As 2025 unfolds, the world faces at least 5 major public health challenges, along with new, more infectious subvariants of Covid 19. But experts believe the US, traditionally a leader in global public health, is ill-equipped to deal with the multiple threats.
The potential US withdrawal from the global health community looms large as President-elect Donald Trump takes office. Trump withdrew from the World Health Organization during his first term, and speakers at an Ethnic Media Services briefing Jan. 10, fear he will do the same in his 2nd run at the White House.
”This affects our ability to be part of the global security framework,” said Dr. Nahid Bhadelia, founding director of the Center on Emerging Infectious Diseases at Boston University. “WHO serves as a vehicle through which countries can participate and share data. And if we withdraw from that, this is at our own peril to miss out from that global community,” she said.
Global Response
Bhadelia previously served as a senior policy advisor to the Biden Administration’s Covid-19 response team, and coordinated vaccine donations globally. She noted previous US leadership on global health crises, including the President’s Emergency Plan for AIDS Relief, established by former President George W. Bush in 2003. PEPFAR has since been established in more than 50 countries, and has saved 25 million people diagnosed with HIV/AIDS.
During the Covid-19 pandemic, President Joe Biden’s administration restarted the QUAD Alliance, which brought together leaders from Australia, India, China, and the US to get 1.2 billion doses of vaccine manufactured in India out to countries most in need.
Vaccines
“It is my hope that the Trump Administration sees the benefits of the QUAD relationship. Certainly that played a big role during COVID-19, particularly around vaccine distribution, and vaccine sharing,” said Bhadelia. She noted the importance of keeping abreast of public health challenges arising around the world, harkening the oft-used phrase: “What circulates in Congo today could be in Colorado tomorrow.”
The Jan. 10 news briefing also featured:
- Dr. Peter Chin-Hong, Infectious Diseases Specialist, University of California, San Francisco
- Dr. Benjamin Neuman, Professor of Biology, Texas A&M University
- Dr. Maurice Pitesky, Doctor of Veterinary Medicine, University of California, Davis
- Dr. William Schaffner, Professor of Medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine
Flu
One of the biggest public health crises all speakers were concerned with is the rise of human influenza. The Centers for Disease Control and Prevention issued a report Jan. 3, noting that influenza cases were up by 20% from 2023.
“I’m worried that the anti-science movement will make people not take advantage of all the tools that we have,” said Chin-Hong.
“Under-vaccination is a threat,” said Neuman, noting significant drops in people taking non-compulsory vaccinations. “We may see some of the safety net of herd immunity that has been protecting us since the mid-1900s lifted,” he added.
As non-contained fires raged throughout Los Angeles County, completely decimating many towns, and killing at least 16 people, panelists at the EMS news briefing said they were also concerned about the impact of climate change-related public health disasters.
HMPV
Schaffner discussed the alarming spike of human metapneumovirus cases in Asian countries, including China, India, Malaysia, and Kazakhstan, but noted that the disease is not new. It has been around for several decades, and many countries, including the US, experience a spike each winter. “Chinese public health authorities have said this is within normal limits of what they see during the winter. So I think we can be confident that human metapneumovirus is not going to cause a global pandemic,” he said.
Norovirus
Norovirus, colloquially known as the “winter vomiting disease,” is highly contagious and can be spread through close personal contact, the environment, and even raw shellfish, said Schaffner, noting that hand hygiene – with soap and water, not sanitizers – is most effective. No vaccine is yet available for Norovirus. Treatment consists of sipping clear liquids slowly, to restore fluid balance.
Oropouche
Chin-Hong discussed the little-known Oropouche virus, which has infected more than 10,000 people in South America, and 188 cases in the US, mostly associated with travel. The virus – which spreads via bites from midges, certain mosquitoes, and also sexual transmission – can cause encephalitis or meningitis in severe cases. Chin-Hong said he did not expect to see an outbreak in the US. “But we’re seeing an explosion that’s unprecedented, particularly in South America right now and in the Caribbean. And that’s for reasons known to us, including deforestation, and climate change,” he added.
Mpox
Like Oropouche, Mpox, which has infected more than 50,000 people in Africa, and killed 1,000 children under the age of 15, is also related to climate change and deforestation, said Chin-Hong. Mpox can be transmitted via sexual contact or contact with animals. The first US case of Mpox was identified last November in the San Francisco Bay Area. China announced Jan. 9 that it had identified a more contagious strain of the virus, but Chin-Hong said he does not expect an outbreak in the US.
Avian Flu
Avian flu, also known as bird flu and transmitted via the H5N1 virus, is on an alarming rise in 6 continents, said Pitesky. It is present in wild and domesticated birds and animals, and now, also in humans. “It’s endemic in North America. We’re 3-plus years into this outbreak and it’s expanded as far as species, geography, economic impact, and food security,” he said.
“It’s also important to realize we don’t have a very good surveillance system up for the workers that have the occupational risk, whether they be dairy workers or poultry workers. And the real risk is that because we don’t have good surveillance, if the virus continues to evolve and mutate, it does show the potential for human-to-human transmission,” said Pitesky.
The researcher believes there is a dramatic undercount of humans experiencing avian flu, because dairy and poultry workers are largely newer immigrants who may be concerned about the impacts of reporting their illness.
Covid-19
Neuman discussed the new, more virulent subvariant of Covid-19, XEC, and the impact of dramatically-lowered vaccination rates. (see related story)
