Healthcare workers were covered in Personal Protection Equipment (PPE) and wore double N95 masks cutting into the back of their ears. Some nurses and doctors shared their frustrations and grief but, for many, emotions could be seen solely in their eyes. Eyes became the only windows into seeing each other’s emotional spirit, and it was dwindling. The COVID-19 pandemic pushed healthcare workers to the breaking point, contributing to a healthcare provider shortage that is still vastly impacting medical institutions today. Although many people have moved on, choosing to forget COVID-19, its consequences are still reverberating. COVID-19’s impact did not just linearly diminish as the number of cases decreased. Therefore, the world cannot just ignore the statistically significant possibility of a future pandemic. 

The memories of COVID-19 cannot be shoved under the carpet; living in a false safety that this circumstance will not happen again is an extreme collective denial. Rather, it is vital that the world rebuilds with a new approach to protecting the global population from the next possible source of a global pandemic, what has become more commonly referred to as Disease X. 

Disease “X” is the World Health Organization’s (WHO) coined term for an unknown pandemic pathogen. This is a placeholder concept the organization has created for a pathogen that has not yet mutated into a global outbreak but could do so in the near future. Disease X was first introduced in the WHO 2018 Annual Review of diseases prioritized under the Research and Development Blueprint. The Disease X term was needed to discuss the threat of a hypothetical pathogen that is not known or exists yet. It is still largely debated whether COVID-19 (SARS-CoV-2) should be considered the first pathogen given Disease X classification. In fact, experts are also discussing whether COVID-19 is just a small taste of what is to come with a far more fatal Disease X. Ultimately, the Disease X concept is considered a pathogen which will hold the right characteristics and ingredients to create another global pandemic. Recognizing the growing threat, the scientific community has turned its attention to defining which types of pathogens the international community should be urgently monitoring. 

For instance, there is specialized focus on zoonotic diseases as the next possible source of Disease X. It takes what is known as a zoonotic jump for an animal virus to become transferable and infectious in human beings. The Center of Disease Control states that an estimate of  “more than 6 out of every 10 known infectious diseases in people can be spread from animals” whilst “3 out of every 4 new or emerging infectious diseases in people come from animals.” These statistics highlight that, in most cases, zoonotic spillover is an inevitability not an anomaly. 

This is especially the case since the boundaries between species have become increasingly  entangled because of deforestation, industrial agriculture, the wildlife trade and climate change. Environmental pressures and human behavior should not be overlooked when addressing zoonotic disease solutions. Notable origins of diseases from animals include Ebola virus, where bats are the suspected virus reservoir; Creutzfeldt-Jakob disease, the human form of the prion disease Bovine Spongiform Encephalopathy (mad cow disease); Zika virus, which is transmitted by mosquitoes; and Avian influenza (bird flu), which originates in birds. These examples illustrate a disease landscape that could serve as the origin of Disease X and has well-established precedent.

Another potential source of Disease X that needs to be scrutinized is an engineered pandemic pathogen. Carl Jung, an influential Swiss psychiatrist and psychotherapist, warns that the “only real danger that exists is man himself.” Bioterrorism is a threat to humans created by humans. Alongside nuclear weapons, bioterrorism has become a new missile in the self-destruction toolbox. The development of biotechnology has allowed for advancements in many health sectors such as pharmaceuticals and vaccines. However, it has also made engineering pandemic pathogens that can be customized to have high virulence and fatality rates possible. During the cold war, viral agents were stockpiled as militarized weapons in the US and the Soviet Union. Viral bioterrorism puts everyone at risk and, whether the release of a bioengineered Disease X could be intentional or accidental, the impact would be globally devastating. 

All these factors suggest that Disease X is not a question of if it will cause the next global pandemic — it is a question of when.

Given this, organizations like The Coalition for Epidemic Preparedness Innovations (CEPI) have identified 25 different virus families that can serve as the host to the next deadly virus. CEPI hypothesizes that Disease X will come from one of these twenty-five different virus families. CEPI’s “100 Days Mission” aims to achieve the ability to respond to the next Disease X pandemic in just under three months by preparing globally accessible vaccines.  The 100 Day Mission is centered around swift and equitable vaccine deployment that will defend those at highest risk in order to stop the spread of an outbreak. Their research on “the most wanted viruses” provides a library of prototype vaccines to preempt the need for the next crucial vaccine by ideally supplying the world with an expedited prophylactic vaccine to contain the spread of the next pandemic. CEPI’s current diversification into the unknown of the 25 families is reimagining pandemic prevention in research. 

The Coalition for Epidemic Preparedness Innovations was born after the Ebola outbreak highlighted just how ill-equipped state and non-state actors are at containing epidemics. The WHO is often criticized for their inefficient reaction and response to the 2014 Ebola outbreak. The WHO did not have efficient intergovernmental cooperation nor the proper funding needed to execute a cohesive effective response. The Ebola outbreak sheds light on the significant gaps in the global health system, harkening the need for an innovative multifaceted approach to respond to epidemics and pandemics. Ebola should have been the wake-up call. Now, the COVID-19 pandemic is the writing on the wall. 

The COVID-19 Pandemic exposed global governments to a new crisis, a war against a common enemy — a virus. 

Sovereign states have the responsibility to protect and provide for the population in crisis. During the COVID-19 pandemic global health security was threatened. However, instead of nations banding together to contain COVID-19, there was global division and politicization of healthcare. The pandemic introduced two predominating questions: who was responsible for COVID-19 and what international actors were going to contain it? 

There needs to be a new framework to instill global cooperation, one that begins with framing viruses as a shared enemy rather than a localized problem. This reframing shifts responsibility not only to individual nations or institutions, but to collective action by changing the narrative to global commitment and shared responsibility. COVID-19 could have been a moment of unification, but it became a moment of polarization. This was not just seen on a global scale. Personally, many people in my own community that didn’t have immunocompromised family members decided it was not their responsibility to protect people from the spread of the virus. This is why framing the virus as a shared enemy and responsibility could create a stronger collective action against the next pandemic. 

 After World War II, global cooperation created the United Nations to prevent future conflict and another devastating world war. The U.N. served as a preemptive measure to ideally maintain peace and established a permanent institution for conflict resolution. Over time, the U.N. has become a platform for diplomacy and has helped shape postwar international order. In addition, the U.N. launched specialized agencies such as the World Health Organization (WHO), founded in 1948 to address global health issues. The WHO was established from the premise that health is inseparable from peace and security. Ten years after the WHO’s Constitution was created, the Soviet Union (USSR) proposed a WHO-led smallpox eradication program that would become a profound example of global health governance. In 1977, the last confirmed case of smallpox was identified and, by 1980, the WHO declared smallpox eradicated. This success was attributed to a moment of unprecedented global political commitment, even during the height of the Cold War, where the US and the USSR both agreed upon this shared goal of eradication. The program’s strength lay in its measurable objective for complete eradication thus countries systematically reported case detection and worked with the WHO. Nations shared the responsibility by sharing resources. The program had political backing and funding for over a decade. The WHO had a Smallpox Eradication Unit that was led by experts in the field like Donald Henderson, who later founded the Center of Civilian Biodefense Studies at Johns Hopkins. The smallpox eradication campaign can serve as a powerful model for international cooperation. Smallpox remains “the only infectious disease to achieve this distinction.”

The evolution of the WHO and the International Health Regulations (IHR) have made expansive strides in global healthcare. However, the accelerating pace of globalization and the changing global health landscape have revealed critical limitations. The WHO struggled to enforce effective governance during the COVID-19 pandemic. It was unable to coordinate an international response, delayed declaring COVID-19 as an international emergency and was not able to hold nations accountable for disease surveillance and timely reporting. The COVID-19 pandemic revealed domestic political agendas which led to a fragmented response and its politicization fueled skepticism on scientific advice globally. What this highlighted is that the WHO has arrived at a critical inflection point where the future of successful pandemic response must be able to transcend political pressures. 

