Why Europe should lead on fight against disease

The fight against diseases of poverty — HIV and AIDS, tuberculosis, malaria and other neglected diseases — may seem an unlikely battleground in our new era of foreign policy. But this is where the effects of the United States’ emerging isolationism will be most obvious. If Europe fails to fill the power vacuum, we will be abandoning millions of people in the world’s poorest countries.

The U.S. has been the world leader in the fight against HIV and AIDS, tuberculosis and malaria — diseases that are responsible for millions of death every year and that we still remain hopelessly ill-equipped to fight. Recent Zika and Ebola virus outbreaks revealed how unprepared we are when facing new pandemics. We desperately need to move from reactive to proactive policies to fight these diseases.

U.S. funding for global health research counts for three-quarters of all spending on disease research but has declined to its lowest recorded levels in recent years. Nothing in the first weeks of the Donald Trump administration suggests the government will work to reverse that downward trend. A survey circulated by his transition team in late 2016 questioned the value of U.S. development assistance and the country’s relationship with Africa. The survey was particularly skeptical about Pepfar, an initiative set up in 2003 by then-President George W. Bush to fight the AIDS epidemic and which has saved millions of lives.

If Europe doesn’t take on a leadership position, any hope of meeting commitments to end the epidemics of HIV and AIDS, tuberculosis and malaria by 2030 will be doomed to fail.

Both on the campaign trail and in his first weeks in office, U.S. President Donald Trump expressed sympathy toward vaccine skeptics. Taking into account a Republican Congress happy to use disease research funding as a political football, the Trump administration will be a clear threat to U.S. leadership in the fight against global disease in impoverished countries.

If Europe doesn’t take on a leadership position, any hope of meeting commitments to end the epidemics of HIV and AIDS, tuberculosis and malaria by 2030 will be doomed to fail. Emerging economies accounted for only 3 percent of total funding for global health research in 2015. In the current climate, it looks like Europe or bust.

Europe is already on the right track: In 2015, the European Union overtook Britain as the second largest public funder of global health research. The German government recently doubled its funding for innovative research in the field. Programs launched by the European Commission in the last decade are finally bearing fruit, and half of all new malaria drugs registered since 2000 have received EU funding.

If it is not dealt with properly, Brexit will pose a significant threat to the EU’s ambitions. It will be crucial that negotiations allow for the U.K.’s continued participation in EU-funded health research programs.

Politicians on the other side of the Atlantic have already started to respond to Trump’s most regressive decisions by creating funds such as “She Decides” to safeguard sexual and reproductive health and rights, and reaching out to researchers spooked by Trump’s anti-science agenda.

But to be a real leader on the issue, the EU desperately needs to resolve its political and bureaucratic obstacles.

The most urgent of these is Brexit. The U.K. remains among the top three public funders for global health research and a large contributor to EU research programs. If it is not dealt with properly, Brexit will pose a significant threat to the EU’s ambitions. It will be crucial that negotiations allow for the U.K.’s continued participation in EU-funded health research programs.

To be taken seriously, Europe needs a comprehensive, long-term vision for global health research that sets out priorities for the next decade, backed up by vocal support from Europe’s politicians and investment. The EU’s member countries need to hit their global health research funding target of 0.01 percent of GDP as recommended by the World Health Organization — right now, none are close.

A four-month-old baby is examined at the State Brain Institute in Brazil. The baby’s mother was infected with the zika virus while pregnant. Zika revealed how unprepared we are when facing new pandemics | Vanderlei Almeida/AFP via Getty

We also need to tear down the bureaucratic barriers that prevent some of our brightest scientists from accessing public funds. This means making funding more transparent, more easily accessible and more innovative. There is a small window of opportunity to achieve all of this in the next two years. Negotiations have started on how to re-tool the EU’s current multi-year budget to address the big challenges facing Europe and the wider world.

Europe needs to tackle these changes in order to truly lead on global health — this is true regardless of Trump’s agenda. But events across the Atlantic have increased the urgency for action: It is clear that we cannot rely on the U.S. for the next four years.

This is an opportunity for Europe to lay the groundwork to end HIV and AIDS, tuberculosis, malaria and other neglected diseases by 2030. Failure to do so would be a historic abrogation of Europe’s responsibility, at a time when it has never been more vital.

Renate Baehr is executive director of Deutsche Stiftung Weltbevölkerung (DSW) in Brussels.