IDS Magazine Volume II, Issue II (Spring 2025) by Brown University IDS Magazine

THE POLITICS OF INFECTIOUS DISEASE

VOLUME II

EDITION II

SPRING 2025

s MAGAZINE

LETTER FROM THE EDITORS

Dear Reader,

It blows all of our minds that we are already on our fourth publication after two successful years of running the Infectious Disease Society (IDS) Magazine. The magazine itself initially began as a small group of individuals who were interested in writing about and creating discourse regarding various topics in infectious disease; however, over the past two years, our team has significantly expanded into a large, tight-knit community of students with various talents who come and work together to create and promote issues of our magazine whose topics have ranged from infectious disease and biotechnology to the effects of climate change on infectious diseases. The growth and success of this magazine is of great pride to us, and with that being said, we are proud to present this

semester’s issue of IDS Magazine: The Politics of Infectious Disease.

During a time in which the world is experiencing the remnants of the COVID-19 pandemic in addition to dealing with infectious disease on multiple forefronts (e.g. Monkeypox, Bird Flu, and Emerging Infectious Diseases to name a few), the new administration has caused widespread upheaval by weakening the federal government’s support for health and disease research. This includes significant budget cuts and layoffs at primary federal agencies such as the National Institutes of Health (NIH) and Centers for Disease Prevention and Control (CDC) and withdrawing the United States from the World Health Organization (WHO). This has resulted in unprecedented changes to scientific research such as the NIH terminating around 800 research projects. At the same time, this leads the nation into a time of uncertainty when it comes to the future of scientific research. How will funding cuts to clinical research trials affect the rates of certain chronic and infectious diseases? Likewise, how will attitudes regarding vaccination and infectious disease screening change under the current administration? It is uncertainties as such and beyond that we would like to initiate discourse on through this semester’s issue.

As always, in the creation of this issue, we would like to acknowledge and give thanks to the stellar work of the IDS Magazine team–our writers, editors, design editors, and communications team–who collectively dedicated their time to creating another successful issue

of the IDS magazine. This magazine would also not be possible without the help of the IDS Executive Board and larger IDS community. Lastly, I (Sean) just want to conclude by saying that it has been such an honor and privilege to serve as Co-Editor-in-Chief of IDS Magazine over the past two years. As discussed at the beginning of this letter, seeing the magazine’s growth over the last four semesters gives me great assurance that IDS magazine will continue to thrive through its future pages. Despite living through times of such uncertainty, one thing I am certain about is the long-term success of this print. As such, I would simply like to conclude by expressing my sincere gratitude.

With kind regards,

Sean Park and Alvaro Uribe Editors-in-Chief

MEET THE TEAM

Dylan Lai Editor

Marymar Vacio Lazalde Editor

Lisa Miyazaki Editor

Esther Liu Writer

Emily Mrakovcic Writer

Rishi Rai Writer

Joanna Renedo Writer

Julia Rodriguez Writer

Jason Hwang Editor

Not Pictured:

Annie Smith (Editor)

Ruviha Homma (Editor)

Kevin Pham (Editor)

Emelyn Madrigal (Writer)

Rachel Xu (Writer)

Margaret Wu (Writer)

Felora Bellamy (Writer)

Annie Song Communications Chair

Shrey Mehta Lead Communications Chair

Pranav Kota Editor

Lilia Felipe Pozo Communications Chair

Kiara Anderson Lead Design Editor

Evan Li Design Editor

Jacqueline Larson Design Editor

Natalie Tse Design Editor

Joanna Renedo

The Cost of Censorship: How NIH Language Restrictions May Hinder Research

Emily Mrakovcic

14 HIV/AIDS and the Global Diffusion of Neoliberalism: The Intersection of Health, Economic Policy, and Politics

16 Felora Bellamy Dependency by Design: NGOs and the Colonial Blueprint of Global Health

20 Unmanned and Unregulated: Political Tensions in Humanitarian Drone Deployment Across Borders Emelyn Madrigal

Joanna Renedo

Detained and Denied: ICE’s Medical Neglect and Corruption

Julia Rodriguez

Robert F. Kennedy Jr. & The Texas Measles Outbreak - A Precursor to what is Next and a Symptom of Before

Public Health Emergencies: A Path to Authoritarianism? Esther Liu

Rishi Rai

Border Barriers: A Longitudinal Review of Health and Immigration Policy

42 What is “Biological Truth”? Margaret Wang

Urban Governance and Infectious Disease Management in the City Emily Mrakovcic

Rachel Xu

The Crisis of PostCOVID Nursing Home Staffing: Medicare Providers Targeted under Trump’s Proposed Cuts

Clinical Enterprises

“Learning about the connection between climate change and disease behavior can help guide diagnoses, treatment and prevention of infectious diseases.”

–George R. Thompson, UC Davis School of Medicine

“Perhaps this is not surprising – many human viruses also cycle seasonally and are associated with particular weather patterns. However, the observed correlations between weather and COVID-19 suggest that the virus might be more susceptible to weather and seasonality than other viruses.”

–Mark C. Urban, Director of the Center of Biological Risk, Professor of Ecology & Evolutionary Biology, University of Connecticut

Source: Adobe Stock https://stock.adobe.com/Library/urn:aaid:sc:VA6C2:478d6f68-58b5-4e06-b041-213a16f138c6?asset_id=177797359

The Cost of Censorship: How NIH Language Restrictions May Hinder Research

Written By: Joanna Renedo

In his first Joint Address to congress, Trump stated, “$8 million for making mice transgender” (The White House, 2025). He also described how the new Department of Government Efficiency would be working to cut down on costs and eliminate DEI initiatives. Though many were expecting the loss of DEI initiatives to impact inclusivity and diversity in fields such as education, government, or healthcare, it has led to the polar extreme of banning words such as female, diversity, and ethnicity in government documents. As a result, research organizations such as the National Science Foundation (NSF) and National Institute

of Health (NIH) have flagged similar words when approving grant and funding proposals to not go against the executive orders. (Yourish et al., 2025)

With language restrictions, research published in Nature found that close to 50% of grants with terms such as LGBT, transgender, and vaccine hesitancy were cancelled amid Trump’s executive order (Kozlov & Ryan, 2025). This is harmful in more ways than one - the ban would not only exclude vulnerable communities from research, but would also hinder research due to potential funding cuts from the NIH and NSF.

In terms of clinical trials and how new government policies would affect the biotechnology industry, Ron Lanton, a [short short description of who

this is], discussed how research and talent acquisition would be impacted in a recent interview (Tracy, 2025). He states that companies conducting research will need to find other sources of funding beyond the NIH, which would mean turning to the private sector. This is challenging, considering that many companies would be competing with each other for funding, or even stop planning certain projects altogether. On top of funding, he added that there is an additional layer to be considered for said companies: politics. He believes the political climate will hinder objective research and will lead to right-winged, conservative biased research. Undoubtedly, he believes many researchers will leave the field to find places where their skills are welcome either by going into a different field or leaving the U.S. (Tracy, 2025)

With cuts in funding and added censorship, what will prospective researchers, or those who are already in the field, do about this situation?

Recent reports have proven Lanton’s predictions of researchers leaving the U.S. to be true (Mallapaty, 2025). Many researchers discuss their wishes to leave the U.S. for jobs in Europe due to the tough job market and anti-science rhetoric in the media. Furthermore, it seems that countries in the EU want to welcome these

of over 100 volunteers, all united in the belief that science is for everyone and benefits everyone” (Stand Up for Science, 2025). Their policy goals include:

1. End Censorship and Political Interference in Science

2. Secure and Expand Scientific Funding

3. Defend Diversity, Equity, Inclusion, and Accessibility in Science

“[...] 50% of grants with terms such as LGBT, transgender, and vaccine hesitancy were cancelled amid Trump’s executive order.”

researchers. Currently, the European Research Council (ERC) is trying to come up with initiatives based on programs they have already established, such as offering €1 million to cover eligible “start-up” costs for researchers moving to the EU from a third-world country (Portala, 2025). Though the US is generally not considered a thirdworld country, the ERC is working to create programs for U.S. researchers entering the EU based on this program.

Although it is understandable why researchers are leaving and going elsewhere, this move further harms vulnerable populations in the U.S. who need research to support their initiatives. Without research in topics such as health disparities, women’s health, or LGBT populations, we would not only be halting progress but also harming these communities by excluding them from representation in life changing research.

Despite widespread funding cuts and banned words, many have found hope through protest. One of the latest events occurred on March 7th in Washington, DC with Stand Up for Science. Stand Up for Science is a “grassroots operation consisting

The first goal they have listed is to end censorship and political interference in science, exemplifying how striking our current political climate is in shaping research. Although Stand Up for Science offers support and resistance against our political climate, organizations such as these show us the importance of sustained advocacy in protecting research. Protesting and rallying have continued to show that the government cannot silence science and that our integrity is stronger than the Trump administration’s attempts at censorship. Science is meant to serve everyone and must be defended.

Edited By: Dylan Lai

References:

Chen, M. (2025, March 24). The Chaos of NIH Cuts Has Left Early-Career Scientists Scrambling. WIRED. https://www.wired.com/story/the-chaos-of-nih-cutshas-left-early-career-scientists-scrambling/

Kozlov, M., & Ryan, C. (2025). How Trump 2.0 is slashing NIH-backed research — in charts. Nature. https:// doi.org/10.1038/d41586-025-01099-8

Mallapaty, S. (2025). These frustrated scientists want to leave the United States — do you? Take Nature’s poll. Nature.com. https://doi.org/10.1038/d41586-02500757-1

Portala, J. (2025). Europe could be a “haven” for US researchers, says ERC president. Science|Business. https://sciencebusiness.net/international-news/ europe-could-be-haven-us-researchers-says-ercpresident

Stand Up for Science. (2025, March 3). Frequently Asked Questions. STAND up for SCIENCE. https:// standupforscience2025.org/faqs/

The White House. (2025, March 5). Yes, Biden Spent Millions on Transgender Animal Experiments. The White House. https://www.whitehouse.gov/articles/2025/03/yes-biden-spent-millions-on-transgender-animal-experiments/

Tracy, D. (2025, March 3). Navigating NIH Funding Cuts, Diversity Bans, and Tariff Challenges: Legal and Industry Implications for Medical Research. PharmExec. https://www.pharmexec.com/view/navigating-nih-funding-cuts-diversity-bans-tariff-challenges-legal-industry-implications-medical-research

Global Health

“Infectious disease is one of the few genuine adventures left in the world. The dragons are all dead and the lance grows rusty in the chimney corner.”

— Hans Zinsser

“Of all the forms of inequality, injustice in health is the most shocking and inhumane.” — Martin Luther King Jr.