Although the WHO has had a historical commitment to global health, another moment of international solidarity is needed — one where a global crisis becomes the catalyst for cooperation just as World War II served as the platform for creating the U.N. A virus may not be treated as a world war, yet its global consequences and strains are not unlike the destructive impacts of warfare. There are extensive fatalities, governmental instability, economic implications and a shared sense of fear and crisis. So, why isn’t there an international institution or organization solely dedicated and committed to preventing the next global pandemic? 

In 2015, Bill Gates performed a TED Talk where he outlined that the world is not prepared for a pandemic. Fast forward 10 years to today in 2025 the global health system is still not prepared for a pandemic. 

Bill Gates has now proposed a systematic multifaceted solution to prevent the next global pandemic. This solution is the Global Epidemic Response and Mobilization (GERM) team. 

The GERM team would be a permanent institution and organization that can combat and coordinate rapid responses to new potential infectious outbreaks. Ultimately the GERM team could be seen as another functional unit of global cooperation and governance. Additionally, they would be coordinated with the WHO. The GERM team would become a multinational unit that comprises over 3,000 full time specialists in epidemiology, vaccine development, genetic engineering, data science, computer simulation, emergency medicine, communications and diplomacy. The GERM team would be actively monitoring and researching threatening outbreaks. Disease X would be contained before it becomes a global health threat. Bill Gates states in his TED talk that if COVID-19 was caught in the first 100 days it would have saved over 98% of the lives lost. The first 100 days are crucial to stop the spread of an epidemic and the GERM team would be equipped to do so. 

The GERM team is an exemplary theoretical model solution that can transition into becoming a groundbreaking reality. For the GERM team to come into fruition it needs funding. Governments spent an immense amount of funds during COVID-19. Money was poured into economic relief programs, healthcare infrastructure and other aid response measures. The U.S government spent 4.6 trillion dollars and created the Coronavirus Aid, Relief and Economic Security (CARES) Act during the pandemic. The International Monetary Fund (IMF), a major U.N. financial agency, estimates that COVID-19 has cost the world around 14 trillion dollars. To put the GERM team’s funding into perspective, spending money on the GERM team now would save nations from spending trillions of dollars later. The GERM team will cost the world 1 billion dollars annually to maintain all the resources and on-the-ground manpower. This is a worthy investment for the survivability of our future. To apply Bill Gates’ motto here — “This is the billions we need to spend in order to save millions of lives and trillions of dollars.”

The funding needed for the GERM team would have an expansive impact beyond stopping Disease X. It could provide another opportunity to advance medical tools for efficiency in many different specialties. To prepare to prevent a pandemic there needs to be investment in diagnostic tools, vaccines and deliverance which will subsequently address health disparities and global accessibility. A case study on microneedle patch vaccines exemplifies the reach the GERM team could have on closing the health security gap. 

The GERM team would fund new research in vaccine deliverance such as microneedle patches. Microneedle patch vaccines provide an efficient delivery system to the dermis and epidermis layers of the skin. Research on this deliverance method has shown higher immunogenicity for some vaccines than the traditional intramuscular needle route. Microneedle patch vaccines could revolutionize immunization strategies because it allows fast global vaccine deployment and mass production. More importantly, this vaccine method does not need large infrastructure or manpower to distribute. The vaccine patches do not require refrigeration, making delivering vaccines in remote areas and rural regions easier, thus improving accessibility. As illustrated, the GERM team’s impact on healthcare development could provide more than just pandemic prevention but could also help remedy the gaps in global health security that disproportionately devastate populations that do not have access to proper healthcare infrastructure. New diagnostic tools and therapeutics, disease surveillance, strengthening existing healthcare infrastructure in low-income countries and pathogen genomic data sharing are just a few more examples of how the GERM team’s impact addresses narrowing the health gap. 

In this era of increasing interdependence between nations, international institutions play a critical role in global governance and are vital forums to address global crises. The United Nations, the World Health Organization and the World Trade Organization are international institutions that are fundamental to global stability in governance, economy and health security. Yet the capacity to respond through these institutions has been undercut by political resistance. The Trump administration, for example, has demonstrated a strong aversion towards global multilateral commitments and institutions. Recently, the administration has cut thousands of programs under the United States Agency for International Development (USAID). USAID has long supported global health, education, humanitarian relief and economic development for nations recovering from conflict or disaster. Increased efforts to defund and discredit governmental agencies and organizations such as the WHO have further politized healthcare and weakened international cooperation. The GERM team could have direct funding that could be insulated from shifting political pressures which would bypass bureaucratic delays and geopolitical conflicts. Detailed frameworks for pandemic response are still under development, but the most important promenet is addressing the governance and enforcement gaps by embedding pandemic preparedness into the core agendas of nations. 

The current geopolitical climate has revealed the fragility of global health governance within the hands of today’s leaders. The tension underscores the relevance of Complex Interdependence Theory, founded by Keohane and Nye, which establishes a framework where states are not solely driven by military power or security concerns. Instead, nations are deeply interconnected through shared economies, trade networks, security interests, technological advancements, international institutions, shared health dependencies and environment (Keohane and Nye). States do not operate in isolation. While interdependence is a defining feature of global order, many states perceive it as a liability during global crises, precisely when collective action is most critical. Disease X will not happen in isolation either, it will thread itself through the web of international interdependence. 

 Globalization has fueled more interconnectedness among states, making global cooperation the cornerstone for global stability. A global pandemic is a wicked problem characterized by its complexity. It requires a multifaceted approach that necessitates international cooperation and robust global governance. A single nation is not able to stop a global pandemic alone, yet a single nation’s outbreak can trigger a chain reaction sending the world into crisis. The GERM team is strategically and uniquely positioned to interrupt the chain reaction. However, the question still remains: Who is responsible for Disease X? The answer is everyone — Disease X is our shared global foreign enemy, and it is our collective responsibility to confront it.

The views expressed in opinion pieces do not represent the views of Glimpse from the Globe.

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Of course, life in a wheelchair comes with its challenges, but I don’t see my wheelchair as a problem. Disabled people are the largest minority in the United States and also the one that any person can become a part of at any point. The issue is not being disabled, but that the United States is not set up for disabled people to thrive.

Disabled rights have an extremely long way to come, but that is not to say that strides have not been made. The Americans with Disabilities Act, or ADA, was passed in 1990 thanks to relentless efforts by thousands of disabled activists. This is one of the most famous – and one of very few – measures that the U.S. government has taken to protect the rights of its disabled citizens. As stated by the federal government, “The ADA guarantees that people with disabilities have the same opportunities as everyone else to enjoy employment opportunities, purchase goods and services, and participate in state and local government programs.”

This change is obviously not one that can happen overnight – and no one expects it to. However, it has now been over 30 years since the ADA was passed and disabled individuals still face significant barriers that prevent access to opportunities that the rest of the population is able to take advantage of. Examples of this exist in every sector that the ADA claims to address, but the most impactful in my life has been that of public transportation. There are elevators that don’t work and bus drivers who refuse to let wheelchairs on their bus, but that is to be expected. These are not things that can be completely eradicated and are just part of the disabled experience. 

However, the country’s most applauded public transportation system was not something that I expected to be so much of an issue. Visiting New York City for the first time as a full-time wheelchair user made me realize just how behind the city is regarding accessibility. Despite being the most popular transit system in the country, the New York subway is only 30% accessible and does not expect to reach 95% accessibility until 2055. The work to make the subway accessible began in the 1980s, yet within the subway system’s 472 stations, only roughly 150 are currently ADA-compliant.

Full accessibility requires time and money, but it also needs advocates. The simple fact is that disabled people are frequently ignored and their needs are seen as less important, if considered at all. However, the fight for accessibility cannot be one that is put on the back burner, and systems such as the New York subway must make this a priority rather than just a passive project that will happen eventually.

