The Trump administration's politics of cruelty and its impact on global health

This Commentary addresses key decisions made and policies approved primarily during the first six months of the second Trump administration in the U.S.A. that affect global health, with an emphasis on their implications for the work of World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United States Agency for International Development (USAID), and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), among others. We highlight the roots of these decisions and priorities in Project 2025 (a policy guidance plan endorsed by more than 100 right-wing U.S. organizations), and their articulation through a series of Executive Orders implemented in accord with the U.S. Department of Government Efficiency (DOGE). The Commentary also addresses the ways in which what might be best be described as a politics of cruelty has informed the U.S. administration's actions, assesses the impact that this is likely to have on the future global health, and suggests some of the reasons why global health proved to be such an easy target for the incoming U.S. administration.