HIV/AIDS and the Global Diffusion of Neoliberalism: The Intersection of Health, Economic Policy, and Politics

Written By: Emily Mrakovcic

Neoliberalism, not to be confused with political liberalism, is an economic ideology that seeks to situate the free market as the central node around which society functions. Favoring mechanisms like privatization and deregulation, neoliberalism advocates for policies that allow the market to run uninhibited while the reach and roles of the state remain limited. However, although neoliberalism originates from the economic realm, it has very real implications for other domains of society, including healthcare and public health. The global diffusion of neoliberalism, beginning in the 1970-80s with the 1973 oil crisis, structural adjustment policies of the International Monetary Fund (IMF), and rise of Margaret Thatcher and Ronald Reagan’s administrations, has undermined and exacerbated various health crises around the world. One challenge that was greatly exacerbated and remains a significant contemporary challenge is the global HIV/ AIDS epidemic.

ology to thrive, the free flow of capital and goods across country borders must be facilitated. This is only possible, however, if individual countries enact policies that favor free-trade. While initially many countries in the Global South opted for isolationist policies that prioritized domestic development over global trade, the debt crisis beginning in the 1980s forced many of them to seek global foreign aid from the IMF. The IMF delivered financial aid to these countries in a package of neoliberal conditionality: the promise to deliver funds on the condition that

“Perhaps the greatest danger neoliberalism presents to the world is its near seamless integration into the very commonsense of economic and political discussion today.”

certain economic policies were adopted. This process, known as structural adjustment, required countries in the Global South to enact neoliberal economic policy in order to receive help with their debt. These policies often involved austerity measures and severe opposition to public expenditures, including public health (Rowden, 2009).

cultural and historical contexts that influence communicable disease transmission. In the case of Sub-Saharan Africa, the assertiveness of a Western understanding of HIV/AIDS, rooted in biomedicine and the medicalization of healthcare, obscures many of the societal norms that uniquely contribute to the epidemic in this region of the world (Comaroff, 2010). Additionally, neocolonial conceptions of sanitation and public health in the “Third World” often accompany the agendas of neoliberal development agencies. This contributes to a narrative that frames Global South countries facing infectious disease epidemics as in dire need of Global North actors with the sufficient knowledge and willpower to address these challenges (O’Manique, 2016).

To understand how neoliberal policy translates into tangible public health detriments, it is first necessary to understand what it requires to function at an optimal level. For neoliberal ide-

In addition to the economic reorganization and prioritization facilitated by neoliberalism, certain Western-centric beliefs that align with neoliberalism are perpetuated across the global stage. These beliefs, shaped by Global North countries, are particularly harmful to Global South countries facing HIV/ AIDS epidemics, as they have distinct

Although Sub-Saharan Africa is one example of the permeation of neoliberalism into public health, it is not the only example. An archival case study of Vietnam’s Ho Chi Minh City from 2007-2008 revealed a shift in the government’s mitigation of HIV/AIDS in the early 2000s. Montoya (2012) proposed that epidemic intervention operated within an “economy of virtue,” where neoliberal values of rationality, technical expertise, and science were used to battle HIV/AIDS and guarantee “the integrity and dignity of the Human.” Although this model aimed to prioritize efficiency, its technical approach risked dehumanizing people

living with HIV (PLWH), and its emphasis on individual responsibility and self-help drew attention away from the greater societal and global factors that placed individuals at a higher risk of infectious diseases like HIV.

The President’s Emergency Plan for AIDS Relief (PEPFAR) is an intriguing example of neoliberalism. Many scholars argue that PEPFAR itself is an extension of neoliberal policy by the United States into the public health sphere. However, beyond PEPFAR’s founding, President Trump’s January 2025 executive order that froze government spending on foreign aid, including PEPFAR, perhaps shines light on yet another dimension of neoliberalism in global governance. Trump and Elon Musk’s Department of Government Efficiency (DOGE) initiatives aim to cut government spending on several public expenditures; one of which is public health. If continued, this focus on efficiency and strict fiscal responsibility will have dangerous ramifications for the millions of PLWH worldwide who

currently rely on receiving treatment from PEPFAR.

Perhaps the greatest danger neoliberalism presents to the world is its near seamless integration into the very commonsense of economic and political discussion today. Neoliberal ideas adopted into our core political framework shift the window of what is considered an acceptable policy in the US, threatening to make advocates of PEPFAR and other modalities of global health solidarity appear far-left and radical. Sustained, evidence-based defenses of global health, accompanied by advocacy for infectious disease prevention and treatment, are required in today’s hostile public health climate to maintain the significant progress that has been made against these health challenges in the past.

Edited By: Marymar Vacio Lazalde

Source: Adobe Stock By Alexskopje https://stock.adobe.com/images/hiv-aids/29586749?prev_url=detail

References:

Montoya, A. (2012). From “the People” to “the Human”: HIV/AIDS, neoliberalism, and the economy of virtue in contemporary Vietnam. positions, 20(2), 561-591. https://doi.org/10.1215/10679847-1538515

O’Manique, C. (2016). Global neoliberalism and AIDS policy: International responses to Sub-Saharan Africa’s pandemic. Studies in Political Economy, 73(1), 47-68. https://doi.org/10.1080/191870 33.2004.11675151

R. (2009). The deadly ideas of neoliberalism: How the IMF has undermined public health and the fight against AIDS. Zed Books.

Comaroff, J. (2010). Morality, hope and grief. Berghahn Books.

Rowden,

Dependency by Design: NGOs and the Colonial Blueprint of Global Health

Written By: Felora Bellamy

Although used interchangeably, international and global health illustrate distinct concepts, evoking similarities of colonial hegemony. According to the World Health Organization (WHO), global health prioritizes “improving health and achieving equity in health for all people worldwide”. In contrast, international health functions as a foreign aid enterprise that only exists to serve developing nations. By working within capitalism, foreign aid enterprises have created a capital market where the temporary medical relief to ‘developing’ nations is maintained for maximum profit. Public health scholar David McCoy, in his influential paper “Developing an Agenda for the Decolonization of Global Health”, argues that examining global health through the lens of colonialism and coloniality is essential for exposing how power, injustice, and exploitation continue to shape its practices. His work sets the stage for rethinking global health not as a neutral, humanitarian field, but as one embedded in and perpetuating structural inequality.

Non-governmental organizations (NGOs) from high-income countries (HICs) play a central role in this system. The structuralization of NGOs are intentionally

designed to reap maximum profit while delivering their purpose, resulting in dependency on external resources rather than local resources, and imposing Western medical paradigms that are ill-suited to the region. Rather than fostering sustainable healthcare systems in low- and middle-income countries (LMICs), where local communities are given the tools to design their specialized health system, NGOs frequently maintain the dominance of donor nations, ensuring that former colonies remain reliant on external intervention. Ultimately, this structure limits LMICs’ agency and obstructs their paths toward self-sufficiency,

mirroring the very dependencies established during colonial rule.

Colonialism is often framed as a relic of the past, an era of brutal occupation long removed from our current societies. However, when analyzing colonialism through an economic lens, as a system built to extract resources and labor for the benefit of colonizing powers, its legacy grows unmistakably embedded in modern global structures, including healthcare. One enduring and insidious legacy is the development of tropical medicine, which laid the groundwork for today’s global health structures, structures still marked by the same colonial hierar-

Source: Adobe Stock https://stock.adobe.com/search?as_channel=adobe_apps&as_campclass=brand&as_ campaign=cc15_app&as_source=app&x-product=IDSN%2F20.2&x-product-location=NavBarSearch&as_camptype=IDSN&as_content=NavBarSearch&locale=en_US&sso_inbound=1&k=&expires_in=86399997&asset_ id=1244189490

chies of power and knowledge.

Tropical medicine emerged directly from colonial imperatives. Malaria was the greatest threat to European expansion in West Africa, with mortality rates reaching 70–80 per 1,000 annually in cities like Lagos and Freetown. The threat was so dire that a British parliamentary committee in 1865 even recommended full withdrawal. While colonial physicians eventually identified the malaria parasite and its mosquito transmission, these breakthroughs had a limited impact on the indigenous populations most affected.

exemplified how colonial governments institutionalized health research that prioritized the protection of European bodies and commercial expansion over indigenous well-being.

This origin story matters. It shows that global health did not evolve from a neutral or humanitarian concern but was objectively shaped by colonial power relations. The same patterns

this neocolonial infrastructure. While they are often presented as neutral or humanitarian actors, their operations frequently crowd out local governments, undermining the legitimacy and capacity of public health institutions in LMICs.

“The structuralization of NGOs are intentionally designed to reap maximum profit while delivering their purpose, resulting in dependency on external resources rather than local resources, and imposing Western medical paradigms that are ill-suited to the region.”

As historian Randall Packard shows, colonialism itself exacerbated malaria through forced migration, labor conscription, dam-building, and land dispossession, all of which created ideal conditions for the disease’s spread and left communities more vulnerable due to poverty and malnutrition.

The priorities and institutional arrangements set during this period did not fade; they became the blueprint for the emerging field of global health. Tropical medicine was institutionalized around the turn of the 20th century by colonial officers seeking prestige and employment beyond their military posts. Key discoveries, such as the identification of the malaria parasite by Alphonse Laveran in colonized Algeria (1880), inspired the institutionalization of tropical medicine. These developments helped establish the London School of Tropical Medicine in 1899, an establishment funded by the British Colonial Office and voluntary contributions from the public. From its inception, the school

persist today, where major research institutions in the Global North control funding, set research agendas, and dominate authorship, often sidelining the knowledge, needs, and leadership of the very communities they claim to serve.

The relationship can be understood through dependency theory, which argues that the global economic system maintains a hierarchy where low and middle-income countries (LMICs) remain economically reliant on high-income countries (HICs). Though colonial powers may have relinquished formal control, they replaced direct rule with economic, political, and institutional mechanisms that sustain inequality. This legacy is especially evident in the global health landscape, where foreign actors continue to shape health systems in LMICs according to donor priorities rather than local needs.

Modern global health institutions, particularly non-governmental organizations (NGOs), are central players in

A notable case of the unintended effects of NGO-led health interventions is illustrated by a recent study conducted by development economist Erica Deserranno and her colleagues, who analyzed the influence of NGO activities on Uganda’s public health infrastructure. Their research reveals how even well-funded, well-meaning NGO’s can destabilize existing systems. After the Ugandan government launched a volunteer-based healthcare program to address infant mortality, a well-funded NGO introduced a similar initiative, offering paid positions. In villages where government workers were already present, 39% of those same workers left to join the NGO, reducing overall access to care by 23% and increasing infant mortality. Instead of complementing existing services, the NGO disrupted them, creating a parallel system that proved unsustainable. On average, the intervention had no net benefit, underscoring how NGOs can crowd out public health infrastructure and undermine long-term development. Rather than strengthening access to services, the NGO’s presence often redirected resources away from government channels, worsening conditions for some communities.

Recent research by Deserranno et al. shows how NGO interventions in

Dependency by Design (cont’d)

Uganda can unintentionally harm the very communities they aim to help. After the Ugandan government launched a volunteer-based healthcare program to address infant mortality, a well-funded NGO introduced a similar initiative, offering paid positions. In villages where government workers were already present, 39% of those same workers left to join the NGO, reducing overall access to care by 23% and increasing infant mortality. Instead of complementing existing services, the NGO disrupted them, creating a parallel system that proved unsustainable. On average, the intervention had no net benefit, underscoring how NGOs can crowd out public health infrastructure and undermine long-term development.

Rather than strengthening access to services, the NGO’s presence often redirected resources away from government channels, worsening conditions

“To achieve sustainability in global health, it is crucial to shift authority away from external agents and towards national governments and local communities, who are best equipped to create lasting change.”

for some communities.

This case study reveals a deeper flaw in global health: many NGOs don’t just fail to strengthen local systems, they actively undermine them. Much like the colonial health of the era of tropical medicine, NGOs often position foreign actors as the primary agents of care, sidelining local expertise and institutions. This replicates a

colonial logic that views indigenous populations as passive recipients rather than viable actors in their own health administration. Without structural transformation, global health remains trapped in a neocolonial paradigm, repackaging dominance as development and charity as progress.