A Trump presidency, and the rise of anti-DEI rhetoric that has come with it, is deeply concerning in relation to the ADA and the general issue of disabled rights. Trump and the GOP have been framing DEI as a new concept and an unreasonable and pointless waste of resources. Trump’s executive order ending government DEI programs lists them as discriminatory efforts that lead to unfairness and inequality. The inclusion of DEIA (diversity, equity, inclusion and accessibility) in this executive order points out an intent to end equitable disability policy as well. Many anti-DEI voices claim that the elimination of these programs will not hurt disabled populations and that disabled rights will not be encroached upon. However, this is simply untrue. 

Accessibility and the ADA exemplify the principles of DEI, most prominently that of equity. The existence of a ramp into a building is equity – equality would mean leaving a set of stairs and leaving those with mobility issues to fend for themselves. This is equal, of course, but that does not make it fair. Many opponents of DEI argue that these policies provide unfair advantage to minority groups and give unqualified individuals opportunities that they do not deserve. However, systemic barriers exist and remain a problem for many people in the United States. 

Redlining was not ended in the United States until the passage of the Fair Housing Act in 1968, the gay panic defense is still permitted in 30 states and historical buildings do not face the same scrutiny from the ADA that others do. The United States presents itself as a progressive nation in many ways and one that has moved past its dark history of civil rights infringements. However, these sorts of things are not nearly as far in the past as we think. Brown v. Board of Education was passed in 1954 and integration remained a contentious issue for the decades following. Frankly, it is ridiculous to believe that wrongs like these could have been entirely fixed in less than a century. Hopefully, the United States will reach a point where DEI is unnecessary. This has not happened yet, though.

In the realm of accessibility, the United States continues to fail its disabled citizens. Although the ADA does exist, that does not mean that it is followed. Personally, I have been rejected from jobs purely because I am in a wheelchair. When I have reported this issue, the most that has happened is that the employer gets reprimanded, if anything at all. I have been turned away from classes I paid for because of an inaccessible environment and refused a refund. These are only some of the barriers faced by disabled people, and other marginalized groups, in the United States. Under Trump, I can only expect for these disparities to worsen. 

Trump’s disdain for disabled communities came into conversation in 2015 after he mocked a disabled reporter during a campaign rally. This has continued and on Mar. 20, 2025, Trump issued an Executive Order to abolish the Department of Education. Special education is guided by the DoE and countless protections for disabled students exist because of the DoE. With his long standing dispute against the DoE, Trump continues to present an air of indifference towards the ability of disabled people to succeed. 

By abolishing the DoE, Trump is effectively removing safeguards to ensure that disabled students have equal access to education. And, by removing all DEIA policies, he doubles down on this. First, the Trump administration is adding barriers to education. Then, the administration is making it harder for disabled people to find jobs. It is already legal to pay disabled workers a subminimum wage and, in 2022, the median annual salary for disabled workers was $46,877 while the median salary for non-disabled workers was $55,208. Even with DEIA policies, there remains a stark difference in the benefits that disabled employees receive. There is already a shocking number of barriers to employment access for disabled people and, by removing governmental support for these communities, Trump is making it even more difficult to succeed in a society that is not set up for disabled communities. The United States is not so far from its horrific past and the country has yet to right all past wrongs. DEIA makes this a possibility and gives hope to the millions of Americans who continue to face discrimination in the workplace.

The views expressed in opinion pieces do not represent the views of Glimpse from the Globe.

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The leader who has emerged in the months since the fall has been Ahmed al-Sharaa, a military commander who led the rebellion against Assad and former al-Qaeda member. His role in al-Qaeda is something that has raised concern on a global stage, though Sharaa cut ties with the group in 2016. The United States has designated Sharaa, previously known as Abu Mohammed al-Golani, as a terrorist when, in 2011, he established a new Syrian branch of al-Qaeda called the Nusra Front. Sharaa refused to bring the Nusra Front into ISIS in 2013 and, in 2016, the group was renamed to Jabhat Fateh al-Sham and broke off from al-Qaeda. Sharaa’s newest insurgent front is named Hayat Tahrir al-Sham (HTS) and is ultimately the group that toppled the Assad regime.

In 2013, while still maintaining ties with al-Qaeda, Sharaa named his intent for Syria to exist as a fundamentalist Islamic state, stating that religious minorities would have no room in the country. Since then, however, Sharaa has appeared to pull back from this intent, announcing in 2015 that he does not wish to target religious minorities or to create conflict with Europe or the United States. In 2023 and 2024, Sharaa showed little understanding for dissenters and was not known to show mercy. Although this may bear similarity to the Assad regime, HTS has shown far less suppression of those with differing beliefs and Sharaa has since maintained his commitment to a freer Syria. With the signing of a new transitional Constitution, Sharaa remains committed to the freedoms of expression and media and remains steadfast in his commitment to a unified Syria.

In a 2021 interview with PBS, Sharaa spoke with a U.S. news outlet for the first time. Here, he re-emphasized that he does not wish to infringe upon the security of Europe and America and criticized his designation as a terrorist, asking, “Terrorism, how do you define it? Today, every country has a terrorism list. Any person or party that the country claims is opposing it is automatically added to the terrorism list.” Sharaa also urged people to ask the question of why people join al-Qaeda and to understand how U.S. policy has driven many to join al-Qaeda. Despite al-Qaeda’s attacks on civilians, such as those on 9/11, Sharaa claims that he does not, and never has, supported external attacks on civilians and that he has never killed an innocent person in one of his operations.

Regarding Sharaa’s plans for Syria’s future, he has highlighted the need for unity and democracy within the country. Sharaa has been named as Syria’s transitional president and HTS has also declared that the Constitution will be repealed and the army and parliament will both be terminated. HTS seems to be planning a complete upheaval of the existing Syrian government and Sharaa has announced his intention to create a constitution for this transition period and to hold a national dialogue conference to discuss the future of Syria. 

As a result of the Syrian civil war, which began in 2011, parts of Syria have been controlled by various militia groups. This civil war began with Assad’s crackdown on pro-democracy protests and did not end until the regime was overthrown. Sharaa has announced that all rebel militia groups will be absorbed into the government and that, to promote unity, all guns held by non-state actors should be surrendered to the new government. Regardless of whether Sharaa’s intentions are in earnest, this will likely be a difficult endeavor and possibly one that will never occur. After 53 years under the iron fist of the Assad regime, Syrians are their militia groups have faced constant terror and threat from their government and can be expected to be distrustful of a future government, especially one led by a former al-Qaeda member and a man who advocated for a fundamentalist Islamic rule. 

Due to the 14-year civil war, it has been incredibly difficult to obtain accurate data about Syria’s population statistics. The numbers vary by source, but it is estimated that Syria’s population is 70% Sunni Muslim, 10% Alawite and 3% Shi’a with a variety of other religious minorities, primarily Christian denominations.Sharaa is a Sunni Muslim, something that has worried many Syrians and even caused some Shi’a Muslims to flee the country for fear that Sharaa will lead religious persecution efforts. Conflicts between Sunni and Shi’a Muslims have defined much of the recent history of the Middle East and it remains to be seen how tensions between the two will play a role in Syria’s future.

Throughout early March 2025, the Alawites, a religious minority in Syria, have experienced a surge in violence against them. This has been a fear among Alawites since the overthrow of Assad as the Alawites have been politically dominant throughout the entirety of the Assad regime. Bashar al-Assad, along with his father, was an Alawate and installed Alawite leaders in his regime, suppressing other religious groups. Because of this, Alawites are often viewed as more sympathetic to the Assad regime. On Mar. 6, 2025, on the coast of Syria, a group of Assad loyalists attacked, killing hundreds of civilians and security forces. Security forces then provided a defense against these pro-Assad fighters. A number of unknown fighters then came in, killing Alawites in, presumably, a retaliatory action. As of Mar. 17, 2025, the Syrian Network for Human Rights (SNHR) has reported at least 639 deaths as a result of the fighting on the Syrian coast. Following these events, Sharaa has called for peace amongst Syrians and promises that those responsible for targeting civilians will be held responsible.

With the changing landscape of Syria and the chaos within the country, the future of Syria remains unclear. Many have hope for the rule of Sharaa and many others worry that this will only continue division within the country and that this new rule will be no better than that of Assad. Sharaa holds firm in his hope for a united Syria, however, and the future of Syria remains hopeful, though unknown.

