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Global health and the T-word

By Kristof Decoster
on December 19, 2016

I know Christmas is approaching and so we’re supposed to become a bit more introspective and all that, but hey, it’s still one week! So allow me to share one last frustration (#rant) with you before we all enjoy some time off. As you might have guessed, the “T-word” has something to do with it.

I’m not exactly frequenting the corridors of power in Washington (pretty much like the corridors of power anywhere), and I understand that many global health watchers are trying to “read the tea leaves” (like Laurie Garrett did on a few occasions already in recent days and weeks),  but seriously, what has J Stephen Morrison (CSIS) been smoking to come up with such a “balanced” view on  the likelihood of the Trump administration sustaining US leadership on global health? Concluding, even, “…With high-level political will and sustained commitment, the Trump administration could create important new legacies in global health.”

I’ve been reading just too many pieces lately on the need to  perhaps “make the business case” for global health, assuming that Trump, ‘the Businessman’, will  be open to this sort of thinking. They forget he’s been a businessman of the rather dodgy kind in the first place, throughout his career. We’re not talking Paul Polman here.

Then there’s the Bill Gates approach, pandering to the gigantic ego of the President-Elect, by claiming Trump has the chance to become the next JFK, during a visit to Trump Tower. When it comes to women, perhaps (although JFK had a bit more style, I’d hope), but otherwise?  Bill, I’m pretty sure you haven’t been smoking, but what on earth were you thinking? No, if you ever set foot again in Trump Tower, I hope you make it a “Grand Challenge” to mess up some of Trump’s golden toilets and faucets with some innovative device of yours. That would be a true global health legacy to be proud of.

In the same vein, all the different versions of ‘how (climate change, innovation, “if he includes women and makes sure he works for gender equality” (etc) …) can make America great again’, which presumably will also get the ear of Trump, are also rather beside the point. Instead, the starting point of any analysis of the upcoming Trump administration and how we should engage with these folks should be this one: America (or at least a big chunk of it) has put somebody who, as far as I can tell, has never really grown up, at the helm of the – still – most powerful country in the world.  Moreover, a narcissist without much ideology, who basically only cares about himself.  I’m sure we can all agree on this. Now, contrast that with the values needed for global health, or even with George Bush jr – for all his flaws, I think he really cared about AIDS victims in Africa. PEPFAR didn’t come totally out of the blue.  Now, ponder the question: what do you think Trump cares about, deep in his heart? Anything remotely related to the good of the country, let alone the world, let alone vulnerable people in the world? …

Although I’m usually in favor of giving all people a decent chance (ànd another chance, if need be), I think in the case of Trump it just doesn’t make sense. I don’t expect anything visionary (or even remotely statesmanlike) from him in the coming years. I rather expect him to crash – just like the kid you give the keys of a Porsche. Reckless tweets on China are just a sign of more havoc to come.  And when that happens (not unlike the politicians in the UK who now have to make sure the Brexit really materializes), we need to be ready – while hoping that the planet won’t get nuked in the meantime.

Till then, I think it’s better not to give much legitimacy to the guy and his “billionaire, banker & babe loving” cabinet.  By all means, if he (and Congress) come up with some sensible policies in some areas, support them, but there really is no reason to collaborate on a structural scale with his people, start cheering “The Donald” on and hoping for him to suddenly become a visionary politician who will not just make America great again but also take the world and global health forward. If there is some global health progress under his administration, chances are it won’t be because of him, but because of other people around him (for example some Republican Congress people who do care, or understand what security in the 21st century really entails).  So far, anybody who was hoping that he’d surround himself with competent people has been rather disappointed, to put it mildly. The criterion, instead, seems to be: the more you can fuck up things in the sector you’re put in charge of, the higher the chance you get the job.

As 2017 is approaching and even Michelle Obama seems to have lost hope, we should avoid the temptation to (1) just switch off  via yoga, tai ji or other forms of meditation; (2) escape in slow Jim Jarmusch movies and other elegant things that make life worthwhile and contrast with the ugliness & murkiness of “Donald Land” ;  or (3) become downright cynical (always a danger, even in better times than now).  No, we should bide our time, and make sure we’re ready when, inevitably, Donald and his crew go down. Just like the Conservative & UKIP politicians who advocated for the Brexit will go down.

In other words, in the current post-truth post-fact times, we need to get ready for the post-Trump era. It will come sooner than you think. In global health terms: If not now, then soon enough 🙂  !  And then, we should try to do something substantial for the many ordinary citizens who voted for these people, hoping to shake up things and change things for the better, as they are already being betrayed on a grand scale.

On that cheerful note, let’s celebrate Christmas!

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