The United States' decision to withdraw from the World Health Organization (WHO) is a cause for concern for global public health, says the former head of vaccines at the US Centres for Disease Control and Prevention.
Dr Dimitris Daskalakis, the Greek-American infectious disease specialist and former head of the CDC's National Centre for Immunisation and Respiratory Diseases (NCIRD), told Euronews Health about the risks that emerge from this decision.
Washington's collaboration with the WHO had more than just an economic dimension, he said. It was a critical pillar of global epidemiological surveillance, creating an environment of public health diplomacy.
Through it, information from around the world reaches the US, enabling a better understanding of epidemics, emerging infections and new threats.
"The US withdrawal leads to isolation and loss of visibility," Daskalakis said.
The US "will not be involved in discussions on the formulation of influenza vaccines, resulting in them being less effective. Information on new infections will be reduced and the WHO, losing a key funding partner, will be less prepared to deal with new epidemics."
The infectious disease expert said that this decision not only harms US public health but also global public health.
At the same time, the US' retreat in pandemic preparedness, reinforced by reduced investment and policy choices, leaves a significant gap.
"I fear that Health Secretary Robert F Kennedy Jr will destabilise the US vaccine infrastructure, and manufacturers may find vaccine production unsustainable," he warned.
Europe's place
But Daskalakis also sees both a challenge and an opportunity for Europe.
"The United States is leaving behind a huge gap in international health security. Europe can fill part of that gap, particularly in pandemic prevention and equitable vaccine distribution," he said.
Referring to RFK Jr's health policies, which have provoked strong reactions in the US, Daskalakis noted that there is often confusion in Europe.
"Some of his ideas already exist in European countries, such as the Danish vaccination programme. The difference is that there, the systems operate within a framework of universal health coverage," he explained.
Trying to transfer these models to the US without changing the health care system reveals a deeper contradiction.
"There is nostalgia for what is in place in Europe, but without the political will to implement universal health care in the United States," he stressed. Many of his European colleagues find it difficult to understand how a system so dependent on profit can produce such great health inequalities.
Daskalakis' long involvement in the fight against HIV makes him particularly sensitive to the destabilisation of health infrastructures. He recalls the importance of programmes such as PEPFAR, which have saved millions of lives by providing access to antiretroviral therapy and limiting the progression of the disease to AIDS.
The US President's Emergency Plan for AIDS Relief (PEPFAR) is the largest commitment by any nation to address a single disease in history, investing over $110 billion in the global HIV/AIDS response since 2003.
"Anything that destabilises this infrastructure means we risk losing ground," he warned.
"Substance users and LGBTI people are an integral part of the HIV story. Creating social stigma only exacerbates the crisis."
For Daskalakis, his resignation from the CDC was not just a professional choice but an act of responsibility.
"When ideology trumps science and red lines are crossed, silence is no longer an option," he said.
