A tale of two U.S. Global health security futures-withdraw or evolve?

Rapid detection and response to biological threats are critical to global health security. For decades, the United States has played a leading role in international outbreak response. However, recent U.S. policy shifts, including deep cuts to global health programs, reductions in personnel, and withdrawal from key institutions like the World Health Organization, are weakening disease detection and response systems worldwide. These actions threaten outbreak preparedness, data sharing, research collaboration, and frontline response capabilities, increasing the risk of uncontrolled epidemics with potentially catastrophic consequences. Diminished U.S. engagement in global health security has created a critical void, weakening disease surveillance, biosecurity, biosafety, outbreak control, and the development and distribution of medical countermeasures. The erosion of American leadership undermines global capacity to detect and respond to emerging threats, increasing the risk of epidemics and pandemics. Rather than retreating, the United States must sustain and strengthen its global health programs, integrating efforts to enhance efficiency and effectiveness, to safeguard both international stability and American pandemic preparedness.