Global health institutions often replicate colonial patterns, not only by concentrating decision-making power in high-income countries (HICs) but also by sustaining systems that extract resources and talent from low- and middle-income countries (LMICs). In a compelling critique published in BMJ Global Health, Xiaoxiao Kwete, a global health researcher focused on equity and development, and her colleagues argue that many LMICs already possess the financial and human resources

Source: Adobe Stock By Pronoia https://stock.adobe.com/search?as_channel=adobe_apps&as_campclass=brand&as_campaign=cc15_app&as_source=app&x-product=IDSN%2F20.2&x-product-location=NavBarSearch&as_camptype=IDSN&as_content=NavBarSearch&locale=en_US&sso_inbound=1&k=&expires_in=86399996&asset_id=412001654

necessary to solve their own health challenges. However, these resources are routinely siphoned away through corporate profits or the outmigration of local skilled health professionals to the Global North. Health-oriented solutions then return in fragmented, donor-controlled forms, rebranded as “global health,” and often come with conditions that limit their effectiveness and sustainability. This structure perpetuates a false narrative of dependency, framing LMICs as helpless and foreign actors as essential saviors, thereby reinforcing the same power imbalances that defined the colonial era.

This systemic bias is not limited to organizational structures alone but also deeply ingrained in the mindset of global health actors, workers, researchers, and advocates, who are conditioned by the assumption that solutions must come from the Global North. Such assumptions blind the sector to the potential of local expertise and indigenous knowledge, reinforcing a paternalistic attitude towards LMICs.

To achieve sustainability in global health, it is crucial to shift authority away from external agents and towards national governments and local communities, who are best equipped to create lasting change. Structural reforms must focus on redistributing power, ensuring that decision-making processes are more centered around local voices, and addressing the imbalance in funding and leadership representation. Without such a transformation, global health will continue to operate as a modern extension of colonial governance, rebranding exploitation as aid, and leaving LMICs dependent on external control rather than empowering them to build their own sustainable health systems.

The prevalence of colonial legacies in global health underscores a troubling reality: despite the rhetoric of

progress and aid, international health systems often function to maintain power imbalances rather than to dismantle them. From the colonial foundations of tropical medicine to the contemporary practices of NGOs, global health continues to prioritize foreign control, sidelining local knowledge, leadership, and indigenous agency. While the narrative of aid and charity paints a picture of benevolence, the reality is that it often sustains dependency and undermines long-term and locally driven solutions. As the case of Uganda demonstrates, foreign interventions can crowd out local health systems, exacerbate inequalities, and create unsustainable models of care.

To truly achieve equity and sustainability in global health, a radical transformation is essential: one that shifts decision-making power to local governments and prioritizes long-term systemic changes over immediate fixes by engaging native populations as active participants in their own health. Unless global health addresses its neocolonial roots, it will continue to be a contemporary form of colonial governance, disguising exploitation as assistance rather than fostering genuine development. We can only aspire to establish a fairer and equitable global health system by dismantling these entrenched power structures.

Edited By: Jason Hwang

References:

Brown, Theodore M., Marcos Cueto, and Elizabeth Fee. “The World Health Organization and the Transition From ‘International’ to ‘Global’ Public Health.” American Journal of Public Health 96, no. 1 (January 2006): 62–72. https://doi.org/10.2105/AJPH.2004.050831.

McCoy, David, Anuj Kapilashrami, Ramya Kumar, Emma Rhule, and Rajat Khosla. “Developing an Agenda for the Decolonization of Global Health.” Bulletin of the World Health Organization 102, no. 2 (February 1, 2024): 130–36. https://doi.org/10.2471/BLT.23.289949.

Dumett, Raymond E. “The Campaign against Malaria and the Expansion of Scientific Medical and Sanitary Services in British West Africa, 1898-1910.” African Historical Studies 1, no. 2 (1968): 153–97. https://doi. org/10.2307/216391.

Bump, Jesse B., and Ifeyinwa Aniebo. “Colonialism, Malaria, and the Decolonization of Global Health.” PLOS Global Public Health 2, no. 9 (September 6, 2022): e0000936. https://doi.org/10.1371/journal. pgph.0000936.

Ahiakpor, James C. W. “The Success and Failure of Dependency Theory: The Experience of Ghana.” International Organization 39, no. 3 (1985): 535–52. https:// www.jstor.org/stable/2706689.

Deserranno, Erika. “Impact of NGO-Provided Aid on Government Capacity: Evidence from Uganda | Journal of the European Economic Association | Oxford Academic.” Accessed April 9, 2025. https://academic.oup. com/jeea/article/23/1/361/7646080.

Kwete, Xiaoxiao, Kun Tang, Lucy Chen, Ran Ren, Qi Chen, Zhenru Wu, Yi Cai, and Hao Li. “Decolonizing Global Health: What Should Be the Target of This Movement and Where Does It Lead Us?” Global Health Research and Policy 7, no. 1 (January 24, 2022): 3. https://doi.org/10.1186/s41256-022-00237-3.

The Politics of Infectious Disease

Unmanned and Unregulated: Political Tensions in Humanitarian Drone Deployment Across Borders

Written By: Emelyn Madrigal

Introduction

From the dominating ‘killer robot/drone’ to the evolving ‘good drone’ or ‘humanitarian drone,’ Unmanned Aerial Vehicles (UAVs) have shifted in interpretation and application over recent years, especially compared to their original military design by Britain and the US in 1917 and 1918 (Lipton, 2023; Sandvik, 2014, 2015). This humanitarian drone contains numerous applications, from disputed surveillance uses (Sandvik, 2014) to mapping, search and rescue, cargo drones, last mile deliveries, demining, and damage assessments during crisis situations, namely health or disaster responses in remote, disaster-affected or conflict-plagued regions (Arnold et al., 2018; Bergengruen, 2023; Germann, 2019; Mechan, 2014; Rejeb, 2021; Soesilo, 2016). This review article explores instances of successful humanitarian drone systems and aims to understand the degree of influence the political environment surrounding aid plays in impeding the effective and efficient deployment of humanitarian drones across borders.

Successful Humanitarian Drone Programs

Where some literature describes

skepticism of the effectiveness and worth of humanitarian drones (Emery, 2016; Raymond, 2012), others acknowledge the increasingly vital role humanitarian drones play in a timely global health response (Leedom, 2024; Rejeb, 2021; Ugwu, 2024). One interview with Zipline describes the company’s collaborations with Rwanda and Ghana, supplying “75% of the nation’s blood supply outside Kigali” by 2024 and starting in 2019, becoming a “critical link in the supply chain, delivering millions of doses of COVID-19 vaccines from six distribution hubs” (Leedom, 2024). Although this caused delays in the beginning, a great portion of the success of these programs can be credited to the company’s efforts to

establish these pre-disaster systems with the intention of local self-sustainability and in alliance with the local government. Another study presents the importance of humanitarian drones in clinical microbiology and infectious diseases (Poljak, 2020). It identifies successful drone deployment projects for transporting blood, vaccines, samples, medicines, organs, and life-saving medical equipment in countries like South Africa, Bhutan, Ghana, Malawi, and Tanzania; again, each case displays a pattern of collaboration with the local government and a respect for their sovereignty (Poljak, 2020).

In regard to the surveillant capabilities of drones, several studies defend their value in the epidemiology of infectious diseases

Source: Adobe Stock https://stock.adobe.com/Library/urn:aaid:sc:VA6C2:478d6f68-58b5-4e06-b041213a16f138c6?asset_id=254820442

such as Ebola, Tuberculosis, Malaria, and more recently, COVID-19 (Estrada, 2020; Euchi, 2021; Fornace, 2014; Mechan, 2014; Poljak, 2020; Ugwu, 2024). For example, the WeRobotics Madagascar Flying Lab used drones to monitor the spread of Malaria by anopheles mosquitoes in the rural areas of Morombe, Madagascar (Madagascar Flying Labs, 2023). Although the results were promising, the project required physical involvement from locals in the operational and developmental areas in order to bypass resistance from the community (Madagascar Flying Labs, 2023). In all of these cases, pre-collaborations with the local government and regulations were critical to guaranteeing the permissions necessary for operations regarding trust and sovereignty. Where humanitarian drones have proven their potential in optimizing global health responses, it is critical to understand how this permissive relationship between host-governments and private organizations, IGOs, or NGOs fluctuates when sensitive political climates influence the significance of sovereignty, security, and politics over the argued neutrality of providing healthcare.

gest their humanitarian use in these complex settings is unavoidable, instead urging for smarter efforts to study and formalize an ethical guideline (Greenwood, 2022; Tatsidou, 2019; Ugwu, 2024). Consequently, impartiality and neutrality become crucial requirements for an unbiased justification of humanitarian drone deployments in conflict zones.

Regardless of the setting, drones

a time when drones were essential to the fight against COVID-19 (Tatsidou, 2019). Non-compliance with these regulations could escalate into political alignment, challenging the sovereignty of a party and leaving room for military retaliation.

“Humanitarian drones, a technology of humanitarian aid, are thus not exempt from political influence nor neutral by default.”

Issues With Deployment in Politically Tense Environments

Public health and natural disasters are deeply intertwined with political conflict and instability, threatening an effective response. While some scholars believe it is too soon for drones to be properly deployed strictly for humanitarian purposes exempt from military influence, experts like Faine Greenwood sug-

are subject to the regulations and orders of the host country’s authorizing officials or parties (Madagascar Flying Labs, 2023; Raymond, 2012; Rejeb, 2021; Soesilo, 2016; Ugwu, 2024). However, current regulations generally do not lay out a proper approach for humanitarian drones to be implemented successfully or productively, some being too restrictive–if present at all–or simply too lax, contradicting, or irrelevant (Kamat et al., 2022; Rejeb, 2021). Many hosts require organizations to submit flight plans and data prior to use. Some limit the dropping or parachuting of cargo that humanitarian aid workers rely on for their personal safety in conflict zones (Soesilo, 2016). Others implement variations of the Visual Line of Sight (VLOS) rules, in which weather conditions (i.e. fog), terrain layouts (i.e. trees, hills, and infrastructure), and human eyesight limitations (i.e. light and distance) restrict the range of drone flights (Kamat et al., 2022; Soesilo, 2016). For example, Bhutan banned drones until the establishment of adequate drone regulations in 2019,

Adjacent to the argument of sovereignty is the slippery slope dilemma and the neutrality of ‘surveillance drones’ (Karlsrud, 2013). How neutral will these drones be in simply monitoring human rights and public health threats? One study points out the dilemma of the UN’s peacekeeping mission in the DRC under MONUSCO–a party in the political conflict–which deployed peacekeeping surveillance drones in 2006, 2013, and 2014 (Emery, 2016). Humanitarians refused MONOSCU’s offer to share the captured data because of the risk of bias and compromising the neutral position locals trusted. The “U.S. targeted killing program began as ‘flying cameras’ over the Balkans and then over Afghanistan,” later being “redeployed as [armed] weapons” (Emery, 2016). How can it be guaranteed that humanitarian surveillance drones won’t follow the same path? How can intention be declared and guaranteed when drones are a dual-use technology with the potential of being hacked, manipulated, or armed (Greenwood, 2022; Sandvik, 2014; Soesilo, 2016)? Even biased or hacked data threats have labeled these aid drones as ‘digital colonizers’ (Greenwood, 2022).

