global public health issues—like pandemics—can disrupt supply chains, travel, and economic steadiness. By contributing to vaccine initiatives on a global scale, we assist in averting outbreaks that may cross borders and affect American lives and livelihoods.

Do vaccination initiatives like these offer additional advantages to citizens of those nations beyond preventing deadly diseases? What about the benefits for Americans?

Absolutely, vaccination initiatives provide extensive and enduring advantages that extend beyond the immediate prevention of illness and mortality. Numerous diseases targeted by global vaccination campaigns, such as measles and polio, are exceptionally contagious. By improving vaccination coverage worldwide, we diminish the chances of these ailments spreading across borders, thereby safeguarding American travelers and minimizing the risk of reintroduction into the U.S.

Additionally, there are long-term benefits for both global and American populations. When diseases are eradicated worldwide, the need for routine vaccinations can ultimately be diminished. We have witnessed this with smallpox, which was eliminated through global collaboration. If we successfully enhance vaccination rates globally for ailments like polio and measles, children in the U.S. would no longer require these vaccinations.

Are there specific diseases that pose the most significant threat? Do they impact U.S. citizens?

I am particularly worried about measles. Even though it is no longer deemed endemic in the United States, it continues to be quite prevalent in various nations. Every measles case recorded in the U.S. currently arises from international travel, either directly or through close contact with someone who has been infected abroad.

Measles ranks among the most contagious infectious diseases, and its spread can incur substantial costs. Public health measures, including contact tracing, emergency vaccination efforts, and community engagement, can amount to an estimated $10,000 to $50,000 per case.

Measles is lethal. Prior to the widespread availability of the vaccine, the U.S. experienced between 300 and 500 measles-associated deaths each year, predominantly among children. Sustaining high global vaccination rates is essential for protecting American communities and preventing the disease from reestablishing itself here.

What are the drawbacks of the U.S. taking on such a significant role in vaccinating citizens of other nations?

Vaccines represent one of the most cost-effective public health interventions available. With large-scale procurement, per-dose expenses decrease even more, rendering global vaccination campaigns a sound investment. These initiatives also cultivate considerable political goodwill and bolster diplomatic relationships. Collaborating on public health can pave the way for broader partnerships and contribute to global stability. The downside lies in the financial burden.

What are your primary concerns as the U.S. reduces funding for programs like this, including support to food banks and other budget cuts aimed at saving taxpayer money?

My greatest concern regarding reductions to initiatives like global vaccination efforts or domestic food aid is that they undermine the systems we depend on to promote fairness and resilience. Government programs are uniquely qualified to reach vast numbers of individuals and guarantee access to vital services, especially for those who would otherwise be excluded. Wealthier individuals will always manage to buy food, healthcare, and vaccines. The real challenge lies in ensuring that access is not confined to those with means.

Social assistance programs are crucial in connecting people, particularly those in remote regions, to care. In numerous areas of the country, it simply would not be cost-effective for private providers to function without public funding. These initiatives are often the sole lifeline linking rural communities to consistent health services, preventive care, and emergency aid. In their absence, rural regions would encounter even greater challenges in accessing fundamental services, leading to worsening health disparities and economic difficulties.

When we cut these initiatives, we’re not merely tightening budgets; we’re dismantling the safety net that safeguards millions of Americans. Taxes represent a collective investment in a society where everyone has an equitable opportunity, irrespective of their location or income. Undermining that foundation endangers both public health and social cohesion in the long term.

What would you convey to individuals who believe that the U.S. should limit its involvement in other nations and concentrate on American citizens, asserting that it is not the government’s responsibility to fund humanitarian efforts?

I wholeheartedly agree that the U.S. has an obligation to look after its residents, but that obligation does not conclude at our borders. In today’s interconnected landscape, public health is a global concern. Diseases do not adhere to national boundaries, and outbreaks in other regions can swiftly escalate into outbreaks domestically. Preventing the transmission of vaccine-preventable diseases abroad preserves American lives, lowers healthcare expenditures, and shields our economy from disruption.

Robust global health systems also bolster the stability of international supply chains. American enterprises depend on worldwide markets for raw materials, labor, and distribution. When other nations are healthier, they become more dependable trading partners and more substantial economic contributors. Investing in global health is not merely charitable; it is economically prudent.

There is also a strategic aspect to consider. Humanitarian aid, including vaccination programs, fosters goodwill and enhances America’s global standing. These endeavors enhance our soft power by creating trust and nurturing collaboration.

Contact: Abram Wagner, [email protected]