The Trump Administration’s criminal separation of thousands of children from their families at the US border has been widely reported. But the fact that Trump funded his mass child abuse program by slashing funding for health care programs, including the prevention of viral pandemics, was reported but largely ignored a couple of years ago and has since been largely forgotten. It bears repeating: Trump’s brutal attacks on migrant children and parents were funded directly by diverting funds earmarked to promote public health and stop pandemics like COVID-19.
During the last Presidential debate, one of the unforgettable moments occurred when the moderator asked the candidates about the ACLU report that hundreds of children that the Trump administration kidnapped from their parents are still languishing in Trump’s cages, and the US government isn’t even attempting to find their parents.
Biden responded effectively, expressing his justifiable moral outrage, calling Trump’s acts a crime. But he didn’t explain that Trump took the funding for these violations of human rights from the Center for Disease Control.
In order to understand how awful Trump’s simultaneous attacks on migrant children and public health and pandemic preparedness were, despite Trump’s frequent whining lie that, for example, “Nobody knew there’d be a pandemic or an epidemic of this proportion,” it’s worthwhile first to examine:
- the highlights of the last few decades of pandemic warnings
- the many warnings provided to Trump directly
- the Trump administration’s slashing of public health and pandemic preparedness planning
The fatal nexus between Trump’s long antipathy to public health spending and his racist anti-immigrant agenda then comes into focus: stealing money from public health in order to abuse immigrant children was an example of Trump killing two birds with one stone. If you’re primarily interested in that nexus, you can skip down below to the “Two Birds” subhead below.
Brief History of Prophetic Pandemic Warnings
I’m sure there were earlier warnings, but the first I remember becoming aware of the existential threat of zoonotic diseases (diseases that jump from non-human animals to humans, such as avian influenza virus jumping from poultry to people), was after Laurie Garrett published her 1994 book, The Coming Plague: Newly Emerging Diseases in a World Out of Balance, a warning reinforced in 1997 by Jared Diamond’s brilliant work of historical synthesis, Guns, Germs and Steel.
In 2004, the "Mapping the Global Future: Report of the National Intelligence Council’s 2020 Project" warned, "Some experts believe it is only a matter of time before a new pandemic appears, such as the 1918-1919 influenza virus...."
In June of 2005, Senators Obama and Lugar wrote a rare bipartisan op-ed, warning, “We must face the reality that these exotic killer diseases are not isolated health problems half a world away, but direct and immediate threats to security and prosperity here at home.” In November of that year, President Bush, after reading an advance copy of John M. Barry’s book, The Great Influenza, set up plans for national stockpiles of masks and ventilators, intoning, "A pandemic is a lot like a forest fire. If caught early it might be extinguished with limited damage. If allowed to smolder, undetected, it can grow to an inferno that can spread quickly beyond our ability to control it."
In 2006, Dr. Larry Brilliant, who helped lead the WHO’s successful effort to eliminate smallpox, one of humanity’s greatest achievements, gave a TED Talk in which he predicted a global economic depression in the wake of an unchecked future pandemic, and discussed the need for funding for global monitoring systems.
The Obama administration, in 2016, developed a National Security Council Playbook, stressing the need for a swift, coordinated response to emerging pandemics by the Federal Government with a unified public health message, in a report called, “Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents.” This report became briefly famous earlier this year when Senator McConnell (R-KY) tried to claim, falsely, that the Obama administration left no pandemic playbook.
The Trump Administration, and Trump, Was Warned
In December 2016 and March 2018, Bill Gates met with Donald Trump, urging him to invest more money in public health and pandemic preparedness, appealing to Trump’s vanity by telling him that with investment, Trump could create a universal flu vaccine and become a global hero.
Bill Gates has been trying to warn us of the dangers of a global viral pandemic for years, most memorably in a TED Talk from 2015, entitled “The Next Pandemic? We’re Not Ready.” Gates tried to make a similar pitch to Trump.
In both meetings with Gates, Trump confused HPV (the viruses that cause genital warts and ovarian cancer and for which there is a vaccine), and HIV, the virus that causes AIDS. Gates later related that, “In both of those two meetings, he asked me if vaccines weren't a bad thing.” Gates told him no.
