The global health community needs to wake up and fight back against the Trump administration.

As with previous years, 2026 began with a flourish of pyrotechnics. But in a deviation from the norm, this year those pyrotechnics were less fireworksy and more coupsy in nature. Obviously, I’m talking about the US invasion of Denmark and the arrest and imprisonment of its Prime Minister Mette Frederiksen [Ed. that’s not planned until 2027. I think you mean the President of Venezuela Nicolas Maduro]. On the one hand, who doesn’t like it when the villain gets what’s coming to them? On the other hand, Trump taking out a villain reminds me of that disturbing painting by Goya, ‘Saturn Devouring His Son’. If one were looking for an image that captures Trump’s approach to – well – everything, this works for me: a grotesque and crazed individual prepared to do anything to maintain power. It is no exaggeration to say that Trump and his enablers are the biggest threat to global health we are likely to experience in our lifetimes, and we should resist them.

“Hang on, Andrew, who is this we you’re talking about? Check your pronouns, young sir! We don’t agree. Breathe for a second and consider Trump’s accomplishments in 2025:

• His political support for Israel in 2025, and facilitating its ongoing genocide of Palestinians in Gaza economically through $39bn in active foreign military sales
• His decision to bomb Iran and Nigeria just because he can.
• His withdrawal from the World Health Organisation and the United Nations Education, Scientific and Cultural Organisation
• His withdrawal from the principal legal instrument for halting global warming, the Paris Agreement treaty
• His public humiliation of heads of state such as Ukraine’s Volodymyr Zelenskyy.
• His public humiliation of women and people of colour.
• His disregard for international law by bombing vessels off the coast of another country and then, for good measure, invading that country and kidnapping its President.
• His disregard for international law in claiming that he ‘needs’ the territory of other countries (Denmark/Greenland, Colombia, Cuba, Canada, etc.)
• His constant undermining of other countries’ and regions’ political systems, now written into US policy.
• His reduction or complete suspension of funding for the vaccine alliance GAVI, the President’s Emergency Fund for AIDS Relief, The Global Fund to fight AIDS, TB and Malaria, the President’s Malaria Initiative, and many others.
• His dismantling of his country’s primary vehicle for distributing international aid, USAID.
• His chronic display of total ignorance and hatred for institutions of learning.

“Surely, surely, we can agree that these are all opportunities for global health, aren’t they? Killing people is good for the economy, invading other countries shows Johnny Foreigner who’s boss, the United Nations system is diseased with wokery, women and black people are annoying and should learn their place, natural resources are there to be taken if we want them, and international laws or norms that seek to prevent us from doing that should be weakened, broken or just disregarded, and replaced with systems designed by us and for us. Global health needs to work for Trump – nobody else, just him – and why the heck shouldn’t it? He’s deserved it. The only thing that will make global health more global and more healthy in the big 2026 will be if Trump finally – finally – gets that peace prize he….so….richly… deserves”.

Sorry, just back from the shops. Did I miss anything? I put ChatGPT on auto while I was out. Let’s see what it’s writt…oh, right [slowly disconnects power cord].

Look, I know that there are some of you out there who are so desperate to see something positive in all this wreckage that you just…can’t…help…yourselves with your ‘2026 should offer opportunities’ horseshit analysis. But, please, if you do find yourself reaching for the keyboard in the dead of late afternoon; maybe it’s after your nap and the effects of the pre-dinner aperitif are starting to kick in; maybe you’re thinking, ‘you know what, I reckon the world needs a pick me up and – by heavens – I’m just the person to do it’, don’t! Don’t, because you might end up writing something as awful as this:

My second criterion is neutrality on Israel. When I was at WHO, I saw the double standard treatment of Israel — in having one resolution reporting on “health conditions in the occupied Palestinian territory” and one for every other health emergency in the world. At the time, I saw this as a nuisance, because I did not understand how it signalled a deeper inclination. After October 7, 2023, I feel differently. By focussing more on attacks against health facilities (by Israel) rather than the root cause of these attacks (militarization of those facilities by Hamas) WHO has likely contributed, even unintentionally, to anti-Israel and anti-Jewish sentiment. It’s also been better than many other UN organs. However, neutrality is a key UN value, and it’s time to take it more seriously.

