The second Trump administration has shaken the foundations of US leadership in global health, with this column assessing rapid shifts in global health governance. By analyzing how the administration’s anti-science ethos, foreign assistance cuts, and multilateral disengagement have undermined global solidarity, the column considers the destabilizing impacts on global health and examines how other states, regional bodies, and international organizations are responding to this US decline. This examination reveals both strains for global health promotion and resilience within a changed governance landscape.