Parallel to intention is identification. Governments can not push for permissive regulations, nor can the public provide popular sup-

The Politics of Infectious Disease

Unmanned and Unregulated (cont’d)

port if the perception of drones, identifiable or not, still causes fear in the name of security (Greenwood, 2022; Kamat et al., 2022; Tatsidou, 2019; Wang, 2021). Are they carrying aid or a bomb? Are they surveilling for epidemiology or gathering political intelligence? Who does that drone belong to? There is a general ‘do no harm’ rule among humanitarian drone users, with some arguing that this extends into emotional harm, suggesting that in countries like Somalia, Afghanistan, and Pakistan where strike drones have been particularly heavy, humanitarian drone use is unethical for it would cause more panic than relief (Soesilo, 2016; Raymond, 2012). Thus, the question stands: Can humanitarian drones prove themselves secure and reliable enough to overcome the challenges posed in politically tense environments?

Are Humanitarian Drones a Neutral Technology?

Humanitarian drones are not neutral or apolitical by default (Sandvik, 2014). Humanitarian aid can be and has been political. One route for political influence is financial support. Although part of the allure of humanitarian drones is their cost-effectiveness compared to other technology, studies have found that funding is still an obstacle in the larger scheme of things (Kamat et al., 2022; Rejeb, 2021; Scanlan, 2017). U.S. President Trump’s recent disinvestment in the USAID under a planned 90-day review period is an example of politically motivated financial cuts on foreign humanitarian aid. This includes programs for humanitari-

an drone use like the Global Health Supply Chain Program-Procurement and Supply Management (USAID GHSC-PSM), which received funds by PEPFAR through the USAID for studying humanitarian drones in the supply chain process of fighting HIV/AIDs (Dubin, 2020). Although PEPFAR was allegedly offered a $500 million exemption, this does not compare to its previous annual budget of $6.5 billion (Landay, 2025). Nor is drone development a priority when PEPFAR is currently facing an expired authorization after political battles within U.S. foreign policy granted PEPFAR only a one-year authorization the year prior compared to previous five-year authorizations (Ratevosian, 2025). Especially in conflict zones such as Ukraine, where President Trump has already threatened aid while teasing different political partnerships, the politicization of humanitarian aid is seen through 3rd party foreign policies and the receptiveness to foreign intervention of the host party or parties. As a 2017 white paper put it, “Global society is either unwilling or unable to devote sufficient resources to these challenges” (Scanlan, 2017).

Conclusion

However successful certain humanitarian drone programs may be or however neutral they may seem, the influence of politics is a far too often overlooked factor impeding their deployment and authorization across borders, particularly in politically tense environments. Productive projects all reflected dependencies on local legal and ethical approval, with published works highlighting the underlying political issues of

sovereignty and security through challenges with regulations, intent, and differentiation. Humanitarian drones, a technology of humanitarian aid, are thus not exempt from political influence nor neutral by default. One angle is the politics behind funding. This is a pertinent modern angle to the recent U.S. disinvestment of the USAID and, in turn, the withdrawal of support for numerous humanitarian aid projects, including those implementing drones. Not all humanitarian drone programs depend on U.S. funding, but this example should start conversations about the politics of humanitarian drones and discussions regarding how their growing use in politically unstable regions like Ukraine or Israel and Palestine can be managed to focus on the response to a global health crisis rather than on the political dispute.

Edited By: Annie Smith

Source: Adobe Stock https://stock.adobe.com/search/images?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=0&filters%5Bcontent_type%3Azip_vector%5D=0&filters%5Bcontent_type%3Avideo%5D=0&filters%5Bcontent_type%3Atemplate%5D=0&filters%5Bcontent_type%3A3d%5D=0&filters%5Bcontent_type%3Aaudio%5D=0&filters%5Bfetch_excluded_assets%5D=1&filters%5Binclude_stock_enterprise%5D=1&filters%5Bis_editorial%5D=0&filters%5Bcontent_type%3Aimage%5D=1&k=drones&order=relevance&limit=100&search_page=4&search_type=pagination&get_facets=0&asset_id=104473205

“Health care must be recognized as a right, not a privilege. Every man, woman and child in our country should be able to access the health care they need regardless of their income.”

-Bernie Sanders

“Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures.”

-World Health Organization Constitution

HEALTH &

Detained and Denied: ICE’s Medical Neglect and Corruption

Written By: Joanna Renedo

In 2019, Emigdio Abel Reyes Clemente died of undiagnosed and untreated bacterial pneumonia in an ICE detention center in Florence, Arizona (ACLU, 2024). The medical staff at this facility assumed he had influenza and did not test him for illness, prescribe antibiotics, provide oxygen, or take a chest x-ray. Two days later, he passed away in a medical isolation cell.

Cases like these are not uncommon in ICE detention centers and continue to happen due to medical negligence and lack of oversight. In June of 2024, the ACLU published a report, Deadly Failures: Preventable Deaths in U.S. Immigrant Detention, where they conducted a comprehensive review of 52 people who died in ICE’s custody from 2017-2021. One of the investigations they highlighted was of Maria Celeste Ochoa de Yoc’s death, where ICE officials mistranslated her. When she said she “felt like she was dying,” ICE agents misinterpreted her pain as suicidal ideation and placed her in solitary confinement, where she died of untreated liver failure. In her case, ICE investiga-

tors omitted evidence that the Kay County Detention Center failed to translate for Ochoa de Yoc. Strikingly, of the 52 deaths the ACLU investigated, medical experts concluded that 49 of the deaths were preventable if proper medical care had been provided. This includes misdiagnoses - as was the case in Reyes Clemente’s death - delaying care, and not providing interpretation services.

With ongoing backlash for their lack of medical care for detainees, the Department of Homeland Security has continued to argue that they are doing all that they can

detained an unidentified person who tested positive for a tuberculosis (TB) skin test and had a suspicious chest X-ray. Despite this, they released this person into the general detention facility population, where 174 detainees were exposed. The individual was then hospitalized 2 months later, and was confirmed to have a rare, drug-resistant form of TB (Pfeil & Woodruff, 2024). Although there were no confirmed cases related to this person, this case exemplifies situations that ICE continues to fail in both ensuring proper routine screenings and in following protocols for isolating the ill.

“...of the 52 deaths the ACLU investigated, medical experts concluded that 49 of the deaths were preventable if proper medical care had been provided.”

to manage the health of detainees. According to ICE:

“As part of its intake process, ICE Health Service Corps routinely screens for infectious disease, such as tuberculosis, within the detained population. The health system has protocols in place to isolate the ill, medically manage and treat infected individuals, and quarantine or cohort exposed individuals and groups to contain the disease” (U.S. Immigration and Customs Enforcement, 2020).

Contrarily in 2024, ICE officials

Recently, ICE’s lack of medical care led to the death of Anadith Danay Reyes Alvarez, an 8 year old girl with a chronic heart disorder and sickle cell anemia. She was exposed to influenza and then placed in isolation with her family. They would visit the medical unit often, where her mom begged officials to send her daughter to the hospital. Unfortunately, she was not taken until she became unresponsive. By that point, it was too late and Anadith was pronounced dead (Gonzalez & Cruz, 2023.) Anadith’s case and other children suffering from medical neglect in these facilities led to investigations by the FXB Center for Health and Human Rights at Harvard University. One of their

Source: Adobe Stock https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcontent_type%3A3d%5D=1&filters%5Bfetch_excluded_assets%5D=1&filters%5Binclude_stock_enterprise%5D=1&filters%5Bcontent_ type%3Aimage%5D=1&k=immigration+detention+center&order=relevance&limit=100&search_page=1&search_ type=usertyped&acp=&aco=immigration+detention+center&get_facets=0&asset_id=601643455

key findings was that there was inadequate supervision and documentation of acute medical care, and inappropriate screening and care for existing chronic medical conditions, malnutrition, and TB (Sridhar et al., 2024). These investigations continue to show the inaction of the Department of Homeland Security in ensuring basic medical care in ICE detention camps, not just for adults, but also children.

With this information, the ACLU suggests legislation within ICE detention centers such as requiring ICE to track and report deaths under their custody. Although these solutions would help in addressing oversight it’s important to recognize that individuals also have a role in demanding change. Whether it be attending rallies, marches

or calling your representatives for bills such as the “Pass the Dignity for Detained Immigrants Act,” we have a responsibility to speak and fight for those who cannot (Cory, 2023). For example, the Alliance to Mobilize Our Resistance (AMOR) organization is working with the community of Rhode Island to shut down the Wyatt detention center and organize rallies and marches. Through their efforts, they were able to pass legislation for undocumented people in Rhode Island to receive a state-issued driver’s license (Alliance to Mobilize Our Resistance, 2019). Ongoing support from community-based organizations remind us that we have the ability to act and demand change.

Edited By: Dylan Lai

References:

Alliance to Mobilize Our Resistance . (2019). Initiatives – AMOR. Amorri.org. https://amorri.org/initiatives/

Cory, B. (2023). S.1208 - 118th Congress (2023-2024): Dignity for Detained Immigrants Act of 2023. Congress.gov. https://www.congress.gov/bill/118th-congress/senate-bill/1208

Gonzalez, V., & Cruz, L. (2023, June 16). Balloons, tears and hugs as family of girl who died in Border Patrol custody holds New York funeral. AP News. https:// apnews.com/article/border-patrol-anadith-custody-death-8cfee1e24758eefc21086ff3a2215943

Hyunhye Cho , E., & Wilson , T. (2024). Deadly Failures. https://assets.aclu.org/live/uploads/2024/06/2024-0701-ICE-Detainee-Deaths.pdf

Pfeil, A. (2024, October 23). ICE detainee tests positive for drug-resistant tuberculosis in Louisiana. The state is suing. NOLA.com. https://www.nola. com/news/politics/landry-louisiana-surgeon-general-respond-after-state-lawsuit-ice-detainee-tb/article_38474266-9150-11ef-812e-8f2e57076a64.html

Sridhar et al. (2024). AN EXAMINATION OF CURRENT PEDIATRIC CARE STANDARDS AND PRACTICES. https://bpb-us-e1.wpmucdn.com/sites.harvard.edu/ dist/c/679/files/2024/01/Child-Migrants-in-Family-Immigration-Detention-in-the-US.pdf

U.S. Immigration and Customs Enforcement. (2020, November 5). Archived: ICE releases first health service corps annual report. Ice.gov. https://www.ice. gov/news/releases/ice-releases-first-health-servicecorps-annual-report

Public Health Emergencies: A Path to Authoritarianism?

Written By: Esther Liu

When the public is introduced to a new infectious disease, uncertainty arises and spreads fear. Beyond our physical immune system, we also have a behavioral immune system that psychologically influences us to minimize exposure to threats. This functions like how the brain reacts to a negative smell, instinctively signaling the body to avoid it. Likewise, fear in response to infectious diseases is an automatic evolutionary mechanism that helps individuals detect and respond to danger or unfamiliar environments [LeDoux, 2013]. This heightened stress during outbreaks manifests in a greater public inclination to obey the government for the perceived collective good, according to the Parasite Stress Theory of Sociality.

expense of unity [Brandt & Henry, 2012]. Since authoritarians focus on group loyalty, those who challenge societal norms may be viewed as morally deviant. This belief system can be adopted individually when social threats arise. For example, increased support for rightwing authoritarianism followed the September 11, 2001 attacks—a threatening social environment that induced immense fear [Nagoshi et al., 2007]. In times of uncertainty, individuals are more likely to adopt group values that offer security, making them more susceptible to

selecting between pairs like “independent or respectful,’ “obedient or self-reliant,’ “well-behaved or considerate,’ and “well-mannered or curious.” [Zmigrod et al., 2021] From a psychological standpoint, child-rearing beliefs reflect broader political preferences for hierarchy and control. On the RAW scale, 1 represented non-authoritarian values like curiosity and assertiveness, while 7 indicated authoritarian ones, such as obedience. The study collected 258,241 responses—206,308 from the United States and 51,933 from 46 other nations [Zmigrod et al., 2021].