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Originally, the heart of this article centered around a nascent policy strategy by the Biden administration in regards to its lesser known allies and trade partners on the African continent. That policy, in my opinion, was likely to be continued under his chosen successor, Kamala Harris. However, due to a recent shift in the political agenda of the White House from Liberalism to Trumpism, the future relationship of the United States with the global south is now in question. Joseph Biden, despite his expansion of Trump-Era tariffs to protect domestic industry, was the furthest thing from an isolationist — in fact, it could be said that he is part of a fading generation of Democrat politicians who placed international cooperation and trade at the forefront of their political agenda, rather than focusing strictly on domestic politics. Still, both the African Union (AU) and Caribbean Community (CARICOM) have agency in regards to their trade and development strategies, and so despite a shift in U.S. interest in these projects, they may continue regardless.

On Sept. 7, 2024, Dr. Carla Bennett, chairman of the Caribbean Community, made a speech before Barbadian leaders and the press  in the capitol, Bridgetown. Dr. Bennett’s words, espousing the “vibrant pan-Africanism” and warm feelings between the Caribbean and African continent, at first seemed to be fairly standard pandering by an international leader. Amid the group of government officials and reporters, however, was an outlier — Okechukwu Ihejirika, chief operating officer of the African Export-Import Bank’s (Afreximbank) Caribbean office. 

Dr. Bennett’s words and Ihejirika’s attendance reflects a noteworthy trend of increasing political, economic, and social integration between the Caribbean Community (CARICOM) and the African Union (AU). The year prior to Dr. Bennett’s speech, Afreximbank constructed a representative office in Barbados with the purpose of helping facilitate Africa-Caribbean trade. African and Caribbean leaders have met consistently since 2020 with the goal of Caribbean nations diversifying their export portfolio and to becoming closer with their neighbors across the Atlantic Ocean. That being said,  CARICOM is primarily an insular organization, akin to the European Union. The primary goal is to coordinate foreign and economic policies among member states, as well as economic integration and relative freedom of movement. To that end, much of CARICOM trade is with other members, and the majority of external trade still goes to larger powers such as the United States and China. Though Caribbean trade with Africa is minimal at the moment, it is clear that this is a developing relationship that may take years or decades to fully coalesce.

While the Caribbean may be best known for its idyllic beaches, rich culture and luxury crops such as nutmeg and indigo, it should start to be considered as a hotspot for a changing global economic order. Although some may overlook its assets, CARICOM has 15 votes at the UN and sits on a vital trade route between the United States, Mexico, South America and West Africa. CARICOM also rests quite comfortably within the U.S. sphere of economic and political influence, with a number of military bases and multilateral trade agreements made between the two actors. The United States wishes to keep CARICOM friendly towards it, as a trade and security partner to bolster the economy, combat the illicit drug trade from South America and project naval power into the southern oceans. How then, does this new strategy of economic development through trade diversification fit into the American agenda?

Under the Biden administration, Democratic leaders were committed to continued trade liberalization in line with neoliberal values. However,  it was abundantly clear that the United States had competition, primarily from an ascendant China who reached out to the global south through a flood of public and private investments, trade agreements and land purchases for the purpose of trade and security. 

This strategy, known as the Belt and Road initiative, sought to tie nations of the global south to China through a mix of debt trap diplomacy and circular trade relationships, blocking the United States out of the region economically. The old trade order, in which U.S. economic dominance relied on open markets, is now in danger of fracturing under the pressure of increased regional integration, potentially shutting the United States out of a Chinese-led trade order. 

Fearing this, the United States has ramped up its own investments, particularly in the African continent. Biden’s cabinet directly named Kenya as a potential trade partner and a major non-NATO ally, a country that has recently become disillusioned with the Belt and Road after a disastrous railway project halted last year. On the Southern cone of the continent, U.S. and European governments have elected to help fund a railway that connects the coast of Angola with the African interior, rich in minerals integral to electric vehicle battery manufacturing. The potential for this project is enormous: Joe Biden already wants to bolster the U.S. EV industry, and diminish Chinese influence in a hotly contested region, rich in UN votes as much as minerals and luxury items, effectively killing two birds with one stone.

The Caribbean could serve as an excellent proxy for this continued United States-Africa partnership. Already kindred in identity (with founding visions based on the ideals of pan-Africanism and decolonization), CARICOM could become the source of a linkage for U.S. foreign policy toward Africa – increased cooperation with one region could coincide with increased cooperation in the other. Rather than being directly managed by the United States, this trilateral relationship grows under tacit approval from Washington, justified as part of an existing history of trade liberalization. Given proper attention and encouragement, a pro-United States trade bloc could have formed among Caribbean and African states, trading with each other as much as they traded with the United States. However, just this last month a bomb was thrown into these plans. Newly elected 47th President Donald J. Trump, a vehement isolationist and staunch anti-China politician, is ambiguous as to his policy regarding trade and investment to either region. For starters, these developments are marginal in the minds of the American people, with domestic matters and the wars in Ukraine and Gaza being the primary foreign issues of interest. Trump’s strategy may be unshackled by commitments to his constituency and may continue under different leadership, in the same way that Trump-era tariffs toward China were maintained under Biden. However, that may also mean a U.S. withdrawal of direct involvement in the growing Caribbean-Africa relationship. The Lobito corridor may lose funding, and the HOPE and HELP acts (which give preferential textile trading rights toward Haiti) may disappear in a tide of protectionism, a policy that seeks to protect domestic industries by shutting out competition via tariffs. However, the CARICOM-AU partnership is not necessarily dead in the water. 

Ignoring the economic incentives to continue working together, there are a number of security and political benefits for the Caribbean and Africa to reap from a continued partnership. A renewed Trump presidency brings the future of trade with the United States as a whole into question – shaking a dependency on American goods and services may lessen the blow should tariffs be implemented. Similarly, African exports are primarily oriented towards advanced industrialized countries such as China, the EU and the United States, often not focusing on developing nations overseas or even other African states. Afreximbank is already focused on developing inter-African trade, and developing a more diverse portfolio only helps to achieve further independence from the northern capital. In addition to these benefits toward sovereignty, unifying policy agendas in international institutions makes a CARICOM-AU bloc a formidable force to reckon with. Leaders have already cooperated on social issues such as petitioning for a formal program to institute reparations for African slavery, a feat that could potentially be replicated on other issues, ranging from civil conflict to economic development. 

Despite a potential setback in what could have been a geopolitical boon for the United States, CARICOM and the AU have no real incentives to end their burgeoning alliance. From trade to development to security to social issues, the two blocs have more similarities than differences, and it is in their best interests to continue cooperation through bilateral agreements and negotiations. Perhaps, this new dynamic may represent a shift toward coordination among developing nations rather than clamoring toward the world hegemons, as it becomes evident that the free trade order is more threatened than ever by protectionists in both Europe and the United States. What remains to be seen is how the new Trump administration wishes to engage with the winds of change.

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Lebanese citizens’ opinions on Hezbollah are varied and many are quite critical of the organization. Throughout Lebanon, Shia Muslims look at the group relatively favorably while Sunni Muslims and Christians have a much more negative opinion of Hezbollah. However, despite disagreements on the stances and actions of the group, 99% of Arabs agree that all Arab countries must cease contact with Israel in response to Israeli military action in Gaza. Hezbollah as an ideological entity is not necessarily well-loved, but it is also one of few groups committed to resisting the Israeli occupation. This then becomes a difficult issue for many Lebanese civilians as Israel continues its attempt to expand into southern Lebanon, in addition to Gaza and the West Bank. It seems that the only solution is the creation of an organization that will both have higher approval from Lebanese citizens and protect the country from Israeli occupation.