I had a dim view of Peter Singer when he had the ear of the WHO DG, whispering ‘special advisory’ nonsense like some modern day Wormtongue. But now, reading his post, I just think he’s a menace. I have no time whatsoever for this ‘double standards’ and ‘every other health emergency’ analysis. Such a nuisance! But neutrality on Israel? How dare he call for that! The accusation that the WHO has “likely contributed, even unintentionally, to anti-Israel and anti-Jewish sentiment” is dangerous conjecture (he provides zero evidence) and mischief-making of the most odious kind. Singer knows full well why there is a resolution on the Palestinian territory, and that the Secretariat prepares it because Member States request it, year on year because the occupation continues year on year, but is now escalating in its awfulness to such a despicable level of cruelty that it staggers and threatens to topple one’s basic grasp of humanity. Obviously, reporting on the health situation in Gaza is not being anti-semitic. And what has happened in Gaza is not just ‘some other health emergency’; it is a genocide. A genocide! If that’s not something that’s going to shake you out of your so-called neutrality, then shame on you.

You can read the rest of his bland substack if you like, but I wouldn’t bother: It’s painful to read and I don’t agree with any of it. You can also read his more ‘public facing’ Opinion piece version that appeared in mid-2025 in the NYT – it’s a more ‘measured’ iteration of what he really thinks: “The W.H.O. could also address criticism that the agency failed to properly condemn Hamas when it was accused of militarizing health facilities during the war in Gaza”. No mention here of a call for Israel’s neutrality or the WHO’s contribution to anti-semitism, so I’m not sure (I am sure) why he’s ratcheting up the rhetoric now. Singer’s Substack is just one of many examples currently doing the rounds of self-appointed global health ‘re-imaginers’ failing to re-imagine anything. Common to all is a sense of entitlement and complete lack of humility as they jockey for position with their ‘think pieces’, desperately hoping that their idea is the one that gets traction. What we’re witnessing reminds me of Robert Cox’s description of global governance as a “nebuleuse” or “loose elite network of influentials and agencies, sharing a common set of ideas, that collectively perform the governance function”. ‘Perform’ is the operative word. Instead of global health leaders possessing something approximating a spine – which is what we need right now – we have a bunch of performers prancing about on stage like Vanilla Ice “cooking MCs like a pound of bacon”.

2026 has started off horribly. I don’t care for Maduro at all – he could get fed to Sarlaac and be digested in its stomach for a thousand years for all I care. No-one should cry a single tear for that man. But, as with Gaza, many, many more people are going to die in Venezuela now as a consequence of the method of arrest and extraction, and the disruption to society that all of that will now bring to Venezuelans. It is unlikely that their lives will be improved one iota. Does Trump care? Does he fuck. He will feel emboldened to act again and pick off other, weaker, countries, like Cuba – reflecting the personal gripes of his henchman Rubio. But put yourself in the shoes of a Venezuelan or a Nigerian or an Iranian, or – looking to the future – a Greenlander/Kalaallit or a Canadian? These are people who have recently experienced bombing raids from the US or are people whose identities are being threatened daily by Trump’s taunts of occupation. How would you feel if the political head of your country was simply abducted over night by special forces from a neighbouring country? Even if you hated them, how would you feel, really? Or, imagine if Trump was kidnapped for his alleged crimes by an elite Unit of the Venezuelan FANB and whisked off to an undisclosed site. What would be an appropriate response?

The point is that ‘we’ (and maybe this isn’t you, maybe it’s just me) are way beyond neutrality. 2026 is a year when global health professionals should take a good, long look in the mirror and think about what they can do to resist Trump and the miscreants who hide in his shadow. If you are working in global health, and especially if – like me – you are a global health scholar, or an academic working along adjacent lines, now would be a good time to wake up and fight back. Here’s what I intend to do, if I have the chance:

• Call out Trump and his minions at every opportunity. On a panel discussion at Chatham House in December I openly described the Trump administration as the biggest obstacle to global health. This should not be a fringe view but a standard repost at any public event where global health issues are discussed.
• Consider disrupting events where US government representatives are speaking – occupy the stage, ask provocative and deliberately pointed questions, boo if you have to. Now is not the time to be polite.
• Engage directly, online, with influencers who peddle pro-Trump lies and disinformation.
• Speak out and up for organisations such as the WHO. If people like Singer start bad-mouthing organisations at the heart of global health or deliberately try to undermine them, then call those people out. There are too many ‘senior’ academics who were once-critical but are now supine, brandishing their most pathetic and asinine thoughts like used diapers – and I’ve had enough of their shit.
• Be honest. Singer is right to call for intellectual honesty even if he has little idea what that means. The responsibility of intellectuals is – as Chomsky pointed out – “to speak the truth and to expose lies”. In my experience, intellectuals are not very good at doing this. So I would extend this responsibility to anyone who has the courage to do this one thing.

‘Global health’ – if that concept has any meaning anymore – is under direct threat by the Trump administration. If that means anything to you – anything at all – then you should be pissed off, angry, and ready to defend it from the freak show currently desecrating the Whitehouse.

Andrew