“The most authoritarian U.S. states had rates of infectious diseases four times higher than the least authoritarian states.”

authoritarian beliefs.

This theory suggests a direct link between disease prevalence and the adoption of authoritarianism—a political system that emphasizes subordination by promoting group cohesion over individual needs and values. In contrast, autonomy prioritizes individual freedom, even at the

In 2021, the Department of Psychology at the University of Cambridge conducted the largest study to date, investigating links between infectious disease and authoritarian attitudes. [Zmigrod et al., 2021]. In collaboration with TIME magazine, the study released a two-part personality survey: part one was a Harry Potter House quiz, and part two was an optional questionnaire based on a psychological model of authoritarianism. Participants were asked to indicate the most important qualities for a child to possess,

Zip codes were used to analyze whether geography influenced authoritarian beliefs. To correlate this with infectious disease prevalence, the researchers examined chlamydia and gonorrhea cases in U.S. metropolitan regions from 2002 to 2010. To draw national conclusions, CDC infectious disease records were used. Historical data for nine diseases—leishmaniasis, trypanosomes, leprosy, schistosomes, filariae, tuberculosis, malaria, dengue, and typhus— were used to evaluate trends in the remaining 46 nations. The study concluded that infectious disease prevalence was positively related to authoritarian psychological tendencies between all three geographic scales. The most authoritarian U.S.

Source: Adobe Stock https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcontent_type%3A3d%5D=1&filters%5Bfetch_excluded_assets%5D=1&filters%5Binclude_stock_enterprise%5D=1&filters%5Bcontent_type%3Aimage%5D=1&filters%5Bcontent_type%3Aaudio%5D=0&filters%5Bis_editorial%5D=0&filters%5Bfree_collection%5D=0&k=china+covid+19&order=relevance&limit=100&search_page=1&search_type=usertyped&acp=&aco=china+covid+19&get_facets=0&asset_id=335817549

states (Mississippi, South Carolina, and Louisiana) had rates of infectious diseases four times higher than the least authoritarian states (Pennsylvania, Montana, and Arizona). Similarly, less democratic nations—measured using Vanhanen’s index of democracy—had three times higher pathogen prevalence than the most democratic nations [Zmigrod et al., 2021]. The study controlled for social factors such as religion, wealth, education, and employment rates.

The psychology behind vulnerability during public health emergencies can be applied to our most recent global pandemic: COVID-19. In its aftermath, public health officials worldwide compared how countries responded, raising the question: which country

handled COVID-19 the best? In 2019, the Global Health Security ranked the United States first in pandemic preparedness [“How the United States, 2021”]. Yet, the U.S. struggled to contain the virus. According to Johns Hopkins University, the U.S. reported 103,802,702 confirmed COVID-19 deaths and ranked 18th in mortality among 190 countries [“Mortality Analyses,” n.d.]. Compared to authoritarian regimes like China and Russia, which reported lower mortality rates, these statistics raise questions: How should the U.S. approach future pandemics? Could authoritarianism offer advantages in emergencies? First, U.S. policies and attitudes will be analyzed and then compared with the structures and outcomes of other countries.

Ranking highest in preparedness merely indicates resource availability, not response effectiveness. In 2019, the U.S. had fewer healthcare providers and supplies per capita than other high-income countries, and limited affordable care access [Taylor & Asmundson, 2021]. Unlike centralized authoritarian nations, the U.S. placed much of the pandemic response responsibility on local governments, which often had fewer resources. This led to delays in test results, increasing transmission risk. The federal government initially restricted independent labs from developing their own SARS-CoV-2 tests, despite available resources [“How the United States, 2021”]. This reduced national testing capacity and allowed undetected spread. Jennifer Nuzzo,

Public Health Emergencies (cont’d)

Director of the Pandemic Center at Brown University’s School of Public Health, said, “I would have liked to see us have better data to understand one, what was happening and two, whether the measures we were using were working.” Masking, for example, was mandated before conclusive research demonstrated its efficacy. This led to anti-mask protests and growing distrust in government, increasing susceptibility to infection [Taylor & Asmundson, 2021]. “I think there was an over-reliance on mandated restrictions,” Dr. Nuzzo said, arguing that mandates without transparency worsened frustration and noncompliance.

Bi-partisan division also reduced public compliance. Since the start of the pandemic, Democrat officials encouraged masking and social distancing. Republicans, on the other hand, questioned the efficacy of these measures [Ollerenshaw, 2022]. This divide was also seen in vaccination rates. By March 2021, every Democratic member of Congress had received at least one COVID-19 vaccine dose, compared to only 95 of 212 House Republicans and 46 of 50 Republican Senators [Ollerenshaw, 2022]. This is not to imply that Republican officials were “anti-vax,” but rather that inconsistent messaging fueled public uncertainty. A fully democratic government without centralized coordination contributed to a series of difficulties in effectively responding to the pandemic.

Evaluating how different coun-

tries manage outbreaks offers valuable insights into successful policies and strategies to address public health emergencies. Many countries established a coordinated governance system, requiring federal and state systems to operate under the same guiding principles. Measures included establishing national committees and unified task forces with leaders and ministries. The U.S. could not adopt this model due to its bipartisan system. Countries such as Hong Kong (14,924 deaths), Taiwan (19,005 deaths), and Vietnam (43,206 deaths) established coordinated governance before reaching five confirmed cases. Interestingly, not all mandated masks—while China and Vietnam did, Hong Kong, South Korea, and Japan kept masking voluntary.

Despite different government structures across East Asian countries, the Harvard Business Review (HBR) argued that digital tools, not just leadership, were key to success. Democratic South Korea performed as well as autocratic China, largely through contact-tracing technology. Singapore implemented TraceTogether, which used Bluetooth signal exchange between phones to track exposure. Hong Kong’s StayHomeSafe app paired with wristbands to surveil positive COVID-19 tests and monitor quarantine requirements. South Korea’s MarketWatch app, which notified users of COVID-19-positive individuals within a 100-meter radius, reached over 1 million downloads. Taiwan’s health officials called quarantined individuals

twice daily to verify compliance. In contrast, Cambridge University’s FluPhone—a mobile contact-tracing app—had less than 1% resident registration rate [Huang et al., 2020]. HBR believes this technological approach addressed the scale, speed, and enforcement needed to control SARS-CoV-2. But privacy concerns limited adoption in Western democracies, sparking debate over liberty versus collective safety—an issue that edges close to authoritarian boundaries.

Nonetheless, it is important for the U.S to reflect on its most recent pandemic responses, especially compared with other governments. Since taking office, President Trump has issued multiple public-health-related executive orders. On January 20, he withdrew the U.S. from the World Health Organization (WHO), citing dissatisfaction with its COVID-19 response and high financial demands. The U.S. was WHO’s largest contributor, providing between 12-15% of its 2022-2023 budget [“The U.S. and the WHO,” 2025]. WHO plays a major role in global coordination, including drug and vaccine distribution. Trump reasoned that funding favored other countries despite U.S. contributions. However, Dr. Nuzzo and other experts warn that this will limit U.S. influence in global health and cause delays in international data-sharing. “I think we suffer the worst in this scenario,” Dr. Nuzzo said, “In my view, I don’t think there’s a pathway to anything other than spending more and getting less.”

After experiencing a global pandemic firsthand, countries must evaluate how to best prepare for future outbreaks. While authoritarian control may seem effective, it is unlikely that the U.S. will fall into this takeover due to its strong emphasis on individual freedom and liberty. Still, ongoing political decisions that distance the U.S. from global health networks raise concerns about the nation’s preparedness for future public health emergencies. References:

Edited By: Lisa Miyazaki

Source: Adobe Stock https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcontent_type%3A3d%5D=1&filters%5Bcontent_type%3Aaudio%5D=0&filters%5Bfetch_excluded_assets%5D=1&filters%5Binclude_stock_enterprise%5D=1&filters%5Bis_editorial%5D=0&filters%5Bfree_collection%5D=0&filters%5Bcontent_type%3Aimage%5D=1&k=world+health+organization&order=relevance&limit=100&search_page=1&search_type=usertyped&acp=&aco=world+health+organization&get_facets=0&asset_id=419257233

Robert F. Kennedy Jr. & The Texas Measles Outbreak - A Precursor to what is Next and a Symptom of Before

Written By: Julia Rodriguez

The United States declared measles, one of the most contagious diseases known to man, eliminated in 2000 (Centers for Disease Control and Prevention, n.d.). However, the current measles outbreak in the U.S. threatens this status. As of April 9, 2025, there are almost 600 cases across four states with three deaths—two of whom are unvaccinated school-aged children in Texas (Mukherjee & Bonifield, 2025). The outbreak is concentrated in West Texas, specifically in Gaines County, and originated in a Mennonite community (Public Health On Call, 2025). It is particularly striking because it is unlike the outbreaks usually seen in the U.S. (Mukherjee, 2025). Typically, measles cases are isolated and do not occur in large groups with sustained chains of transmission, as seen in this outbreak (Mukherjee, 2025).

Vaccination is the most effective tool in preventing and controlling measles outbreaks (Public Health On Call, 2025). The two available measles vaccines (MMR and MMRV), which are recommended for children aged 12 to 15 months, are extremely effective, with a completion of doses providing

97% protection against contracting the disease (Public Health On Call, 2025). Despite its effectiveness, vaccine coverage lower than 95% of the population significantly increases the risk of outbreaks as the disease is highly contagious (Public Health On Call, 2025). In fact, most of the cases seen in this outbreak are among the unvaccinated or people with unknown vaccination status (Public Health On Call, 2025).

Recently, Robert F. Kennedy Jr. (RFK Jr.) was sworn in as the secretary of the U.S. Department of Health and Human Services (HHS). His selection and eventual confirmation as HHS secretary was controversial, especially among the public health community. In addition to not having a public health background, RFK Jr. has a history of promoting anti-vaccine sentiments and founded Children’s Health Defense, a nonprofit organization that pushes anti-vaccine messaging (Ostberg, 2025; Lawrence & Broderick, 2024). Recently, he has toned down his anti-vaccine messaging and now claims that there should be more studies over vaccine effectiveness, despite the existence of a rigorous approval process and a long history of research into the efficacy and safety of vaccines (Lawrence & Broderick, 2024). Yet, he continues to emphasize the importance of individual

choice in vaccination (Kennedy, 2025). According to experts, this negative and false messaging around vaccines may be one of the most significant ways this administration could impact vaccination (Lawrence & Broderick, 2024).