In this conversation of Lebanese support for Hezbollah, it is important to understand the religious makeup of Lebanon. While Lebanon recognizes 18 religious sects, there are three major factions, with 31.9% of Lebanese citizens identifying as Sunni Muslims, 31.2% as Shia Muslims and 32.4% as Christians. While all three groups are very close in size, it is interesting to note that Hezbollah is a Shiite group despite Shia Muslims being the smallest of the three largest religious groups. Shia Muslims are the largest group in Iran, however, which is the country responsible for the funding of Hezbollah.

Conflict between Sunni and Shia Muslims has been a cause of division throughout the Middle East, with major clashes in both Syria and Iraq. Despite 85% of Muslims identifying as Sunni and 15% as Shia, Sunnis have not dominated militarily and there remains a great sectarian divide in countries like Lebanon. Fear of conflict is not limited to one group, though, with 67% of Lebanese Muslims believing that Shia-Sunni tensions are a big issue. The emergence of Hezbollah has certainly not aided this and, despite having governmental representation, Sunnis and Christians alike feel as though Hezbollah as a governing entity does not represent them.

Notably, in September 2024, an Israeli airstrike killed Hassan Nasrallah, a Hezbollah founder who led the group for over 30 years. Despite disagreements over Hezbollah’s existence, Nasrallah was relatively well-liked due to his resistance to Israel, including overseeing the end of Israel’s 18-year occupation of southern Lebanon.

During an interview in September 1992, Nasrallah asserted that Hezbollah is a resistance party that opposes the creation of an Islamic Republic in Lebanon. Additionally, in their 1998 Statement of Purpose, Hezbollah says, “It should be clear that the kind of Islam we want is a civilized endeavor that rejects injustice, humiliation, slavery, subjugation, colonialism and blackmail while we stretch out our arms for communication among nations on the basis of mutual respect.” 

In the U.S. Counterterrorism Guide, Hezbollah has been classified as a terrorist group since 1997, a designation shared by the Arab League and the EU, among others. Since the group’s inception, it has been responsible for several terrorist attacks around the world. Hezbollah has bombed the U.S. Embassy in Beirut both in 1983 and 1984, with a total of 101 killed and at least 120 injured.

While Hezbollah was created to force Israel to cede its occupied Lebanese territory, the group has now morphed into a different sort of entity. Now, Hezbollah has transitioned from a military wing to a group with heavy influence in both Lebanese military action and politics. In addition, Hezbollah no longer solely targets the Israeli occupation. A prime example of this is the 1994 operation targeting a Jewish community center and killing 94 people in Buenos Aires. 
Since its inception, the United States has given Israel a total of $310 billion in aid, a vast majority of such being military. While the United States views the Hezbollah attacks as unprecedented, Hezbollah sees the United States as a proxy for Israel, funding the occupation of Palestine as well as southern Lebanon. As the United States continues to fund Israel’s attacks on Gazan civilians, a direct opposition to the goals of Hezbollah, it is difficult to see a future where Hezbollah’s terrorist designation is removed.

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Ukraine

After the election, Ukrainian president Volodymyr Zelensky congratulated Trump, saying he looks forward to a strong U.S. approach to global affairs. Trump has pledged to end the war in Ukraine but has revealed little plans on how he would do so. The United States provides the most aid to Ukraine out of any other country, and Trump, alongside his Vice President JD Vance have cast doubt on whether they would continue military aid to Ukraine. This would be devastating for the hopes of beating Russia, which is steadily advancing into Ukraine’s Donbas region. President Putin has not congratulated Trump, and re-iterated U.S. hostility towards Russia making them hesitant to make any statements on the future of the two countries’ relationship. However, given Trump and Putin’s friendly-ish relationship (possible collusion between Russian officials and Trump campaign members in 2016 and Trump calling Putin a “genius” for invading Ukraine), it would not be surprising for the Trump administration to reduce aid to Ukraine. Last week, President Biden sent Ukraine official approval to use American long-range missiles to strike deep within Russian territory, a move seen as Biden hedging against Trump’s future plans.

Hungary

Moving westward, another relationship that should be watched is that between Trump and Hungarian Prime Minister Viktor Orbán, a right-wing autocrat. Hungary and Russia are close, despite Hungary’s membership in the European Union and NATO. Hungary relies on Russia for gas and is refusing to let aid pass through Hungary into Ukraine. Additionally, Orbán was the only EU leader to endorse Trump for the U.S. presidency and flouted their close relationship. Therefore, under the new administration, Hungary might gain an influx of foreign investment from American companies or enjoy a closer economic relationship. These circumstances suggest there will be good relations between the United States and Hungary over the next four years. 

Poland

Another conservative leader, Poland’s President Andrzej Duda, congratulated Trump on his win. Duda wants to strengthen Poland’s relationship with the United States, but Poland is against Russia’s invasion of Ukraine, sending more than $3.5 billion to support Ukraine’s army. Duda’s main goal is to curry U.S. favor and keep the United States in NATO, so it’s no surprise that Duda has tried to become closer friends with Donald Trump. In April 2024, Duda and Trump met in New York City for dinner, and both shared positive sentiments, with Trump stating that he is “behind Poland all the way.” Thus, it would not be surprising to see Poland continue to schmooze up to the incoming president in the coming months. 

Czech Republic and Slovakia

The Prime Ministers of the Czech Republic and Slovakia, both populist conservatives, have welcomed Trump with open arms.

Petr Fiala, the Prime Minister of Slovakia, and President Biden have enjoyed positive relations, with the U.S. and Slovakia becoming closer over the past four years. The Czech Republic has continued sending military aid to Ukraine, but Fiala is growing weary as the war has surpassed its 1000th day. In September, he stated that Ukraine “will have to be realistic” about the growing possibility of ceding some territory to Russia, even if temporarily.

Fico has ended Slovakia’s military aid to Ukraine and opposes Ukraine’s bid to enter NATO. Slovakia is in the midst of a political crisis, with a sharp divide between Fico’s conservative government and the liberal opposition party. Fico has been consolidating power, undermining media independence, eliminating the office responsible for investigating political corruption and prohibiting protests. As such, expect to see Slovakia drifting towards an Orbán-style populist way of governing, to Trump’s delight.

The fate of Ukraine lies, in large part, in the hands of Trump and Vance. 

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Despite diligent efforts to contain the radiation, around 5.5 metric tons of radioactive water leaked from the area in February 2024. Although the water was successfully contained before escaping the premises, preventing the surrounding environment from being contaminated, TEPCO was unable to prevent the damage done to its reputation. 

While the initial reactions to the 2011 meltdown in the international sphere were mainly those of sympathy and a growing general weariness of nuclear power, the tone changed after Japan’s announcement that it would release the treated wastewater into the ocean beginning Aug. 24, 2023. The international community, specifically Japan’s neighbors, was furious about the decision as they believe the wastewater is still toxic; however, their outcries did not deter the Japanese government’s decision. The recent wastewater spillage of 5.5 metric tons occurred around half a year after the initial release of wastewater and only contributes more to the anti-dumping rhetoric present, fighting for a reversal of Japan and TEPCO’s initiative.

South Korea, arguably one of Japan’s most valuable neighbors due to the two nations’ respective alliances with the United States, has been one of the first and most vocal in calling out Japan’s actions. The relationship between the two countries has historically been incredibly tense and volatile, largely due to Japan’s colonization of Korea during World War II. To this day, both Japan and South Korea continue to harbor resentment towards one another, making cooperation between the two difficult. However, Japan’s decision to dump the wastewater was originally viewed as a unique opening for the South Korean government to better its relationship with Japan. Under Prime Minister Han Duck-soo, the South Korean government endorsed Japan and TEPCO’s dumping but was instantly met with outrage from the majority of the South Korean citizenry, who took to the streets to protest the endorsement. South Korea quickly switched its position to one of condemnation for Japan, increasing its number of trade restrictions on the regions around Fukushima.

Although the new South Korean trade restrictions harmed Japanese exports, specifically in the aquatic sector, China’s reaction to the wastewater dumpage was far worse. Unlike South Korea, the Chinese Communist Party did not waver in its response, instantly putting pressure on Japan to stop its wastewater disposal and banning aquatic goods from Fukushima and other surrounding prefectures. Ignoring the Chinese warning, Japan continued to carry out its plans, causing China to retaliate still further with a universal ban on all Japanese aquatic-based products. The import bans from South Korea and China, as well as several other countries, severely harmed Japan’s fishing sector, however, Japan’s overall economy remains strong.

