Geopolitical influences, public health values, and ethics

Geopolitical forces significantly challenge public health ethical principles and require deeper attention from public health experts. We have lacked awareness of geopolitical trends, particularly how neoliberalism fuels wealth inequality (fostering the super-rich and oligarchy), which in turn drives populism, culture wars, and performative cruelty, escalating toward conflict and autocracy. This has left us poorly prepared to respond effectively to health threats. The negative impacts of the information revolution have accelerated neoliberalism and populism, particularly through the control of social media platforms and industrial scale disinformation. All of these harm public physical and mental health, and create division and insecurity in societies. The second Trump presidency is bringing all these aspects of the neoliberal agenda into stark relief. Global and domestic health is being undermined through cuts to health services, wealth transfer, politicized aid, erosion of international order, and the dismantling of scientific and democratic institutions. To remain relevant and effective, public health professionals must reaffirm their commitment to ethical principles like solidarity, responsibility to act, and evidence-based practice. We must show courage and speak out, advocating for the health of the public and a healthy state. The protection of people and planet, and indeed human survival, depends on it.