By RICHARD SKOLNIK
White Rock

Healthcare providers have a special obligation to follow data, science, and evidence. Thus, I remain deeply disappointed at the content of Dr. Lisa Shin’s letters to the editor.

In her latest letter to the editor (link), Dr. Shin ignores the impact on the federal budget of the “Big Beautiful Bill Act.” The non-partisan Congressional Budget Office (CBO) has just estimated that the Senate Bill would add $3.9 trillion to the federal deficit from 2025 to 2034.

Dr. Shin should also note that the annual growth rate of GDP in the US since the late 1940s has been higher under Democratic administrations than under the Republicans. In addition, only two modern presidents had a balanced budget or a budget in surplus, both Democrats – Lyndon Johnson in 1969 and Bill Clinton from 1998 through 2001.

Moreover, there is no evidence the “One Big Beautiful Bill Act” will spur economic growth. By contrast, there is considerable evidence it will not spur growth but will spur additional inequity. The organizations that Dr. Shin cites have consistently been wrong in their support for what is called “Voodoo economics” for a reason.

I am happy to say that Dr. Shin and I agree that the US needs to reduce the burden of chronic disease and encourage healthier eating. I spent much of my career working on such matters in countries in Africa and South Asia.

However, I am appalled that Dr. Shin fails to mention the extraordinarily cruel attack that the Trump administration has launched on our health and the health of people globally:

• Trump, Rubio, and Kennedy have decimated global health programs under USAID that have a long record of success. Nature magazine estimated that the cuts to USAID could lead to 25 million excess deaths in the next 15 years. Diseases against which progress has been made will grow and threaten us, as well.
• Kennedy has stopped US contributions to GAVI, The Vaccine Alliance, one of the most successful global partnerships in history. As a result of financing gaps, more children globally will get and die from hepatitis B, measles, rubella, and pertussis. The effort to eradicate polio will be set back, as well. If Dr. Shin cares about cancer, why isn’t she shouting from the rooftops about likely cuts to GAVI’s support for the HPV vaccine – which has reduced the cervical cancer rate by 90% in vaccinated populations?
• Kennedy, a long time anti-vaxxer, has begun to unravel the US vaccine program. Outside of customary procedures and largely ignoring science, he changed eligibility guidelines for the COVID vaccine. He has fired the members of the Committee on Immunization Practices and stacked the new committee with people who are anti-vaxxers and have no background in science, medicine, or epidemiology. We should expect to see recommendations on vaccines that are not science-based, more vaccine hesitancy, greater difficulty in accessing vaccines, and less insurance coverage for the vaccines we do want.

If Dr. Shin really wants to “work for a healthier society,” I encourage her to pay attention to data, put science and evidence in the forefront, and work to correct the inhumane and misguided policies above. In addition, she should be fighting against other Trump/Kennedy attacks on our health, such as the rolling back of tobacco control efforts, the cuts in NIH funding, the cuts to CDC, the decimation of our 80 year-old program of university-based medical and public health research, and the millions of people who will lose health insurance.

Note: Richard Skolnik is the former Director for Health, Nutrition, and Population for South Asia at the World Bank. He was a Lecturer in Global Health at The George Washington University and Yale, where he still holds an appointment, and the Executive Director of a Harvard AIDS treatment program for three countries in Africa. Richard is also the Instructor for the Yale/Coursera course Essentials of Global Health and the author of Global Health 101, Fourth Edition. The opinions expressed in this commentary are Richard’s alone.