While RFK Jr. has stated he will not ban vaccines, as HHS secretary, he may influence the approval process for vaccines, insert anti-vaccination activists in committees, and propel misinformation and disinformation (Lawrence & Broderick, 2024). Reflecting his views on vaccines, RFK Jr. recently wrote an opinion piece for FOX News regarding the current measles outbreak (Kennedy, 2025). In this piece, he acknowledged the importance of herd immunity (Kennedy, 2025). He also encouraged parents to “understand their options to get the MMR vaccines” and claimed “the decision to vaccinate is a personal one” (Kennedy, 2025). Furthermore, RFK Jr. promoted the use of Vitamin A in response to the measles outbreak (Kennedy, 2025):

“It is also our responsibility to provide up-to-date guidance on available therapeutic medications. While there is no approved antiviral for those who may be infected, CDC has recently updated their recommendation supporting administration of Vitamin A under the supervision of a physician for those

with mild, moderate, and severe infection. Studies have found that Vitamin A can dramatically reduce measles mortality.”

“Tens of thousands died with, or of, measles annually in 19th Century America. By 1960 -- before the vaccine’s introduction -- improvements in sanitation and nutrition had eliminated 98% of measles deaths. Good nutrition remains a best defense against most chronic and infectious illnesses. Vitamins A, C, and D, and foods rich in vitamins B12, C, and E should be part of a balanced diet.”

RFK Jr.’s promotion of Vitamin A is misleading. Previous studies have shown that taking Vitamin A supplements may lower measles mortality rates among undernourished and Vitamin A deficient communities (Public Health On Call, 2025). However, the possible benefits of Vitamin A are highest in and most applicable to these specific undernourished and Vitamin A deficient populations - not

the general U.S. population (Public Health On Call, 2025). Additionally, Vitamin A supplements do not prevent measles, as the vaccine is the most effective tool in prevention (Public Health On Call, 2025). As too much Vitamin A is also toxic, this treatment is not the silver bullet RFK Jr. is making it out to be and should be treated with caution (Public Health On Call, 2025). Highlighting the severity of this false claim, several children in West Texas have already been hospitalized for vitamin A toxicity after attempting to treat measles (Martin, 2025).

In addition to the misleading promotion of Vitamin A, during a February cabinet meeting, RFK Jr. said measles outbreaks are “not unusual,” which is false (Mukherjee, 2025). Typically, measles outbreaks involve some people, not hundreds of people as we have seen in Texas, New Mexico, and now Oklahoma (Mukherjee, 2025). No one had died from the Measles in the U.S. in the 10 years

prior to the first death recorded in Texas this year (Mukherjee, 2025). Normalizing and downplaying outbreaks of vaccine preventable diseases, as RFK Jr. continues to do, can have negative consequences for vaccine uptake and future disease outbreaks.

RFK Jr.’s confirmation as HHS secretary is an effect of the foothold anti-vaccine proponents have gained in American vaccination discourse in the past decade. Anti-vaccine sentiments have continued to ripple across the country (Jones, 2024). According to a 2024 Gallup Poll, 40% of Americans agreed with the statement that “it is extremely important for parents to have their children vaccinated” (Jones, 2024). This percentage has decreased from 58% in 2019 and 64% in 2001 (Jones, 2024). Gallup also reported that “there has been a similar decline in the combined “extremely” and “very important” percentage, which was 94% in 2001 but sits at 69% today” (Jones, 2024).

Pictured: Scott Rivkees

Source: Brown School of Public Health https://sph.brown.edu/news/2022-11-30/stat

Robert F. Kennedy Jr. & The Texas Measles Outbreak (cont’d)

These beliefs have led to an increase in vaccine exemptions. As per the CDC, the exemption rate for the 2023-2024 school year increased from 3.0% in 20222023 to 3.3% and increased in 41 jurisdictions. 14 jurisdictions saw exemption rates higher than 5% (Centers for Disease Control and Prevention, 2024). As mentioned previously, 95% of the population must be vaccinated against measles in order for herd immunity to take effect. Therefore, exemption rates above 5% are concerning and increase the risk of an outbreak. This has already been seen. Last year, there was an outbreak of measles in Broward County at the Manatee Bay Elementary School in Florida (Huang, 2024).

8% of kindergarten students in Broward county were not vaccinated for measles, which is under the 95% threshold (Huang, 2024). Dr. Joseph Ladapo, the Florida Surgeon General at the time of the outbreak, did not advise parents to vaccinate or quarantine their children (Huang, 2024). Similar to RFK Jr. ‘s messaging, Ladapo sent out a letter that said it was the parents’ decision to send their children to school, once again emphasizing freedom of choice over public safety (Huang, 2024; Odzer, 2024).

professor of the Practice of Health Services, Policy and Practice at the Brown University School of Public Health, commented on the causes of this increase in anti-vaccine sentiment. He said RFK Jr. is “in part responsible for this outbreak and other outbreaks. He’s played a leading role in the anti-vaccine movement and there’s a certain base that follows him… he certainly is complicit in this outbreak.” Dr. Rivkees has already written two opinion pieces for the Hill over this topic as well (Rivkees & Benjamin, 2025; Rivkees, 2024).

When asked about the implications of RFK Jr.’s role, Dr. Rivkees

no question that culture wars started before the pandemic. Culture wars, attacks of vaccines, attacks on the scientific expert, attacks on education, and attacks on what individuals can read, and unfortunately this has become a rally and cry in terms of personal freedom. What we are seeing now is a reflection of what we’re seeing in society.” Poignantly, he added, “...Frankly I find that very sad that political affiliation is really driving a lot of these decisions rather than science and medicine.”

“‘...Frankly I find that very sad that political affiliation is really driving a lot of these decisions rather than science and medicine.’”

Dr. Scott Rivkees, the former Florida State Surgeon General and

replied, “I think we are going to see a rollback of respect for six decades of research into vaccine effectiveness, you’re going to hear people increasingly not following mainstream medicine and recommendations but rather these fringe unsubstantiated recommendations, whether it’s related to measles vaccine, drug safety, lifestyle changes, so the things that he is saying are not grounded in science.” He also notes that RFK Jr.’s confirmation has been in the making for years. “This is something that has exploded, really, over the past 3 to 4 years,” said Dr. Rivkees. “There’s

Dr. Rivkees also commented on what needs to happen moving forward. “We have to address the incredible polarization and split that we have in society,” he said. “It’s gonna take individuals on both sides of the aisle to show some responsibility and caring for the public, to come together, and say ‘listen, these are the kinds of things that we all can believe in.’”

Dr. Rivkees warned, “As long as we have somebody in the White House threatening to remove all school funding for areas that recommend COVID vaccines, as long as we have somebody in charge of HHS who is part of the anti-vaccine movement and is advocating fringe treatments, like Vitamin A, this is going to continue.”

Edited By: Ruviha Homma

Source: Adobe Stock https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_ vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcontent_type%3A3d%5D=1&filters%5Bfetch_excluded_assets%5D=1&filters%5Binclude_stock_enterprise%5D=1&filters%5Bcontent_type%3Aimage%5D=1&k=robert+f+kennedy+jr&order=relevance&limit=100&search_page=1&search_ type=usertyped&acp=&aco=robert+f+kennedy+jr&get_facets=0&asset_id=611005637

Pictured: Robert F. Kennedy Jr.

The Politics of Infectious Disease

Border Barriers: A Longitudinal Review of Health and Immigration Policy

Written By: Rishi Rai

From barring immigrants believed to be “undesirable” due to their health status to labeling illegal migrants as public health risks, the United States has always made health the utmost priority when handing out green cards to hopeful immigrants. Trump’s return to the Oval Office has made the intersection between health and policy, especially immigrant policy, greater than ever before, and to understand his stance on immigrant health, we must go back to the beginning: early America.

Early Immigration Health Screening

During the colonial era, states were responsible for regulating immigration; however, as the number of immigrants looking for new opportunities increased and citizens started to fear foreign diseases making

their way into the country, the federal government took control. For example, in the late 19th century, Ellis Island became the main federal immigration station for the US (Bateman-House & Fairchild, 2008). The federal government also established the Public Health Service (PHS) to inspect and even diagnose immigrants for health conditions and diseases in order to safeguard national health: for example, by prohibiting entry to the country for individuals with infectious diseases like tuberculosis (lung bacterial infection), trachoma (eye bacterial infection), and favus (scalp infection). Although the PHS’s mission was mainly to prevent infection from entering the US, PHS officers took it upon themselves to prevent “undesirable people” from passing through the border: particularly those who wouldn’t supply much manpower and would need more healthcare. The PHS also viewed non-infectious conditions such as insanity and epilepsy as health issues meriting expulsion from the US (Bateman-House & Fairchild, 2008).

In order to gauge whether prospective

immigrants were fit to become U.S. citizens, the PHS used an examination method called the “line,” a process in which immigrants would line up and be individually examined, similar to quality assurance in a production line. Unfortunately, medicine was still quite primitive, so physicians relied on observing physical characteristics and behaviors, a process similar to profiling. The elderly were frequently sent for further examination while the young and fit were quickly approved. If the immigrant was sent for further examination, they would be examined with stethoscopes, thermometers, and mental tests. If they passed these tests, they would receive a medical certificate or OK card, allowing them to enter (Bateman-House & Fairchild, 2008).

Understandably, immigrants feared the PHS’s process, causing many attempts to conceal deformities and diseases. However, while this process seems cruel, fewer than 1% of immigrants were turned away from the US for medical reasons, probably due to the US’s need for cheap labor (Bateman-House & Fairchild, 2008).

The

Great

Source: Adobe Stock https://stock.adobe.com/Library/urn:aaid:sc:VA6C2:478d6f68-58b5-4e06-b041-213a16f138c6?asset_id=144869954

Depression

and the 1930s

The Great Depression was undoubtedly one of America’s lowest moments. This period was marked by large shifts in immigration policies and access to healthcare, primarily for immigrants of Mexican descent.

The US implemented a series of repatriation drives, which were informal raids that resulted in around 1 million people being deported to Mexico, with 60% of these individuals being American citizens born in the US (Little, 2025). President Hoover believed that these Mexican immigrants were taking jobs that white Americans were entitled to instead.

conditions because they were seen as a high public resource burden during a time of economic hardships.

Similarly, in 1935, FDR established New Deal programs like the Social Security Act. These programs initially excluded agricultural and domestic workers, which were occupations heavily populated by immigrants (“Social Security Act,” 2025). Exclud-

Researchers have found that these changes, while not directly affecting immigrants, have led to 24% of immigrants (rising from 8% before) avoiding applying to health assistance programs in fear of being deported as a public charge.

in dire need of labor after millions of young men enlisted. The federal government established the Bracero Program to allow Mexicans to migrate to the US and provide cheap labor in the form of building railroads and cultivating agriculture to feed Americans, including soldiers abroad. The program was designed to be a managed temporary migration—only allowing Mexicans to live in the U.S. for the duration of the war—and although it was economically beneficial for the U.S., Mexicans continued to face discrimination while residing in and working for the country.

In addition to repatriation drives, President Hoover implemented a public charge rule: an extension of earlier immigration practices that restricted immigrants who were seen as likely to rely on the government for support (Gelatt, 2024). This specifically affected immigrants with health

ing immigrants from these benefits prevented them from accessing proper healthcare, worsening the wage gap as their health conditions rendered manual labor nearly impossible to complete.