Accusations about the immorality of wastewater dumping are constantly being thrown at Japan by its neighbors, but are the criticisms even valid? In terms of hazard levels, the International Atomic Energy Agency (IAEA) has consistently reported that TEPCO’s wastewater dumps have all been significantly below legal radiation limits. Likewise, the entire site is compliant with IAEA guidelines, even having an IAEA office on-site for constant feedback and monitoring. The recent radioactive water spillage was one of the only notable incidents during the entire decommissioning process of Fukushima Daiichi, meaning that such mistakes are a rare occurrence. This can be attributed to TEPCO’s commitment to prevent any accidents from happening twice, being aware of the dangerous nature of the hazards they handle. While it has not necessarily done a perfect job, TEPCO has made a large effort to keep Japan compliant with the rules of the IAEA, preventing further backlash from occurring.

In addition to verifying the levels of radiation in wastewater, the IAEA is also responsible for ensuring that radiation in fisheries and other aquatic resources remains at a safe level. As such, the fish and other products produced in Fukushima prefecture have been declared legally safe for consumption, contrary to public concerns.

In terms of the international community, the case against Japan becomes far weaker when considering that some of the dissenting countries, namely China, also have a history of releasing radioactive wastewater into the ocean. China’s wastewater has actually been shown to have higher traces of tritium, a radioactive isotope created from nuclear power plants, compared to Fukushima Daiichi.

International tensions surrounding Japan’s release of radioactive wastewater most likely do not, in actuality, stem from the perceived dangers of TEPCO’s operations, but rather from Japan’s difficult history with its neighbors. Due to the precarious relationship between Japan, South Korea and China, experts theorize that it is Japan’s colonial World War II background that created a lack of trust between it and the larger international community. Becoming a major colonial power, Japan managed to colonize parts of China, all of Korea and a large section of Southeast Asia. Aside from the colonization of the respective countries, Japan also enacted the policy of comfort women in the places they conquered, forcing women into sexual slavery in brothels. The horrors of colonization, pleasure women and other terrible acts still hang heavy in the minds of many South Korean and Chinese citizens, making cooperation between the three countries difficult—the situation of Fukushima Daiichi is but another part of this pattern.

While the Fukushima Daiichi meltdown was purely domestic, its consequences had an expansive international reach. With increasing pressures from rival nations, Japan’s attitudes towards Fukushima Daiichi need to shift or else their already strained relationships might reach a breaking point. Despite this, through cooperation with protesting countries, a common ground towards the disposal of toxic wastewater could be reached, ultimately resolving this decade-long issue.

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In a video she posted en route to court, she stated, “I am freedom… I am the oxygen you breathe. This autocratic regime wants to stop you from breathing. This autocratic regime wants to imprison freedom.”

Seng was arbitrarily detained on Jun 14, 2022. Over two years later, Seng’s lack of release is a haunting display of how democracy is failing our very own “Lady Liberty.” 

A survivor of the Cambodian genocide, Seng emigrated to the United States at age nine and went on to receive her B.S. from Georgetown University and J.D. from the University of Michigan. She then returned to Cambodia and founded two advocacy organizations, the Cambodia Center for Justice and Reconciliation and the Center for Cambodian Civic Education. In her advocacy efforts, she became a vocal critic of the reigning Cambodian People’s Party, particularly its leader, Hun Sen, and a proponent of the opposition party. 

Seng’s civic work was highlighted by the USC Shoah Foundation, an institute dedicated to collecting testimonies from subjects of genocide. This article outlined Seng’s triumphant journey from an orphan by the Khmer Rouge to the fiery political activist, lawyer and author she is today. Attached to this article is a headshot in front of a vertically columned building, a location eerily familiar to a USC student. This image was taken in front of the Dr. Joseph Medicine Crow Center for International and Public Affairs, the same building that houses classes such as International Courts and Globalization of the Law, Leadership and Democracy and Global History of War Crimes: Ethnic Cleansing and Genocide and Crimes Against Humanity. Although initially published just a paltry two months before her arrest, Theary’s photo with the backdrop of our campus now appears next to articles discussing her political suppression from news channels around the world. Seng’s continual detainment taints the walls of not only our capital but our campus, too. 

The face in that professional headshot is unrecognizable from Seng’s mugshot, where she dons a shaved head, orange prison garb and a sullen expression. During her two years in prison, numerous human rights organizations such as Freedom House and Robert F. Kennedy Human Rights Groups have spoken out against her arrest. The Clooney Foundation of Justice’s TrialWatch Initiative found that she was imprisoned on a lack of evidence in a marred justice procedure, resulting in an arbitrary conviction under international law. The United Nations Working Group on Arbitrary Detention supports these claims, asserting that her detention violated the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights. Despite a change in leadership when Hun Sen’s son, Hun Manet, took over the prime minister role, the call for Theary Seng’s release remains ignored by the Cambodian parliament. 

These calls for release are heard not only outside her prison cell but inside it as well. In Dec 2023, Theary held a hunger strike while in prison, which ended in a stay at Phnom Penh Hospital. This hospital visit delayed an appeals court visit scheduled for later months. Her brother, Mardi Seng, reported that Theary fired her lawyers and plans to represent herself when the appeal eventually occurs. 

Even President Biden has echoed the ubiquitous call for justice. When visiting Cambodia in Nov 2022, five months after Seng’s detainment, Biden called for the release of activists detained on politically motivated charges, explicitly naming Theary Seng. However, simply calling on Seng’s release is a shallow and cowardly display of Biden’s presidential powers. 

The Robert Levison Hostage Recovery and Hostage-Taking Accountability Act, signed into law in Dec 2020, establishes various procedures and entities to address the wrongful detainment of US citizens abroad. If the Department of State designates Seng as “unlawfully detained” under this act, her case will be transferred to the Office of Special Presidential Envoy on Hostage Affairs. This case transfer allows for additional resources and expertise, ensuring her case receives the attention it deserves. The bi-partisan Levinson Act is bolstered by Executive Order 14078, which expands the tools available to deter and reprimand those responsible for the detainment of US citizens abroad. Issued by President Biden a month after Seng’s arrest, this order declared hostage-taking a national emergency and provided a pathway to impose sanctions on hostage-takers.

Biden’s unwillingness to invoke the Levinson Act reflects a larger loosening of US influence on Cambodian Politics as China’s power expands south. The United States adopted the Cambodian Democracy Act in 2021, which allowed for the sanctioning of individuals who have undermined democracy. This act, coupled with an arms embargo, caused a rapid deterioration of US-Cambodia relations, providing ample opportunity for China to assert dominance. China recently moored its naval fleet at Cambodia’s Ream Naval base, representing China’s first maritime post in the Indo-Pacific. Chinese funds built this base, which was met with concern by U.S. Secretary of Defense Lloyd Austin. As democratic influence in the nation withers away, so does hope for Theary Seng’s release. 

Infuriatingly, Seng’s imprisonment is not an idiosyncrasy. Despite protections such as the Levinson Act and Executive Order 14078, the State Department has routinely abandoned foreign citizens abroad. The 2023 Hostage report by the James Foley Foundation found that 59 US nationals are held captive in foreign countries, 90% of whom are wrongful detainees. The instituted protections don’t mean anything if they are not implemented to serve those immediately affected. 

US democracy is rooted in the enshrined freedoms put forth in the First Amendment of the Constitution, securing freedom of speech and freedom of petition. Democracy in Cambodia echoes those same values, with Article 41 of the Cambodian Constitution stating, “Khmer citizens shall have freedom of expression of their ideas.” Seng’s arbitrary detainment for expression of her belief reflects a blatant disregard for the very values that democracy stands on. 

Cambodian democracy neglected Seng with imprisonment and a botched trial. But US democracy is a violent bystander in her prosecution, abandoning not only her but a whole nation desperate for hope and equality. 

