America First in Global Health and High-Level Week at UNGA
September 26, 2025
Editors' Note
On Monday, Annalena Baerbock, only the fifth woman to preside over the UN General Assembly (UNGA) in its 80-year history, ushered in High-Level Week. Citing the desperate need to address crises and conflicts such as those in Gaza, Haiti, and Ukraine, Baerbock said, "This eightieth session is not about big celebrations. It's about finding the resolve to not give up. The resolve to be better together."
That togetherness stood in contrast to President Donald Trump's remarks to UNGA, which questioned the efficacy and purpose of the United Nations and multilateralism. His speech mirrors the provisions outlined in the recently released "America First Global Health Strategy." The plancalls for the U.S. government to negotiate bilateral agreements on global health, circumventing multinational institutions and nongovernmental organizations.
To lead this week's edition, former U.S. Coordinator for Global Health Security at the National Security Council Stephanie Psaki, CFR's Bloomberg Chair in Global Health Thomas J. Bollyky, CFR Senior Fellow Prashant Yadav, and CFR Research Associate Elena Every detail what the America First strategy could mean for supply-chain reforms, transnational threats, and congressional oversight on global health spending.
Continuing the conversation, Chatham House's Ebere Okereke outlines how Africa should respond to the strategy, given how it reframes U.S. health assistance from a global public good to a strategic asset deployed in pursuit of national advantage.
Next, a trio of articles unpack the future of multilateralism in the arena of global health. Bollyky and CFR Research Associate Chloe Searchinger remind governments that UNGA is an opportunity to shape global health cooperation and establish common ground. Chatham House's Emma Ross advises European countries to build coalitions with regional global health groups to adapt to a new model of polycentric health governance and minimize the risk of uneven preparedness. Turning to Latin America and the Caribbean region, Victoria Costoya from the Argentine Council on International Relations explores why preserving the integrity of the World Health Organization (WHO) and Pan American Health Organization (PAHO) is "not optional but a strategic necessity."
The newsletter wraps with a pair of articles set to the theme of UNGA's high-level meeting on noncommunicable diseases and mental health. Zooming in on Mexico, Eric Crosbie from the University of Nevada, Reno, outlines how Big Industry blocks and weakens regulations for tobacco and alcohol. TGH then travels to India, where clinical pharmacologist Sameer Khasbage explains why the country lacks access to mental health treatments, despite it producing nearly 20% of the world's generic medication.
Until next week!—Nsikan Akpan, Managing Editor, and Caroline Kantis, Associate Editor
The real cost of U.S. withdrawal and multilateral retreat is in deaths, lost opportunities, and the degradation of human capital in countries that can least afford it