World War II and Post-War Health Reforms

During World War II, the US was

Health policies continued to view Mexican immigrants as health threats, and Mexicans were required to get health screenings in both Mexico and the U.S. In the U.S, they were required to have a physical exam, get X-rays for tuberculosis testing, and psychological testing. Some were denied for having fresh scars as investigators deemed them unfit for strenuous manual labor. Some Mexicans also reported feeling humiliated and harassed during the medical procedures as they were told to strip down to their underwear and

The Politics of Infectious Disease

Border Barriers (cont’d)

poked and prodded, and since Spanish-speaking accommodations were not established, they were unable to understand what the English-speaking PHS officers were instructing them to do (Molina, 2011).

At the same time, employers did not provide safe working and living conditions for braceros, contributing to the healthcare problem. Some accounts recall being served spoiled meat, lacking access to camp doctors, and being paid below full wage, preventing braceros from seeking alternative, higher quality healthcare (Molina, 2011).

Combined with the stigma associated with being an immigrant possibly bringing disease into the country, these issues were a clear sign that the U.S. prioritized native-born citizens’ health over all others, even those who sought to live in and serve the country despite harsh discrimination..

Late 20th Century and Early 21st Century

In 1965, President Lyndon B. Johnson signed the Social Security Amendments, introducing Medicare and Medicaid for low-income individuals. Neither program had any specific clauses restricting immigrants from receiving benefits (Centers for Medicare & Medicaid Services, 2024).

to the equal protection of the laws of the State in which they reside” (The New Equal Protection, 2025).

The 1990s, however, marked a shift in healthcare benefits, especially for illegal immigrants. Most significantly, President Clinton signed The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, which restricted the welfare system and required public agencies to verify immigration status before providing benefits (US Citizenship and Immigration Services, 2025). It also directly denied Medicaid benefits to immigrants entering the US after August 1996 and increased requirements for immigrant entry to the Temporary Aid to Needy Families (TANF) program. One study

immigration status (Heyison & Gonzales, 2023).

The Current Trump Administration

President Trump began his second term earlier this year, and he has already made quite a few changes to immigrant access to healthcare benefits. In only a couple months, he has issued executive orders reversing many of the decisions Biden made during his presidency, paving the way for his proposal to “Make America Healthy Again.”

“Some Mexicans also reported feeling humiliated and harassed during the medical procedures as they were told to strip down to their underwear and poked and prodded.”

discovered that such “welfare reform is associated with a 150% increase in the proportion of uninsured among this group [immigrant children]” (Kaestner, 2003).

Trump plans to reinstate the Title 42 policy he created in 2020 to rapidly deport migrants without allowing them to seek asylum. In the reinstated policy, the Public Health Service Act will be used to label undocumented immigrants attempting to enter the country as public health risks and tuberculosis vectors, similar to early American ideas about infectious diseases and immigrants (Montoya-Galvez, 2025).

The 1970s and 1980s was a period of conservatism, bringing with it a wave of anti-immigrant activists who wanted to increase the distinction between citizens and non-citizens by limiting non-citizen access to public services, including healthcare (Coleman, n.d.). Despite conservative efforts, liberal activists successfully pushed back by calling attention to the 14th amendment Equal Protection Clause, which granted both “lawfully admitted resident aliens as well as citizens of the United States…

In 2010, however, conditions began to change: President Barack Obama signed the Affordable Care Act (ACA), increasing immigrant access to healthcare. Lawful immigrants could purchase affordable health insurance through the marketplaces created by the ACA and qualify for savings depending on their income (HealthCare, n.d.). Undocumented immigrants, on the other hand, were excluded from all federal benefits (including ACA), but fortunately, some states began offering benefits to all residents regardless of

Furthermore, in 2020, Trump attempted to end the Deferred Action for Childhood Arrivals (DACA) program but was blocked by the Supreme Court due to violating the Administrative Procedure Act. In November 2024, the Biden administration published a policy to extend the Affordable Care Act to DACA individuals, but in December of that year, a North Dakota judge appointed by Trump blocked its enforcement in court. As a result, DACA individuals in 19 states are currently unable to receive ACA benefits, and the Trump administration is unlikely to reinstate these benefits given their

Source: Adobe Stock https://stock.adobe.com/search/images?load_type=search&is_recent_ search=&search_type=autosuggest&k=illegal+immigration&native_visual_search=&similar_content_ id=&acp=0&aco=illegal+immigration

conservative views (Baron, 2025).

Trump may also reinstate the public charge policy he made in 2019 during his first term. Previously, he increased the number of programs considered under the policy, including Medicaid and the Children’s Health Insurance Program. Researchers have found that these changes, while not directly affecting immigrants, have led to 24% of immigrants (rising from 8% before) avoiding applying to health assistance programs in fear of being deported as a public charge (Pillai & Published, 2024).

The intersection of health and immigration policy in the United States has evolved significantly over time, reflecting broader social and political shifts. From early health screening at Ellis Island to modern debates about DACA access to the Affordable Care Act and public charge policy changes, the nation has always attempted to balance public health concerns with economical and political issues. While

America continues to evolve and administrations come and go, the debate over immigrant healthcare will always remain a complex issue influenced by historical data, social views, and public health considerations.

Edited By: Pranav Kota

References:

What is “Biological Truth”?

Written By: Margaret Wang

In January, President Trump signed a slew of far-reaching executive orders, including one titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”

The order asserts that binary sex is a “biological reality,” characterizing the category of “woman” as “true and biological” (The White House, 2025). This conflation of biological truth is elevated further— the order proclaims that “basing Federal policy on truth is critical to scientific inquiry, public safety, morale, and trust in government itself.”

The Trump administration recognizes two sexes, males who produce the small gamete and females who produce the large gamete at conception. However, this representation of the “reality” of sex is highly disingenuous. Gamete production doesn’t occur at conception, as the reproductive system develops only about 6 weeks into pregnancy (Hesman Saey, 2025). Not everyone even produces gametes; for example, men with Klinefelter syndrome, a sex-linked condition resulting in XXY chromosomes, don’t produce sperm. And gamete size is only one among many sex-related variables that aren’t dichotomous— almost 2% of the population may have sex chromosomes that are not consistent with markers such as hormone levels and reproductive anatomy.

This isn’t the first time the government has flattened sex into a meaningless binary. Designed to address the lack of women’s representation in medical research, the NIH’s 2015 Sex as a Biological Variable policy mandated that researchers study “both sexes” by incorporating female research subjects in addition to males (NIH, 2015). Yet “male” and “female” are themselves not useful categories; without identifying specific sex-related factors pertinent to the research question, sex differences can be misrepresented. For instance, using the category “women” instead of the more specific “cervical presence” significantly underestimated cervical cancer prevalence by including women with hysterectomies in the data, which also obscured racial disparities in mortality (Beavis et al, 2017).

somes (Gay et al, 2021). Hormone levels play a separate role— tuberculosis mortality rate is much lower for women who have had ovariectomies (0.7% vs. 7%), and a similar effect presents for castrated men. Socially gendered factors cannot be ignored either; women’s higher risk of developing COVID-19 infection may be linked to their representation in 70% of essential healthcare roles (Lawry et al, 2023). Each of these findings contribute to an understanding of health not by asserting binary sexual dimorphism, but by critically investigating differences among individuals without using sex as a catch-all.

“The Trump administration recognizes two sexes, males who produce the small gamete and females who produce the large gamete at conception. However, this representation of the ‘reality’ of sex is highly disingenuous.”

Sex-related differences play a role in a number of health conditions, but it’s important to study them under a contextual framework rather than accept a priori binary differences. For example, it’s not enough to say that being male is a risk factor for infectious diseases when mechanisms of difference can differ greatly. Pathogen recognition is completed by Toll-like receptors (TLRs), and TLR7, the molecule that detects viral RNA, is encoded on the X chromosome. This leads to higher expression in those with XX chromo-

The administration’s order has detrimental effects in both clinical practice and research. In response to the January 31 deadline to erase “gender ideology” from federal websites, the CDC removed recommendations for clinicians treating sexually transmitted infections and administering vaccines to trans and nonbinary people (Tin, 2025). Contrary to the order’s ostensible purpose, removal of such data is an active effort to impede truth and erodes clinicians’ ability to serve patients. Researchers also fear the halting of grants for valuable studies on LGBTQ+ health. The NIH currently funds about $1 billion worth of projects whose abstracts mention “gender”, and about half focuses on HIV/AIDS (Wadman & Jacobs, 2025). The most impacted institutes are those studying infectious diseases, mental health, and substance abuse, for which LGBTQ+ people are at higher risk. This lack of information involving sexual/gender minority individuals contributes to

Source: Adobe Stock https://stock.adobe.com/search/images?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_vector%5D=1&

negative health outcomes. But it’s not just LGBTQ+ individuals who are affected— the CDC took down its Youth Risk Behavior Surveillance System, the nation’s largest database of students’ health information and a crucial adolescent health resource. The removal of tools like AtlasPlus, which tracks HIV and STI cases across the country, has also explicitly been called “dangerous” by practitioners from the Infectious Disease Society of America (Stone, 2025).

It is critical to “base federal policy in truth,” yet the current administration seems too willing to ignore data and shroud understanding of sex behind the generalized cloud of “male/ female.” Far from offering “clear and accurate language and policies” aimed for the promotion of health nationwide, vague biological concepts are instead weaponized by the Trump administration in service of ideology.

Edited By: Jason Hwang

References:

Beavis, A. L., Gravitt, P. E., & Rositch, A. F. (2017). Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Cancer, 123(6), 1044–1050. https://doi.org/10.1002/ cncr.30507

Consideration of Sex as a Biological Variable in NIH-funded Research. (2015, June 9). National Institutes of Health (NIH). https://orwh.od.nih.gov/sites/ orwh/files/docs/NOT-OD-15-102_Guidance_508.pdf

Gay, L., Melenotte, C., Lakbar, I., Mezouar, S., Devaux, C., Raoult, D., Bendiane, M.-K., Leone, M., & Mège, J.L. (2021). Sexual Dimorphism and Gender in Infectious Diseases. Frontiers in Immunology, 12. https://doi. org/10.3389/fimmu.2021.698121

Hesman Saey, T. (2025, February 20). Biological sex is not as simple as male or female. Science News. https://www.sciencenews.org/article/biological-sex-male-female-intersex

Lawry, L. L., Lugo-Robles, R., & McIver, V. (2023). Overlooked sex and gender aspects of emerging infectious disease outbreaks: Lessons learned from COVID-19 to move towards health equity in pandemic response. Frontiers in Global Women’s Health, 4. https://doi.org/10.3389/fgwh.2023.1141064

Stone, W. (2025, January 31). Trump administration purges websites across federal health agencies. NPR. https://www.npr.org/sections/shots-healthnews/2025/01/31/nx-s1-5282274/trump-administration-purges-health-websites

The White House. (2025, January 20). Defending women from gender ideology extremism and restoring biological truth to the federal government. The White House. https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/

Tin, A. (2025, February). CDC purges STD and vaccine recommendations after Trump gender order. Cbsnews. com; CBS News. https://www.cbsnews.com/news/ cdc-std-vaccine-gender-trump/ Wadman, M., & Jacobs, P. (2025). Trump’s ban on funds to “promote gender ideology” could threaten hundreds of NIH research projects. AAAS Articles DO Group. https://doi.org/10.1126/science.zh6g9gm

Urban Governance and Infectious Disease Management in the City

Written By: Emily Mrakovcic

Infectious disease prevalence and mitigation differ widely across geographic locations and local cultures, politics, and societal norms. For example, the same disease may manifest differently in a small rural village compared to a large urban area, potentially resulting in the same public health intervention succeeding in one setting while failing in the other. Various diverse factors–social determinants of health, public policy, and public health interventions–all influence which diseases are most prevalent in a community, which populations may be most at risk, and whether the diseases are managed effectively. Especially in cities, where certain infectious diseases pose higher risks due to dense populations, harmful environmental exposures, and zoonotic spillover events, urban governance is crucial in establishing best practices for context-specific infectious disease control.

