Lawfare Daily: Why Public Health is Critical to National Security
Apr 2, 2025
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Atul Gawande, a surgeon and public health expert, formerly led global health initiatives at USAID. In this discussion, he explores how recent cuts to USAID threaten national security by jeopardizing effective public health strategies. Gawande emphasizes the crucial link between health and stability, especially post-COVID-19. He redefines soft power as 'pragmatic power,' arguing for improved health systems globally. The conversation also highlights legal issues stemming from aid freezes and advocates for transparency and accountability in health programs.
Public health is crucial for national security, as health crises can destabilize nations and exceed wartime casualties, emphasizing its strategic importance.
The dismantling of USAID jeopardizes both global health initiatives and U.S. national security, threatening humanitarian assistance and stability in crisis-affected regions.
Deep dives
Public Health as National Security
Public health is increasingly recognized as a critical component of national security, particularly in the context of global health threats. The COVID-19 pandemic serves as a stark reminder of the loss of life and economic disruption caused by diseases, illustrating how health crises can exceed wartime casualties and destabilize nations. Investments made during the time Atul Gawande led global health at USAID significantly improved response times to outbreaks, showcasing that effective public health measures can prevent pandemics and promote stability. The strategic benefits of global health initiatives also extend to fostering relationships and economic partnerships in regions like Africa and Asia, highlighting the multifaceted relationship between health security and national interests.
Domestic Public Health and Military Effectiveness
Domestic public health issues, such as the resurgence of measles due to falling vaccination rates, directly impact national security by affecting the health of populations vital for military effectiveness. A healthy population is essential for maintaining military readiness, as widespread illness can hinder troop fitness and readiness for active duty. Gawande emphasizes that the historical gains made in child mortality reduction and immunization, primarily through vaccination efforts, are now at risk due to disruptions caused by policy shifts and vaccine skepticism. This connection illustrates that national security is not merely about military strength; the overall health of the population is fundamental to supporting a capable and resilient defense force.
The Impact of Defunding Scientific Research
Recent reductions in funding for scientific research, including cuts impacting the National Institutes of Health, pose a significant threat to national security through the weakening of America's research capabilities. Public health breakthroughs and innovations, such as the development of vaccines, rely heavily on robust research funding, which has contributed to improved life expectancy and disease prevention. The diminishing investment in research shifts the balance of scientific leadership globally, with countries like China increasing their productivity in scientific output while the U.S. loses ground. Gawande argues that a thriving science enterprise is crucial for national security, as it directly contributes to economic strength and public health advancements that protect citizens.
USAID's Role and Consequences of Its Dismantling
USAID plays a vital role in both public health and humanitarian assistance, providing essential support to countries in crisis, and its recent dismantling threatens not only global health but also U.S. national security interests. The organization has historically served as a crucial ground force for the U.S. in conflict zones, contributing to stability and resilience in affected regions. Gawande highlights the immediate consequences of halting services, such as disruptions in health systems and humanitarian aid, leading to increased mortality from preventable diseases globally. Restoring and empowering USAID is essential for mitigating the devastating impact of policy changes, and for ensuring that the U.S. remains a leader in global health and security humanitarian efforts.
Atul Gawande is a surgeon and a public health expert. He's also the former head of global health at the U.S. Agency for International Development (USAID), an agency that the Trump administration has prioritized for dismantling since its first day in office. On today's episode, Executive Editor Natalie Orpett sat down with Gawande to discuss what USAID does, the consequences of destroying it, and why public health is so important to U.S. national security.
Editor's Note: This episode was recorded on March 27, 2025. The following day, the Trump administration announced that USAID would be dissolved by the end of this fiscal year.