On January 13, 2017, seven days before Trump was inaugurated, the Obama Administration provided a three-hour briefing to incoming Trump administration officials on plans for pandemic response, but the Trump officials didn’t seem to care much. For example, “Incoming Commerce Secretary Wilbur Ross appeared to keep dozing off. ” Ross denies this account.
Just before the inauguration, Dr. Anthony Fauci also foretold, at a forum on preventing global pandemics at Georgetown, that, “What about the things we are not even thinking about?… No matter what, history has told us definitively that [outbreaks] will happen because [facing] infectious diseases is a perpetual challenge. It is not going to go away. The thing we’re extraordinarily confident about is that we’re going to see this in the next few years.”
In January 2019, the Worldwide Threat Assessment of the US Intelligence Community tried to warn the Trump Administration that, “We assess that the United States and the world will remain vulnerable to the next flu pandemic or largescale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.” The Center for Strategic and International Studies, similarly, in November of 2019, reported, “In reality, the American people are far from safe. To the contrary, the United States remains woefully ill-prepared to respond to global health security threats.”
From January to August 2019, low-level Trump administration officials at Health and Human Services, FEMA, and other agencies, including state agencies, participated in a simulation of a deadly flu epidemic in a scenario called, “Crimson Contagion.” According to the New York Times, the results, circulated internally in October 2019, predicted widespread shortages and “laid out in stark detail repeated cases of ‘confusion’ in the exercise. Federal agencies jockeyed over who was in charge. State officials and hospitals struggled to figure out what kind of equipment was stockpiled or available. Cities and states went their own ways on school closings.” The report-writers implied that these challenges should be addressed and points of confusion should be clarified before a pandemic actually hit. They weren’t.
Instead of listening to Bush, Obama, Gates, the intelligence agencies, Dr. Fauci, or other public health experts, the Trump Administration has repeatedly cut, and attempted to slash, public health funding.
Trump Slashed Public Health Spending
The reality is that public health investment has perhaps saved and improved more lives globally in the last 100 years than any other global initiatives, with the possible exception of nitrogen-based fertilizers and green revolution crops. Yet, despite the warnings detailed above, baseline national and global public health funding, except in response to emergencies such as HIV/AIDS, Ebola, and Zika, has been paltry for decades, only a few hundred million dollars per year. The Obama administration was no exception, promoting emergency appropriations in response to flu threats, and securing 5-years of extra funding in response to Zika, but baseline funding to treat and prevent all other infectious disease threats under Obama stayed essentially flat.
The Trump administration has attempted every year to gut both national and global public health funding, and with notable exceptions, Congress has often refused to make cuts as large as Trump proposed. But despite some pushback by Congress, the damage has been enormous.
In 2017 the Trump administration proposed cutting $15 billion and managed to gouge $10 billion from the Department of Health and Human Services budget. The American Public Health Association (APHA) warned against making these cuts:
Unfortunately, the CHAMPIONING HEALTHY KIDS Act includes a $10.5 billion cut in funding to the Prevention and Public Health Fund as part of the offsets to pay for extending these other programs.
“We strongly urge you to immediately extend funding for the safety net programs that expired on Sept. 30, and urge you to do so without using any portion of the prevention fund as an offset,” wrote APHA executive director Georges Benjamin, MD, in the letter to members of Congress.
The Prevention and Public Health Fund provides critical resources to our state and local health departments to keep our communities healthy and safe from infectious disease, lead poisoning, tobacco-related diseases and much more.
Emily Holubowich of the Coalition for Health Funding predicted that the massive proposed cuts to the CDC, totaling 30%, “… [C]ould “completely erode the safety net system — you’re looking at a tidal wave of need that would completely subsume the system.” (Emphasis added).
The Prevention and Public Health Fund had already been partially raided by the Obama administration to pay for a payroll tax cut, a move that Democratic Senator Tom Harkin regarded as such a betrayal that he refused to speak to Obama.
But the Trump Administration took these cuts much further. When Trump attempted to repeal the Affordable Care Act, he advocated zeroing out the Prevention and Public Health Fund altogether.