Seng’s case is a vile example of the detrimental encroachment on civil liberties, both domestically and to citizens abroad. Despite the damaging history of the US presence in the nation, The United States does not deserve the privilege to step back and disengage from Cambodia. They must act on the human rights violations and collaborate with advocates, such as Seng, to pave the way for a more equal and just Cambodia.

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Antibiotics are particularly powerful because the medication targets and restricts bacterial cell functions, either immobilizing their spread or killing them completely. The first antibiotic created was Penicillin, invented by physician and microbiologist, Alexander Flemming, in 1928. 

Dr. Mukherjee, the author of the Pulitzer Prize winner, The Emperor of All Maladies, concludes that, “Penicillin kills the bacterial enzymes that synthesize the cell wall, resulting in bacteria with ‘holes,’ in their walls. Human cells don’t possess these particular kinds of cells, thereby making penicillin a magic bullet”. Penicillin was revolutionary because it was the first time in history that there was a cure for infectious bacterial diseases. The efficacy of this new antibiotic had a monumental impact on World War II by controlling bacterial infections. During war, infectious diseases were often referred to as the “third army” because disease was a primary threat to soldiers. The unsanitary conditions, nutrition, overcrowding and open wounds created an ideal environment for bacterial diseases to thrive. “In World War I the death rate for bacterial pneumonia was 18% and in World War II it was less than 1%.” After World War II penicillin was being manufactured by the billions every month. 

Ever since its introduction, penicillin has become the “magic bullet” in medicine. However, the medical world realized it would not last forever. Alexander Flemming accepted the Nobel prize warning generations to come that the overuse of penicillin will cause bacterial resistance. The magic bullet, antibiotics, would become an old-fashioned bayonet against modern nuclear weapons – resistant bacteria.  

Bacterial infections can become resistant to antibiotics. Essentially, the process begins with antibiotics killing the microbes that are causing the infection. Then, the fraction of those microbes that survive the antibiotic treatment are naturally selected for the genes that make them resistant. As such, the presence of antibiotics increases the propagation of the surviving microbe, creating generations of antibiotic-resistant bacteria. 

The new generation of antibiotic-resistant bacteria essentially outsmarts the drug through the process of evolution. Therefore, the increasing usage of antibiotics generates new strains of antibiotic-resistant bacterial infections. Many bacterial strains have not only become resistant to one antibiotic but have become multidrug-resistant.  

Consequently, the world has moved into an era of pan-resistant infections, where microbes are no longer just multidrug-resistant, they are resistant to all available antibiotics. The drug that once protected and saved millions of lives has become a threat due to its overuse and misuse. 

Antimicrobial resistance (AMR) and Antibiotic resistance (AR) is the global silent pandemic. 

Antimicrobial resistance is a term that captures a broader range of infections caused by other microbes and is used in conjunction to antibiotic resistance. Millions of people die from antimicrobial resistance annually. The World Health Organization (WHO) published in 2019 that AMR contributed to 4.95 million deaths, including 1.27 million deaths where AMR was the direct cause of death. The WHO has declared AMR as “one of the top 10 global public health threats facing humanity.” 

Antibiotics are notoriously inappropriately prescribed. C. Lee Ventola, a highly cited researcher on drug response, has uncovered that “treatment indication, choice of agent, or duration of antibiotic therapy is incorrect in 30% to 50% of cases” in the United States. He also highlights that 30% to 60% of antibiotics prescribed in intensive care units (ICUs) follow suit. 

Antibiotic prescriptions and over-the-counter antibiotics are unregulated in many countries. Antibiotic resistance is largely attributed to the overuse and misuse of antibiotics. Antibiotics have become a convenient catch-all drug that is commonly prescribed for unnecessary treatments. Antibiotics accessibility, economic costs and lack of new advancing antibiotic research in the medical and pharmaceutical sectors contribute to its misuse. 

The antibiotic resistance issue is defined by its complexity and is in need of progressive, multifaceted solutions that will require the cooperation of many international actors. 

The fight against antibiotic resistance needs new global economic incentives for drug development, a reimagined advocacy viewpoint and an approach to stimulate awareness and cooperation. 

Modern medicine has created some of the most revolutionary achievements of mankind. The twentieth century has ushered in futuristic genetic engineering, novel immunotherapies, RNA vaccines and numerous developments in all medical specialties — antibiotic resistance is threatening these achievements.

The WHO states that organ transplantations, chemotherapy and surgeries such as caesarean sections become much more risky and dangerous without effective antibiotics for the prevention and treatment of infections that arise from such procedures.

Re-imagined Awareness Platform 

People from all walks of life are affected by antibiotic resistance but cancer patients are on the frontlines and are one of the most vulnerable populations.

Bacterial infections are the second leading cause of death in cancer patients. Unfortunately, many people are not strangers to the painful treatments and strenuous fights against cancer. Globally, it was estimated by the Worldwide Cancer Research Fund in 2020 that there are 18.1 million cancer patients. Cancer patients endure treatments that kill both cancerous cells and healthy cells, compromising their immune system. Furthermore, much of their care is provided in hospitals, where hospital-acquired infections (HAI’s) are a significant concern. Constant invasive visits that require puncturing skin for IV lines or the use of IV ports, surgery recovery, wound redressing and being present in an environment that treats some of the harshest multi-drug resistant infections makes cancer patients highly susceptible to HAIs. 

Kevin Outterson is the Executive Director at CARB-X, Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, a global nonprofit partnership and his research focuses on global antibacterial innovation. He is also a professor of Health and Disability Law at Boston University. He published a review with other scientists that addressed the issue of HAIs and antibiotic resistance in the Clinical Journal of the American Cancer Society. In a podcast interview with the Union for International Cancer Control, Outterson discussed the increased dangers of AMR to cancer patients. 

“Data shows that while antimicrobial resistant superbugs are a problem for everyone, for people with cancer, the risks are really three times higher that they’ll get a fatal infection from these superbugs,” Outterson said. He highlights that innovative cancer treatments have advanced so far that we can’t have the progress “undermined by the old foe of infection. ”

This point can be extended to how society has come so far in medical science that there is no time to be defeated by pan-resistant superbugs. 

Cancer patient communities have developed many awareness groups that have contributed to the demand for new treatments. Money is being pipelined into research funds and cancer institutes. There is a lot of awareness surrounding the cancer community, which is why there is a demand for new drugs. 

Cancer patient communities and advocacy groups work hard to spread awareness. Every month on the calendar is attributed to the awareness of different cancer types. The assortment of colorful ribbons divides cancers by where it was initially localized. However, that very ribbon no matter what color, symbolizes a plethora of support and unity for cancer patients.

There isn’t the same caliber of support and awareness for antibiotic resistance. The silent pandemic cannot remain quiet. 

AMR poses a threat to cancer treatments and many people are unaware of this. The Union for International Cancer Control is striving to “sensitize” and educate the cancer community to the AMR threat. Cancer patients and supporters could become the global ambassadors for antibiotic resistance advocacy. They have a strong base to instill action and awareness for antibiotic resistance. 

If health advocacy groups could implement AMR awareness in their programs and platforms, the impact would be monumental. Currently, there are some movements to spread awareness such as the global campaign, such as World AMR Awareness Week. However, AMR awareness requires a larger approach because it affects everyone. Imagine if every medical condition organization embedded AMR awareness in its mission. Kevin Outterson comments that not many patients identify as “I’m a survivor from a drug-resistant infection,” however, a wide range of patients would fall under this category. Countless patient groups rely on antibiotics, to unite those groups with the cancer community could change the fate of antibiotic resistance through awareness. 

There needs to be a public outcry, just as the cancer community has fought for preventative measures to ensure others avoid cancer, such as HPV vaccinations, wearing sunscreen and laws surrounding cigarette usage. The mobilization of these patient groups that already have an established platform could make a significant difference in both raising awareness and mobilizing funding for antibiotic research and solutions. 

