The Trump administration is reportedly working on plans to develop an alternative to the disease-surveillance and outbreak-response programs it previously had access to as a member of the World Health Organization (WHO).

According to reporting by the Washington Post, the Department of Health and Human Services (HHS) is seeking up to $2 billion a year to build a worldwide disease-monitoring system that would “recreate systems such as laboratories, data-sharing networks, and rapid-response systems” that the United States once helped build for the WHO. The Post notes that the price tag is roughly three times the $680 million the US government contributed annually to the WHO before it left the organization.

The Trump administration formally withdrew from the WHO on January 22, saying that the agency had “abandoned its core mission and acted repeatedly against the interests of the United States.”

“Although the United States was a founding member and the WHO’s largest financial contributor, the organization pursued a politicized, bureaucratic agenda driven by nations hostile to American interests,” HHS Secretary Robert F. Kennedy Jr. and Secretary of State Marco Rubio said in a joint statement.

The statement also said the United States would continue “advancing global health security through direct, bilateral, and results-driven partnerships.”

Path forward for global health

What that will look like is unclear. In response to a request from CIDRAP News for confirmation and further clarification of the Post’s reporting, HHS spokesman Andrew Nixon said, “HHS is working with the White House in a deliberative, interagency process on the path forward for global health and foreign assistance that first and foremost protects Americans.”

The decision to leave the WHO has been widely condemned by global health and infectious disease experts, who’ve warned that it will jeopardize disease surveillance and the ability to keep the country safe from outbreaks.

Health care-associated infections (HAIs) are responsible for an estimated 6,774 deaths each year in Spain, according to a large study published yesterday in Eurosurveillance. That number is more than three times the number of deaths caused by car accidents in the country each year. 

HAIs are infections patients acquire while receiving care for other conditions in a health care setting. The analysis, based on data from 107,781 hospitalized patients in 2022 and 2023, found that roughly eight of every 100 patients acquired a HAI. Thirty-day mortality among patients with HAIs was 11.0%, compared with 5.7% among those without infections. Patients with HAIs had a 70% higher risk of death than those without infection. 

Overall, 41.2% of deaths among patients who had a HAI were attributable to the infection itself. Across all hospitalized patients, 3.2% of deaths were attributable to HAIs. 

50% of HAIs are considered preventable

Respiratory infections were the most common HAIs (26%), followed by surgical site infections (22%) and urinary tract infections (18%). Respiratory infections, bloodstream infections, and urinary tract infections were the most deadly; pneumonia was associated with a nearly threefold increased odds of death (adjusted odds ratio [aOR], 2.92), while bacterial bloodstream infections were linked to a roughly 70% increase in mortality risk (AOR, 1.68).

The authors note that at least half of HAIs could be prevented and emphasize the need for strengthened infection-prevention measures. 

“HAIs constitute the most important complication for inpatients in Spain and while not being an official cause of death, the number of deaths they resulted in was comparable to other relevant causes, such as road traffic accidents (1,750) or breast cancer (6,492),” write the authors. “Given that 50% of HAIs are considered preventable, it is reasonable to expect that, with full implementation and compliance with infection prevention and control measures, up to half of HAI-related deaths could be avoided.”