In 2018, not only did Trump propose cuts, but Congress sadly acceded to many of them. Ashley Yeager, writing in The Scientist, reported:
Today (February 9), Congress passed and President Donald Trump signed a bill that would cut $1.35 billion from the PPHF over the next 10 years, leaving the fund up to $1 billion short of its initial goal each year. And, Congress has the power to divert these remaining funds to programs outside the PPHF’s mandate.
With the monetary shift, it is not clear which programs will be affected, but the shortfall will create holes in public health programs, Georges Benjamin, the executive director of the American Public Health Association (APHA), tells The Scientist. The CDC will also suffer a blow in the coming year as funds from a five-year, $582-million supplemental package to combat Ebola run out with no hint of being renewed.
“CDC’s mission is to keep Americans safe,” the agency’s former director, Tom Frieden, now president and CEO of Resolve to Save Lives, an initiative to bolster public health, tells The Scientist. “But without funding, the CDC won’t be able to protect us.”
I just want to repeat that last prophetic statement: the former director of the Center for Disease Control warned Trump, Congress, and the public that because of Trump’s budget cuts, “the CDC won’t be able to protect us.”
The Trump administration then systematically dismantled the National Security Council and HHS infrastructure set up by the Obama administration to respond to pandemics and slashed the CDC global health budget. Laurie Garrett, the author of the Coming Plague book I mentioned above, writing in Foreign Policy magazine in January 2020, in an article entitled, “Trump Has Sabotaged America’s Coronavirus Response: As it improvises its way through a public health crisis, the United States has never been less prepared for a pandemic” summarized the impact of these cuts:
In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10. Meanwhile, throughout 2018, the U.S. Agency for International Development and its director, Mark Green, came repeatedly under fire from both the White House and Secretary of State Mike Pompeo. And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40 percent, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced.
Many public health advocates tried to sound the alarm. Krishandev Colamur, writing in The Atlantic in 2018 explicated the threat that Trump’s budget cuts, conspiracy theories, and blinkered xenophobia posed (emphasis added):
“There is a real reason for us to be scared of the idea of facing this threat with Donald Trump in the White House,” said Ron Klain, who served as President Obama’s Ebola czar, at the Spotlight Health Festival, which is co-hosted by the Aspen Institute and The Atlantic. Klain said the “president is anti-science” and “trades in conspiracy theories.”
“All those things would lead to the loss of many lives in the event of an epidemic in the United States, where we need the public not to trade in conspiracy theories, not to believe that the news was fake, but to respect scientific expertise,” said Klain, a veteran Democratic operative who served in both the Clinton and Obama administrations.
Klain added that Trump’s isolationist mindset has led to the United States pulling back from its leadership role in global health crises, which, he said, “is ... going to be a serious threat to our security.”Klain called Trump’s policies and views “xenophobic, if not racist,” leading to the blaming of immigrants and foreigners for problems that need public-health interventions.
Reading that today, it’s almost difficult to believe it was written two years before COVID-19 emerged.
In 2019, President Trump’s budget request to Congress attempted to slash public health spending even more. The APHA again raised the alarm:
APHA Executive Director Georges Benjamin, MD, said, “In a time where life expectancy is falling, our leadership should be investing in better health, not cutting federal health budgets.” The president’s budget proposes a 31 percent cut to the Environmental Protection Agency and a 12 percent cut to the U.S. Department of Health and Human Services. The budget includes more than $750 million in cuts to Centers for Disease Control and Prevention programs and a nearly $1 billion cut to Health Resources and Services Administration programs.
Might the CDC have botched the creation of the initial COVID-19 test, failed to craft a consistent public health message, and betrayed its mission by caving-in to Trump’s anti-science bullying if it hadn't been lacerated by Trumpian budget cuts for years? Perhaps. But the odds of such deadly snafus were certainly increased by Trump’s continual attacks on the agency.
Symptomatic of the impact of these cuts in preparedness: In the summer of 2019, FEMA allowed the maintenance contract on its emergency supply of 7000 ventilators to lapse, so when they became urgently needed in 2020, thousands no longer worked.
