Global health and pandemic preparedness at a crossroads

The re-election of Donald Trump as the 47th president of the USA has raised concerns among health-care professionals and public health experts about the future of global health and pandemic preparedness.1 Trump's COVID-19 response was marked by unclear guidance, politicised public health measures, and withdrawal of US support to WHO.2,3 This led to public confusion, declining trust in health authorities, and doubts about US global health leadership.4 Driven by an ‘America First’ approach, the administration's Operation Warp Speed accelerated COVID-19 vaccine development. However, the absence of a coordinated strategy for vaccine distribution and communication fostered vaccine hesitancy and misinformation, ultimately diminishing the initiative's potential benefits.5 The new administration could further weaken evidence-based policy and international collaboration as the country addresses emerging threats such as H5N1 avian influenza which could result in the next pandemic.6,7