Social determinants of health, including education, healthcare quality, neighborhood and built environment, social and community context, and economic stability (Centers for Disease Control and Prevention), determine approximately 60% of one’s health (Hill-Briggs et al., 2020). Melody Goodman, assistant professor at Washington University in St. Louis, once stated, “Your zip code is a better predictor of your health than your genetic code” (Harvard T.H. Chan School of Public Health, 2014), underscoring the importance of urban governance in curating public spaces

Source: Adobe Stock https://stock.adobe.com/search/images?k=politics+and+infectious+disease&search_type=usertyped&asset_id=331075265

that contribute positively to all aspects of life. Kashem et al. (2021) explored the nexus between social vulnerability, built environment, and COVID-19 in Chicago, Illinois in 2020, finding that zip codes with low educational attainment rates consistently experienced higher case rates. This study suggests a relationship between social vulnerability and COVID-19 prevalence, highlighting the need to address socioeconomic barriers as a crucial component of infectious disease mitigation.

Public policy in the urban governance arena plays an instrumental role in shaping the social determinants of health that subsequently influence disease prevalence in communities. Advocacy for ecologically diverse urban green spaces, for example, may attract non-disease carrying animals to the

area, such as birds or small mammals, that distract disease-carrying animals from infecting humans (Fournet et al., 2024). Additionally, Keil & Ali (2007) investigated SARS in Toronto, Canada in 2003, finding that city leaders primarily viewed the outbreak as an economic crisis, rather than a health one, resulting in interventions failing to address critical challenges. As the world becomes increasingly globalized, Keil & Ali urge urban policymakers to frame cities as places of health and prioritize infectious disease management and global health in urban governance.

Urban interventions bridge the gap between public health academia and the provision of vital community resources. Modern public health originally arose in response to epidemics occurring during the onset

of the Industrial Revolution. Mass migration to cities, poor living conditions, overcrowding, poorly ventilated housing, contaminated drinking water, and mismanaged sewage disposal enabled the spread of infectious diseases in urban areas (Moloughney, 2016). What truly mobilized public health interventions, however, were the disproportionate morbidity and mortality rates faced by the cities’ poorest strata (Susser & Stein, 2009). Advocacy for intervention in urban

As the world continues to globalize in ways previously unimaginable, it is crucial now more than ever to not only strengthen the ability of urban spaces to withstand infectious disease risks, but also to promote healthy and sustainable practices. With 55% of the world’s population (4.2 billion people) living in urban areas as of 2018 (United Nations Department of Economic and Social Affairs, 2018), infectious disease mitigation in cities is without a doubt worth the investment. Fur-

“What truly mobilized public health interventions, however, were the disproportionate morbidity and mortality rates faced by the cities’ poorest strata”

spaces not only ensures controlled disease transmission, but that cities are equitable spaces to build livelihoods and communities.

Following President Donald Trump’s executive orders to cut funding to various government agencies, infectious disease mitigation efforts in communities across the country have either been weakened or terminated. The New York Times reported on March 26, 2025 that over $12 billion in federal grants to states for infectious disease tracking and other urgent health issues had been cancelled (Mandavilli, Sanger-Katz, & Hoffman). With resurgent syphilis infections and emergent bird flu threats, now is an especially unfortunate time for multiple state health departments to have to lay off dozens of epidemiologists and data scientists. Furthermore, CBS News reported that wastewater surveillance, community health jobs, immunizations and vaccines for children, and health disparities efforts–all historically vital public health interventions–have been weakened or terminated due to funding cuts.

ther illustrating this point, financing infectious disease preparedness in the U.S. would cost approximately $4.5 billion per year, while the cost of dealing with a pandemic is approximately $570 billion per year (Lee et al., 2020). Healthier cities generate higher levels of success for all sectors of society, underscoring the interconnectivity of all urban elements and the non-negotiable standard for healthy living that all cities should be held to.

Edited By: Marymar Vacio Lazalde

References:

The Crisis of Post-COVID Nursing Home Staffing: Medicare Providers Targeted under Trump’s Proposed Cuts

Written By: Rachel Xu

Since taking office in late January, President Trump has unleashed massive cuts to federal agencies in line with his campaign rhetoric and public calls for systematic deregulation. Most recently, the Department of Health and Human Services (HHS) fired around 5,200 probationary employees in compliance with these orders; this not only included researchers, scientists, and providers in the CDC and NIH, but also those who oversaw the implementation and day-to-day operations of Medicare and Medicaid programs nationwide. Among seniors who rely on one or both of these subsidized insurance plans, Trump’s rapidfire directives to slash funding and employment in long-term care (LTC) settings carry worrisome implications for the stability of the direct care workforce and hospice systems charged with looking after elderly residents.

the pandemic, coronavirus infection, transmission, and mortality devastated facilities. In 2020 alone, 2 in 5 Medicare beneficiaries in nursing homes were diagnosed with COVID-19, and over 1,000 nursing homes experienced infection rates of at least 75 percent (Grimm, 2024). As a result, overall mortality increased to 22 percent, with at least 172,000 resident deaths in total (Grimm, 2024; Rau, 2024).

Considering these ongoing and debilitating challenges, it’s no wonder that administrators cite significant workforce attrition and difficulties in hiring and training as grave risks to ensuring

“In the wake of these large-scale funding freezes and communication disruptions, the White House’s unfettered rampage to cut corners and prioritize savings threatens the ability of nursing home providers to maximize resident wellness and comprehensively address their diverse psychosomatic needs.”

Consumer Voice for Quality LongTerm Care, have already decried the overwhelming harm of rolling back this reform in terms of reducing standardized metrics for adequate staffing (Rau, 2024). Likewise, the Moving Forward Nursing Home Quality Coalition recently published an appeal entreating the administration to clarify its plans for tangibly enacting an actionable strategy for “a more humane, cost-effective, and comprehensive LTC system” (Johnson, 2025). Similarly, the Medicare Rights Center is also citing “staff shortages, office closures, and service backlogs” under the new administration as clear impediments to streamlining coverage for Medicare-eligible citizens and existing beneficiaries (Carter, 2025).

COVID-19 represented a fundamental paradigm shift in reshaping the occupational landscape of inhome hospice care, assisted living, and nursing homes. At the start of

quality of care for residents. Last April, the Biden administration set minimum standards for facility staffing; a move estimated to save 13,000 lives annually when implemented in 2027 for urban nursing facilities and in 2029 for rural facilities that don’t qualify for exemptions (Coe & Warner 2025; Hellmann, 2024). Under Trump, however, these guidelines are being rolled back and weakened drastically as part of his “patients over paperwork” crusade.

Nonprofits and patient advocacy organizations, like the The National

Moreover, according to Drishti Pillai, director of immigrant health policy at KFF, the outsize role that foreign-educated nurses play in delivering crucial medical services to at-risk and marginalized communities has doubled in the last decade through official tracks like the J-1 visa exchange program (Johnson, 2025a). The Trump administration’s sweeping and aggressive immigration enforcement raids – particularly those targeting hospitals and healthcare settings – could thus significantly worsen the present shortage of over 78,000 registered nurses across the country (Biron, 2025).

Likewise, his push to fast-track Medicare privatization by incentivizing Medicare Advantage aligns with his increased attempts to reverse minimum staffing regulations. Republican state attorneys and nursing home interest groups have seized these opportunities to advance the for-profit care industry, in spite of evidence that the hundreds of millions in profits channeled to company executives and shareholders could easily be redirected to compensate nursing home labor shortages. Indeed, it was actually through the expansion of Medicare coverage in early 2020 that promising mechanisms like telemedicine were able to be successfully introduced and utilized by skilled nursing facility practitioners to increase care accessibility while avoiding contagion spread (Ulyte et al., 2023). Instead, current fund diversions from Medicaid and other entitlement programs will likely undercut provisions for vital medical infrastructure and service technology, in addition to depleting salaries and benefits for nurse aides, CNAs, and caregivers (Johnson, 2025).

In the wake of these large-scale funding freezes and communication disruptions, the White House’s unfettered rampage to cut corners and prioritize savings threatens the ability of nursing home providers to maximize resident wellness and comprehensively address their diverse psychosomatic needs. By exacerbating the existing trend of worker shortages and under-retention, advocates predict growing disparities in substandard, inadequate “life enrichment” and nutritional services for underserved areas, weakening the foundations of long-term and post-acute care for a majority of elderly Americans (Coe & Warner 2025). Considering these conditions, the best course of action necessitates renewed stakeholder engagement, federal oversight, and increased rather than limited investment in health equity. It is yet to be seen if sufficient constituent pressure can realize these goals.

Edited By: Marymar Vacio Lazalde

Source: Adobe Stock https://stock.adobe.com/Library/urn:aaid:sc:VA6C2:478d6f68-58b54e06-b041-213a16f138c6?asset_id=207860016

Biron, C. L. (2025, January 23). Trump deportation pledges raise concerns over U.S. health system. Context. https://www.context.news/ socioeconomic-inclusion/trump-deportationpledges-raise-concerns-over-us-health-system

Carter, J. (2025, March 13). Trump Administration and Elon Musk’s DOGE Closing Social Security Offices, Harming Access to Services. Medicare Rights Center. https://www.medicarerights.org/ medicare-watch/2025/03/13/trump-administration-and-elon-musks-doge-closing-social-security-offices-harming-access-to-services

Coe, N. B., & Warner, R. M. (2025, February 7). Your Parents Deserve More From Their Nursing Home. The New York Times. https://www.nytimes.com/2025/02/07/opinion/nursing-homecare-parents.html

Grimm, C. A. (2024, February). Lessons Learned During the Pandemic Can Help Improve Care in Nursing Homes. HHS Office of Inspector General. https://oig.hhs.gov/documents/evaluation/9808/OEI-02-20-00492.pdf

Hellmann, J. (2024, December 4). Nursing home staffing rule in limbo as Trump 2.0 approaches. Roll Call. https://rollcall.com/2024/12/04/nursing-homestaffing-rule-in-limbo-as-trump-2-0-approaches/

Johnson, Z. (2025a, January 28). LTC providers ‘drinking from the firehose’ as Trump signs dozens of executive orders. McKnight’s Long-Term Care News. https://www.mcknights.com/news/ltc-providersdrinking-from-the-firehose-as-trump-signs-dozensof-executive-orders/

Johnson, Z. (2025, February 27). Coalition urges Trump administration to take stance on nursing home care. McKnight’s Long-Term Care News. https://www. mcknights.com/news/coalition-urges-trump-administration-to-take-stance-on-nursing-home-care/

Rau, J. (2024, November 29). Nursing Home Industry Wants Trump to Rescind Staffing Mandate. The New York Times. https://www.nytimes.com/2024/11/29/ health/trump-nursing-homes-staff-mandates.html

Ulyte, A., Mehrotra, A., Wilcock, A.D., SteelFisher, G.K., Grabowski, D.C., Barnett, M.L. (2023). Telemedicine Visits in US Skilled Nursing Facilities. JAMA Netw Open, 6(8):e2329895. doi:10.1001/jamanetworkopen.2023.29895