Even after the COVID-19 pandemic emerged, Trump proposed even more cuts for next year’s budget. The always reliable American Public Health Association reports:
In February [2020], President Donald Trump released his federal budget proposal for fiscal year 2021, calling for a cut of more than $693 million at the Centers for Disease Control and Prevention, as well as a $742 million cut to programs at the Health Resources and Services Administration. Overall, the president’s budget proposes a 9% funding cut at the U.S. Department of Health and Human Services, a 26% cut at the U.S. Environmental Protection Agency, massive cuts in Medicare and Medicaid spending, and funding decreases for safety net programs such as food and housing assistance.
How well did the Trump administration learn the lesson of how important it is to prevent zoonotic diseases, such as COVID-19? It is proposing to cut that line item by $85 million.
Trump Kills Two Birds With One Stone
As Ron Klain reminded us above, Trump regards both disease and immigrants as something dangerously foreign, hence his repeated racist references to COVID-19 as the “China Virus,” and “Kung Flu,” something that can be kept out with a high enough wall. Trump sees both immigrants and viruses as infectious aliens. But instead of attacking viruses, Trump chose to defund health care programs, including our defenses against viruses, by reallocating money that Congress had appropriated for public health and using it on his scheme to steal children from refugees coming across the US border.
In the summer of 2018, the Trump administration decided to change US policy and accelerate its formerly secret practice of stealing children who crossed the US border with Mexico from their parents. By the time the policy was blocked by ACLU lawsuits in the Federal Courts, over 4500 children had been kidnapped. This resulted in a spike in children being housed in inhuman conditions. To pay for these crimes, Caitlin Dickson first reported on Yahoo News on September 19, 2018, that HHS Secretary Alex Azar was diverting the funds (emphasis added):
The Department of Health and Human Services is diverting millions of dollars in funding from a number of programs, including the Centers for Disease Control and Prevention and the National Institutes of Health, to pay for housing for the growing population of detained immigrant children.
Politico reported that the costs of Trump’s new separation policy quickly escalated. “One major spending driver is that HHS has been forced to use ‘influx shelters’ — temporarily contracted facilities — because of the surge in migrant children separated from their parents. The cost to care for a child in an influx shelter is reportedly nearly $800 per child per night, more than triple the cost of standard shelters.” How it cost $800 per night to house children without beds, soap, toothbrushes, bathrooms, drinking water, cups, or adequate food, and how a Trump administration official could try to justify these conditions in court, is another question.
According to Congressperson Rosa DeLauro (D-CT), the initial reallocation of funds from health care totaled $446 million. DeLauro protested on September 20, 2018:
“The Trump administration should not rob funds from vital health and human services initiatives to make up for their failed immigration policies. Appropriators in Congress worked hard to ensure that programs like research at the National Institutes of Health, Head Start, universal flu vaccine research, education for women on the symptoms and risks of gynecological cancers, family caregiver support services, teen pregnancy prevention, and so many more, get the funding they deserve. Cuts to these programs—especially those with relatively less funding and those that are already shortchanged—will undoubtedly affect their work and the people who count on it. That is unacceptable. If the Trump administration needs additional funding to carry out their failed policies, like the government-sanctioned child abuse that resulted from their ‘zero-tolerance policy,’ they should request an emergency supplemental package from Congress instead of hiding behind transfers.”
Six months later, in March of 2019, Julia Conley, of Common Dreams reported, in an article with a descriptively long title, Trump to Divert Up to $385 Million From Crucial Health Programs To Pay for 'Government-Sanctioned Child Abuse.’ Added to what was taken last year, say critics, that's ‘almost $1 billion in HHS funds diverted from real public health emergencies to sink into manufactured ones’:
Health and Human Services (HHS) Secretary Alex Azar told Congress this week that he plans to divert $385 million from numerous healthcare programs to pay for detention centers across the country where more than 15,000 young undocumented immigrants are currently being held.
About $286 million will be taken from the Centers for Disease Control and Prevention, the National Institutes of Health, and HHS's programs for children and families, according to The Hill. Programs including HIV prevention and Head Start are expected to be affected.
Congressperson DeLauro again objected in March of 2019, “We cannot continue to spend taxpayer dollars on the President's manufactured crisis at the border, which is government-sanctioned child abuse."
