Greer Scott L, Jarman Holly, Kulikoff Rachel, Panteli Dimitra, van Ginneken Ewout, Wismar Matthias
Health Management and Policy, Global Public Health and Political Science, University of Michigan School of Public Health, Senior Expert Advisor on Health Governance, European Observatory on Health Systems and Policies, Ann Arbor, MI, 48019-2029, USA.
Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, 48019-2029, USA.
Health Policy. 2025 Aug;158:105350. doi: 10.1016/j.healthpol.2025.105350. Epub 2025 May 18.
The second Trump administration has already made major changes in US policies that affect health and health systems worldwide.
We use the Health System Performance Assessment categories developed by the European Observatory on Health Systems and Policies to identify areas in which US actions affect the health systems and policies of European states and the EU, and presidential Executive Orders supplemented by campaign statements to understand US actions.
We identify relevant US policies in the areas of finance, resource generation (regulation, vaccines, artificial intelligence, supply chain resilience, workforce, research, education) and governance (geopolitical turbulence, climate change, US departure from the World Health Organization, and foreign aid). We then identify opportunities for states or the EU to strengthen their health systems, potential threats to their health systems that might arise from US actions, and serious confirmed threats.
The second Trump administration is creating heavy demands on European governments in many areas, which might undermine their fiscal capacity and willingness to fund health systems or new ventures, but diminished US investment in areas such as multilateralism, pandemic response, research, education, and aid (especially in areas such as gender and reproductive health) all create opportunities for European policymakers to strengthen their health systems, health-related economic sectors, and influence in global health governance.
特朗普第二届政府已对影响全球卫生与卫生系统的美国政策做出重大改变。
我们运用欧洲卫生系统与政策观察站制定的卫生系统绩效评估类别，来确定美国行动影响欧洲国家及欧盟卫生系统与政策的领域，并利用总统行政命令辅以竞选声明来理解美国的行动。
我们确定了美国在金融、资源生成（监管、疫苗、人工智能、供应链韧性、劳动力、研究、教育）及治理（地缘政治动荡、气候变化、美国退出世界卫生组织、对外援助）等领域的相关政策。然后，我们确定了各国或欧盟加强其卫生系统的机会、美国行动可能对其卫生系统构成的潜在威胁以及已确认的严重威胁。
特朗普第二届政府在许多领域给欧洲各国政府带来了沉重负担，这可能会削弱它们为卫生系统或新事业提供资金的财政能力和意愿，但美国在多边主义、疫情应对、研究、教育和援助（特别是在性别与生殖健康等领域）等方面投资的减少，都为欧洲政策制定者加强其卫生系统、与卫生相关的经济部门以及在全球卫生治理中的影响力创造了机会。
