Trump’s Global Health Pullback Creates Leadership Opportunity for Europe

The Trump administration’s “America First” approach may be rooted in domestic priorities, but its ripple effects are being felt well beyond US borders—especially in Europe’s health systems. According to new research published in Health Policy, shifts in US global engagement are reshaping health dynamics across the Atlantic, presenting both challenges and opportunities for the European Union (EU) and its member states.1

Global health | Image credit: zephyr_p - stock.adobe.com

One major concern highlighted in the research is the steep drop in US support for global health programs. The second Trump administration slashed funding for key international initiatives, including reproductive health and HIV/AIDS programs.2 For many low- and middle-income countries that rely heavily on this aid, the loss has been significant. European nations have stepped up in the past—pledging millions to fill the void in 2017 in response to policy shifts during the first Trump administration—but those efforts can only go so far.3 The gap left by billions in US funding has triggered real-time strain on global health systems.1

Yet, this US pullback also leaves a leadership vacuum—and Europe appears ready to fill it. The new study noted that countries like the UK and the Netherlands have made early moves, increased their global health commitments, and positioned themselves as champions of reproductive rights and pandemic preparedness. The shift gives Europe a rare opportunity to strengthen its voice in international health governance—if political momentum and financial support hold.

“European countries and the EU, nevertheless, have a lot to work with…. They are among the world's largest economies, have a strong commitment to multilateralism, and powerful policy tools as well as opportunities that will emerge if the US becomes a less predictable ally, research collaborator, or employment market. They can link issues as well as the US, defending their policy interests and challenging the US, and build new alliances,” the authors wrote.

Domestically, US policy changes are creating indirect pressures on European health systems, particularly through economic channels. The research pointed to how the Trump administration’s tariff escalations and trade tensions have stirred fears of broader economic slowdowns.4 In Europe, where tight fiscal space is already a challenge, any economic contraction could squeeze health budgets, further affecting everything from delivery of health services to long-term investments in research and innovation.1

Pharmaceutical policy is another pressure point. With the US prioritizing domestic production and signaling protectionist trade policies,5 there’s a growing risk of research and development and manufacturing shifting stateside.1 That could spell trouble for Europe’s pharmaceutical sector, which may see reduced investment and innovation. According to the study, this shift could also put the EU at greater risk of drug shortages or supply chain disruption—an issue already underscored during the COVID-19 pandemic. Some EU nations may now consider boosting regional manufacturing capacity to safeguard access to critical medicines.

The Trump-era distancing from multilateral institutions like the World Health Organization has added another layer of uncertainty.6 Reduced US engagement weakens coordination during global health emergencies and undermines joint efforts on issues like vaccine equity and disease surveillance.1 The analysis suggested that, for Europe, this is both a setback and a strategic opening. EU leadership could play a stronger role in shaping global responses if member states can align on common goals and speak with one voice.

Still, there are limits. Reduced collaboration, strained funding, and shifting geopolitical alliances could stall progress on shared priorities—from global immunization efforts to antimicrobial resistance strategies. Without US partnership, some initiatives may struggle to maintain scale or impact, forcing European leaders to rethink how they approach global health partnerships.

The authors explained, “The new Trump administration will be a serious challenge for Europe and its multilateral approach to world politics. Assimilating global health to a narrow, right wing, American nationalist agenda, it threatens everything from the supply chain for medicinal products to major flows of refugees caused by increased war and climate change…. European commitments to multilateralism and international rules, however much they have been critiqued, could be the basis for deepening relationships with lower and middle income countries and democracies.”

While some effects, like funding cuts and economic uncertainty, pose clear risks, others open the door for the EU to assume a more active role in global health leadership. The challenge ahead, as emphasized in the study, is not just in filling gaps, but in seizing the moment to build a more resilient, autonomous, and forward-looking health policy strategy.

References

1. Greer SL, Jarman H, Kulikoff R, Panteli D, van Ginneken E, Wismar M. The second Trump administration: a policy analysis of challenges and opportunities for European health policymakers. Health Policy. Published online May 18, 2025. doi:10.1016/j.healthpol.2025.105350

2. Bonavitacola J. End of PEPFAR funding could lead to tens of thousands of HIV deaths. AJMC®. July 8, 2025. July 11, 2025. https://www.ajmc.com/view/end-of-pepfar-funding-could-lead-to-tens-of-thousands-of-hiv-deaths

3. At least 9 nations pledge support to Dutch-led fund aiming to fill funding gap left by Mexico City policy reinstatement. KFF. February 21, 2017. Accessed July 11, 2025. https://www.kff.org/news-summary/at-least-9-nations-pledge-support-to-dutch-led-fund-aiming-to-fill-funding-gap-left-by-mexico-city-policy-reinstatement/

4. Steinzor P. Trump tariffs on pharmaceuticals risk causing higher costs, drug shortages. AJMC. April 25, 2025. July 11, 2025. https://www.ajmc.com/view/trump-tariffs-on-pharmaceuticals-risk-causing-higher-costs-drug-shortages

5. Fick M. Trump's trade war: prescription drugs become a target. Reuters. April 10, 2025. Accessed July 11, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/prescription-drugs-become-target-trumps-trade-war-2025-04-09/?utm_source=chatgpt.com

6. Grossi G. Executive orders suggest swift pivot in managed care and health policy. AJMC. January 22, 2025. Accessed July 11, 2025. https://www.ajmc.com/view/executive-orders-suggest-swift-pivot-in-managed-care-and-health-policy