Donald Trump has promised to change Washington, and he surely will. Yet while he may play some wild cards in the realms of medicine, science, and public health, you can also look for some surprising continuity with President Obama’s administration.
Here’s our preview of what to expect.
The H1N1 flu pandemic broke out within Obama’s first few months in office, and nearly 61 million Americans eventually contracted it. He later had to contend with the worst outbreak of Ebola in history, which left thousands dead in Africa and led to some hysteria stateside, and the unexpected rise of Zika.
The White House and Congress were stalled for months trying to reach agreement to fund the Zika response, a precedent that worries many outside groups. Ambitious efforts to shore up the international infrastructure to stop epidemics before they come to the United States are at risk as a result.
Still, the general verdict is that the president handled these crises calmly and with scientific rigor. Most recently, the administration spearheaded an effort that could lead to a Zika vaccine being produced in record time.
Trump could not be more different. Where Obama was calm, perhaps a little aloof in his critics’ eyes, the president-elect was often sensationalist.
“A single Ebola carrier infects 2 others at a minimum,” Trump tweeted in November 2014. “STOP THE FLIGHTS! NO VISAS FROM EBOLA STRICKEN COUNTRIES!”
He even became conspiratorial at times, casting doubt on the scientific consensus.
“Ebola is much easier to transmit than the CDC and government representatives are admitting,” he said that October. “Spreading all over Africa-and fast. Stop flights[.]”
As for the Zika outbreak, which unfolded during the presidential campaign, Trump never expressed much interest in the issue. In one notable interview, he largely deferred to Florida Governor Rick Scott on what should be done to stop the global health crisis.
Our verdict: Things are going to change.
Perhaps no issue has attracted as much bipartisan consensus as the heroin and painkiller epidemic, which is now killing more than 30,000 Americans a year.
In his last months in office, Obama signed the first major legislation to address the crisis and another bill that provided $1 billion in funding for those programs. His surgeon general produced a landmark reportexplaining the origins of the crisis and outlining a comprehensive vision to stop it.
Trump, too, takes the crisis seriously. He said repeatedly on the campaign trail how much he had heard about it from supporters in states like Ohio and Pennsylvania.
“The incoming administration has acknowledged the issue,” Dave Zook, who lobbies on behalf of the Collaborative for Effective Prescription Opioid Policies, told STAT after the election. “Obviously a lot of the impact is in the red areas of the map.”
In the final weeks of the campaign, Trump laid out a detailed plan for addressing the crisis. He emphasized the need for better addiction treatment and reiterated policies supported by Obama, such as raising the cap on how many patients doctors can treat for opioid addiction.
Trump could focus more on law enforcement than Obama did — he liked to say on the trail that his proposed wall on the Mexican border would keep out heroin along with undocumented immigrants. But unless the president-elect departs dramatically from his campaign rhetoric, he will largely build on what Obama has started.
Our verdict: More of the same.
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