Neil Sircar, JD, LLM

Adjunct Professor of Global Health and Human Rights, University of Minnesota School of Law and Adjunct Professor of Global Health, St. Catherine University (sirca006 umn.edu). He is a staff attorney with the Public Health Law Center at Mitchell Hamline School of Law.

*This blog reflects the personal views of the author and not that of any organization.

“Why does this matter?” is not the question any professor wants to receive in their first class of the term, and yet, in the realm of global health and human rights, it is a question that never truly disappears. My students signed up to learn about global health law, global health governance, and human rights, and I was eager to bring in the brilliant work of scholars to guide critical discussions. But this moment demands more than academic discourse; it demands a reckoning with the chaos unfolding around us. As the Trump Administration methodically dismantles essential funding, cripples global health infrastructure, and reshapes governance structures to reflect a narrow and partisan agenda, we must confront a reality many had hoped to never see again: the erosion of international cooperation and the unraveling of decades of progress.

The devastation is immediate and tangible. Friends and colleagues have lost jobs; irreplaceable funding for research and programs has disappeared overnight; organizations worldwide are being forced to scale back their efforts, risking worsening health outcomes and deepening disparities. The reinstatement of the expanded Global Gag Rule (also known as the Mexico City Policy) is likely to mirror what we saw the first time the Trump Administration instituted this policy, which led to the closure of clinics and cut maternal and child health programs in sub-Saharan Africa and Latin America, stripping reproductive health services from millions. The first, particularly during the COVID-19 pandemic, disrupted global disease response mechanisms at a critical time -  and is likely to do so again this second time. Even temporary funding suspensions have meant missed treatments, interrupted care, and lives put at risk.

The United States has never been the most reliable partner in global health - even as it stood among the largest funders - but many of us clung to the expectation of at least some degree of stability. Priorities may always shift, but what we are witnessing now is a wholesale assault on the institutions and expertise that global health depends on.

As an American public health lawyer, trained in Global Health Law, who has twice now confronted a stormy sea-change in prospects for this important space, let me echo these words to my colleagues the world-round: our government is unreliable, and you should not trust the US. We have squandered 80 years of US-led or US-supported international order, and even if things change with a new administration in four years, we have shown that many Americans will embrace a charismatic leader who embodies some of the worst sentiments humanity has to offer.

And, despite everything we are witnessing, I remain hopeful. At no point in the brief history of global health law has it been more important to mentor students on the problems in global public health and cultivate their empowerment for addressing them. Grief for the former order must not end in despair; it falls on us educators - and practitioners - to not only keep the faith that global health matters, but to boldly propose new paths that we and our next-generation leaders can pursue.

Resilience: Upholding the Right to Health Amidst Instability

Global Health Law and global health governance have always been shaped by instability. From pandemics to political upheavals, progress in public health has never been linear. Today’s students must be trained not only in legal principles and policy frameworks but in the art of adaptation. The right to health, enshrined in international treaties and human rights law, provides a powerful framework for resilience. Even as governments retreat from their obligations, human rights principles offer a legal and moral foundation for holding them accountable.

One way to foster resilience is to emphasize historical parallels. Global health has been upended before - by economic recessions, by ideologically driven funding restrictions, by sudden geopolitical shifts. The 2008 financial crisis led to severe cutbacks in public health funding, and prompted countries and organizations to better plan for sudden and significant financial challenge. The Bush Administration’s initial restrictions on HIV/AIDS funding, tied to abstinence-only programs, were later countered by bipartisan support for PEPFAR and ultimately dropping the requirement to fund abstinence-only programs. The current crisis, egged on by political determinants, demands similar adaptive strategies from today’s global health leaders.

Resistance: Using Human Rights to Challenge Harmful Policies and Rebuild Global Health Norms

Teaching resistance is not about partisanship; it is about equipping students with the tools to challenge and counteract harmful policies that undermine health and human rights. Whether through legal advocacy, coalition-building, or direct engagement with affected communities, students must see themselves as active participants in shaping global health governance rather than passive observers. The right to health, recognized in instruments such as the International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of the Child, serves as both a shield against regressive policies and a sword for advancing equitable health systems.

This requires a focus on advocacy strategies. How have past global health movements successfully pushed back against restrictive policies? Lawsuits, rallies, and public pressure may not always succeed, but that they can succeed counts for something – even in places with challenging legal environments for health. Countries and organizations have stepped up to fill funding gaps and provide technical expertise, ensuring that critical programs continue despite U.S. disengagement. Human rights advocates are accustomed to adversity and lukewarm governments at the best of times, and the right to health for people living in places that work closely with the WHO and other global health partners will continue to be championed.

Resolve: Strengthening Global Health Governance Beyond the United States

If there is one certainty in this moment, it is that the global health system must become less dependent on the political whims of any single country. Since the 1940s, international health initiatives have been structured around the assumption of stable U.S. leadership – whatever form it took. But, that era is over, and thinking of Trump as an outlier and not the harbinger of a new form of American politicking is a mistake. In style and in affinity for right-wing populism, we can see in Europe, Asia, Latin America and Africa that a shift is underway; the post-World War II international order, under which many of us have been born, raised, and committed careers to strengthening, is neither impervious nor immune. The work ahead is not just about mitigating loss or building a bridge over the gap, but about reimagining a new and more resilient global health framework—one that is not vulnerable to the next U.S. election cycle, or any other country’s domestic politics. Human rights principles and human rights law can and must serve as a foundational principle for this reimagining.

This means supporting alternative funding models – like the decentralized 1 Dollar 1 World campaign, bolstering the role of civil society in regional and global health mechanisms, and training students to think beyond the traditional power structures that have dominated global health. The EU’s leadership in financing COVID-19 vaccine distribution, particularly in the absence of U.S. support, is an example of how global health governance can shift. African Union health initiatives have gained momentum, demonstrating that regional leadership can fill critical gaps. Public-private partnerships may rise to the occasion as fulfill greater roles in both global health financing and delivery, and could be encouraged to do so – while, at the same time, advocates and global governance bodies develop rights-based rules to ensure private actors are advancing human rights and accountable for their actions.

The goal is not just to repair the damage done, but to create a system that can withstand future crises. By embedding human rights protections into global health law and governance structures and diversifying those structures and who has a voice within them, we can ensure a more just and equitable system that does not depend on the goodwill of unreliable state actors.

The Work Begins Now

This moment is devastating - but it is also clarifying. It is a reminder that global health cannot rest on the whims of a single government. Our students will be the ones to build a more robust future for global health law, one that is not beholden to unreliable actors. Perhaps some of them will go on to be the leaders we need, taking with them these hard-earned lessons and applying them in ways we cannot yet imagine. That work begins now—and it begins with a steadfast commitment to the right to health, as with all human rights, as a universal and inalienable principle. That is something worth fighting for, wherever and for however long it takes.