Exclusion vs Inclusion

My perspectives stem from conscious thinking, science, nursing, and public health. My target audience is everyone, so the language is as non-medical and neutral as possible. I challenge my readers to dream, imagine, and consider contradictions and controversies, encouraging them to make their interpretations. As an opinion column, it is not data-driven and is not intended to replace any research study.

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President Donald Trump signed an executive order beginning America’s withdrawal from the World Health Organization (WHO). Today’s discussion will focus on this public health concern: Exclusion vs Inclusion.

First of all, let us briefly revisit WHO.

WHO is an intergovernmental organization established in 1948. Its primary mission is to improve global health by expanding health coverage and responding to public health emergencies. WHO is governed by 194 member states divided into six regions. These regions are:

1. Region of the Americas/ Pan American Health Organization

2. African region

3. European region

4. Eastern Mediterranean region

5. South-East Asia region

6. Western Pacific Region

Each region has a regional office coordinating with the countries in that region and responding to public health activities. This organization strives to deliver health care impact globally, covering a triple-billion-person population. This includes health care coverage for one billion, emergency response for one billion, and one billion people experiencing good health.

One of the key functions of health care coverage is conducting vaccine coverage.

WHO promotes and delivers vaccination for:

· Measles

· Polio

· Cholera

· Meningitis

· Yellow Fever

· New and Emerging threats

Measles and Polio are covered globally, and other vaccines are covered in the regions where these healthcare problems prevail. Healthcare emergencies are handled by preparing, preventing, detecting, and responding when issues arise.  

Historically, WHO has worked to eradicate Smallpox and reduce Polio, Malaria, and Trachoma. WHO was the leading international health organization to combat the following global health crises:

· HIV epidemic that began in the 1980s.

· Zika virus outbreak that began in Brazil in 2015.

· Covid virus outbreak that began in China in 2019.

· Monkeypox outbreak that began in London, UK, in 2022.

When we exclude ourselves from the safety net of the global health umbrella, we are compelled to foresee the consequences that may come shortly. As a separate country, we may say we have our healthcare-regulating national organizations, such as the Centers for Disease Control (CDC), National Institutes of Health (NIH), Food and Drug Administration (FDA), and the American Public Health Association (APHA). According to the U.S. Census Bureau, as of 2023, the U.S. had 47.8 million foreign-born residents, which accounts for 14.3% of the total population. With a significant increase in the travel and tourism industry worldwide in recent years, the global movement of vector-borne illnesses and communicable diseases is extremely high. It is imprudent action to exclude oneself from health concerns worldwide. For a nation built with more than one generation of immigrants, it will be a grave situation to isolate from international collaboration.

This calls for caution and warrants action for the Center for Disease Control (CDC), National Institute of Health (NIH), Food and Drug Administration (FDA), and the American Public Health Association (APHA) to come forward and take initiatives regarding tropical illnesses such as Malaria, Chagas disease, yellow fever, dengue fever, schistosomiasis, and other vector-borne illnesses. Vaccination coverage will be a challenge to partake. In addition, these organizations will now be isolated and need to take extra measures to be able to respond to any public health emergencies.

Most of all, healthcare workers on the frontlines exposed in outpatient or inpatient settings such as clinics, hospitals, long-term care facilities, nursing homes, and hospices will all be affected by this exclusion. We will be the last to know if any epidemic is happening outside the country.

On the other hand, the US is the largest donor to WHO. Resources, workforce, and outreach capacity will be massively reduced if the US removes itself from WHO. The United States may still be able to collaborate with a few countries, but not all six regions covered by WHO.

WHO acts as a leading body that coordinates worldwide by:

· Monitoring

· Gathering data

· Developing guidelines

· Providing vaccines, medicines, and supplies

· Providing workforce or assistance.

The US will not be able to perform healthcare activities on such a scale, and when the crisis hits home, we will regret our decision to isolate ourselves from the rest of the world.

Therefore, I request my readers to contemplate and be concerned about this significant public health issue, take the initiative to speak, and let our voices be heard.

Let us all come together and serve humanity together.