The impact of these policies on the children and the parents have been dire. KQED News reports that the policy constituted government-sponsored torture under international law:
The paper argues that the government's treatment of migrant children falls under three criteria [of The United Nations Convention against Torture], as well as the Rome Statute of the International Criminal Court.
Researchers argue that actions like family separations caused "severe pain and suffering" and were inflicted with a specific purpose and with the consent of government officials — oftentimes by order from the president himself.
"I would describe cages and sleeping on the floor and being forcefully separated from their parents as severe pain or suffering. No different than I would if someone was beaten with a truncheon," [Dr. Coleen] Kivlahan explained.
Furthermore, in February of 2019, KQED Newsreported that “In each of the past four years, 1,000 or more immigrant children who arrived at the southern U.S. border without their parents have reported being sexually abused while in government custody....”
On October 21, 2020, KQED News broke the news that the ACLU has determined that there are 1000 children who were forcibly separated from their parents by the Trump Administration whose parents have still not been located, despite a federal court order.
Also in October of this year, the majority on the House Judiciary Committee issued their formal report on the Family Separation Policy, The Trump Administration’s Family Separation Policy: Trauma, Destruction, and Chaos, concluding that: “The investigation reveals a process marked by reckless incompetence and intentional cruelty.” Unfortunately, the committee failed to investigate, or at least failed to report on, the damage done and the consequences to this country and the world of the nearly $1 billion in cuts made to public health in order to fund these crimes.
In 2019, Common Dreams foretold the likely additional dire consequences of paying for the kidnapping and torturing of migrant children by cutting public health (emphasis added):
The public health community is in the midst of responding to a series of crises throughout the country, including a measles outbreak and addiction epidemic, and every dollar counts," said Emily Holubowich, executive director of the Coalition for Health Funding, in a statement.
‘Additional funding, not less,’ she added, ‘is what is required to improve and protect the health of the population. In total, HHS has diverted nearly a billion dollars from the discovery of cures, outbreak response, and access to critical preventive and primary care services.’
They didn’t know how right they were.
We Are All Part of One Another
In 1965, Martin Luther King, Jr., in his prophetic, Letter from a Birmingham Jail, implored us to live our lives with the awareness that:
Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.
The story of how Trump endangered us all through his attacks on migrant children illustrates once again how, in this globalized world, struggles for human rights and public health on the one hand, and against racism, exploitation, domination, violence, and cruelty on the other, are indivisible.
Ron Klain reminded us of King’s sentiments in The Atlanticarticle quoted above in 2018, “We can’t be safe here in America when there’s a risk of pandemics around the world…. The world’s just too small. Diseases spread too quickly ... There is no wall we can build that is high enough to keep viruses and the disease threat out of the United States. We have to engage in the world.”
The Global Preparedness Monitoring Board of the World Health Organization issued a report in September 2019, A World at Risk, explaining that in pandemics:
Leaders at all levels hold the key. It is their responsibility to prioritize preparedness with a whole-of-society approach that ensures all are involved and all are protected.The world needs to proactively establish the systems and engagement needed to detect and control potential disease outbreaks. These acts of preparedness are a global public good that must meaningfully engage communities, from the local to the international, in preparedness, detection, response and recovery. Investing in health emergency preparedness will improve health outcomes, build community trust and reduce poverty, thereby also contributing to efforts to achieve the United Nations Sustainable Development Goals.
Instead of being chastened by not heeding their (or anyone else’s) warnings, the Trump Administration is planning to accelerate racist attacks on immigration if re-elected and has already announced the withdrawal of the United States from the World Health Organization.
ScienceAlertreports, “WHO chief Tedros Adhanom Ghebreyesus responded to the news with a one-word tweet -
"Together!"
- as he linked to a discussion by US health experts on how leaving the global body could impede efforts to prevent future pandemics.”
Our struggles for a more healthy, just world are interconnected, intersectional, and inseparable. As lesbian-feminist civil rights activist Barbara Deming wrote, “We are all part of one another.” David Hart, of Nonviolence International, recalled Barbara Deming’s life and work when he reminded us earlier this year that,
“The global pandemic has once again revealed how broken our system is.
May it also remind us of our shared humanity.”