Antibiotic Resistance Research Pipeline and Economy 

The antibiotic research communities are described by Outterson as looking “over longingly at the pipeline and the money going into cancer, ” Outterson said. Compared to the revolutionary research being done in the cancer industry, the antibiotic industry has fallen short. The predominant cause for this discrepancy is lack of funding. 

The science behind both cancer research and antibiotic research is remarkable. Science is not a limiting factor for research in the antibiotic field, it is that society does not expend money or resources for antibiotic development as if they are valuable. 

Antibiotics are relatively cheap in comparison to cancer treatments as common antibiotics are mass-produced. However, the WHO states that, “just 27 new antibiotics for the most threatening infections are in the clinical trial stage of drug development. In contrast, there were more than 1,300 cancer drug trials in 2020.” To further extend this alarming condition, the WHO only recognized two antibiotics to be effective for surviving antimicrobial-resistant bacteria. 

The underlying issue is that there is not enough research going into the solution for antibiotic resistance. Internationally, there was only one antibiotic, “cefiderocol, that was approved to treat the superbugs on WHO’s most critical list.” The recently published urgent threat multi-resistant bacteria and fungi include Carbapenem-resistant Acinetobacter, Candida auris, Clostridioides difficile, Carbapenem-resistant Enterobacteriaceae and Drug-resistant Neisseria gonorrhoeae. Carbapenem-resistant Acinetobacter, which cause pneumonia, bloodstream infections, urinary tract infections and wound infections, especially in patients receiving care in intensive care units. It is also one of the many resistant strains cancer patients are susceptible to. The Carbapenem-resistant Acinetobacter carries “mobile genetic material” that can produce enzymes that inhibit the effect of antibiotics.

There are limited incentives to produce new innovative antibiotic drugs to combat these threats. The cancer research industry has fantastic reimbursement through selling cancer treatment drugs. The economic model for pharmaceutical companies is to invest upfront and reap the rewards from sales once approved. This model is not applicable for antibiotics and it stems from its market nature. Negative externalities arise as the production of new antibiotics results in a cost to a third party. Antibiotics may help a group of patients but then create resistant bacteria for the rest of the population.

It is an unusual market condition because companies invest time and money to produce antibiotics that are then used sparingly to reduce antibiotic resistance. 

Antimicrobial resistance escalates when there is an increased use of antibiotics; it creates a cycle of developing smarter microbial infections. That is atypical for the general medicines used today. For example, anticoagulants, antihistamines and antiepileptics will not lose their efficacy over time and only affect the individual patient prescribed. 

According to Doctor Venkatasubramanian Ramasubramanian, president of the Clinical Infectious Diseases Society of India,  “with a new antibiotic, we say, ‘don’t use it,’ or ‘use it sparingly so it lasts longer… It is not an attractive proposition for anyone in the industry,” Ramasubramanian said. 

Antibiotics need to be conserved to prevent the evolution of more antibiotic resistant bacteria. This is why newly developed antibiotics are typically used sparingly for five to fifteen years to ensure its efficacy. 

The flipside to this situation is that companies “developing one new antibiotic can take up to two decades and usually costs $568 million to $700,” according to Pharmaceutical Research and Manufacturers of America’s, Medicines in Development for Antimicrobial Resistance 2021 report. After all, the resources and money is put into approving a new antibiotic drug; it is then not used for as long as possible until necessary. Therefore, a large majority of antibiotic companies have gone bankrupt or abandoned the antibiotic field. Big Pharmaceutical companies are fleeing, such as Melinta Therapeutics, a large antibiotic developer warned the regulators they were running short of funds. Achaogen, a biotech company, went bankrupt after dedicating 15 years to develop a new antibiotic that was then added to the WHOs list of essential new medications. This market exit is a terrible trend as antibiotic resistance becomes more exacerbated.

Antibiotic resistance is a massive global financial burden worldwide and the highest burden is for low-resource countries. The United Kingdom’s AMR policy paper mentions that the World Bank predicts that “28 million people will be forced into extreme poverty by 2050 unless AMR is contained.” The World Bank also highlighted that there will be a global cumulative cost of $100 trillion by 2050 if the issue of antibiotic resistance remains under the radar for most people. 

There is a need for new global initiatives to stimulate more money into researching not only new antibiotics, but innovative solutions targeting antimicrobial resistance. 

The United Kingdom has pioneered an incentive payment model that could be emulated globally. In 2019, the United Kingdom’s Department of Health and Social Care launched an AMR project titled “UK 5-year action plan for antimicrobial resistance 2019-2024” that aims to contain AMR in the UK by 2024. 

The UK is the first country to create a subscription-based payment model for antimicrobial pharmaceutical companies where the government pays a fixed fee upfront to companies developing new antibiotic drugs. Since this model makes profits independent of prescription volume, it could dis-incentivise part of the reasons for antibiotics overuse . 

In 2022, Shiongi, a Japanese discovery-based pharmaceutical company signed an agreement with the National Health Service to begin a “subscription payment model for reimbursement of cefiderocol in England,” and Shionogi commented the company welcomed the “introduction of pull incentives to help bring urgently needed new antibiotics to market.” Although the UK’s initiatives have been attracting international pharmaceutical companies, they recognize that their actions to combat AMR need to be coupled with a global response where countries implement this model or their own variation of incentives into their domestic markets.

In the United States, the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR) Act introduced in 2023 follows a similar suit where companies would be paid contractually. The PASTEUR Act begins to address the broken marketplace for developing antibiotics and would authorize the Department of Health and Human Services to “enter into subscription contracts for critical-need antimicrobial drugs, providing $6 billion in appropriations for activities under the bill”. 

The PASTEUR Act is being debated, and if passed, it would fund vital antimicrobial stewardship programs as well. The UK serves as a role model for the rest of the world by taking a step in the right direction to solving the interdisciplinary issue of antimicrobial resistance. 

COVID 19’s Impact on Antimicrobial Resistance 

In the CDC’s 2022 Special Report on COVID-19’s impact on antimicrobial resistance, they state that Antimicrobial resistance was the “greatest public health concern prior to the COVID-19 pandemic, and it remains so.” The CDC also released that antimicrobial resistance is a leading cause of death globally. 

COVID-19 taught the world that viruses are a threat to human vitality, and preventative measures were crucial to combat the contagious spread of COVID-19 as it continued to mutate and create new strains. Even countries with strong healthcare infrastructures suffered from the fatal virus. 

The pandemic overshadowed the antimicrobial resistance pandemic. During COVID-19, patients upon admittance to the hospital would be prescribed antibiotics. This was an overuse of antibiotics when patients frequently did not have bacterial infections. This was due to the fact that healthcare professionals did not have any cure for COVID-19 and had to be greatly cautious. Patients that had weakened immune systems from COVID-19 were more susceptible to bacterial infections. In the US, “from March 2020 to October 2020, almost 80% of patients hospitalized with COVID-19 received an antibiotic.” 

COVID-19 should serve as a lesson that the international community must invest in the preparedness to fight the next pandemic. Antimicrobial-resistant will have severe, long-term consequences and it is our “silent” pandemic. The best way to fight this pandemic is to be preventative. This is why funding in antimicrobial resistance research is crucial and should be at the forefront for the scientific community. For example, there is a need for specialized laboratory tests to efficiently identify bacterial infections and new effective stewardship programs for infection prevention measures. 

The COVID-19 pandemic created a race to find curative measures against the virus. The novel vaccine restored the world. However, it is important to note that antibiotics are a “shared resource” drug, one person’s use of antibiotics impacts the efficacy of the drug. This is why global cooperation is so important to combat AMR. The WHO created the Global Antimicrobial Resistance and Use Surveillance System (GLASS) to inform, collect data and connect global actors on solution strategies. This is a representation of global cooperative measures that are needed. 

Vaccine development is at the forefront of antibiotic resistance research fields and serves as a new hope to decrease antibiotic use. Drug-resistant S. pneumoniae is the only bacterial pathogen that has an effective vaccine, pneumococcal conjugate vaccines (PCVs) listed in the CDC’s special report. This vaccine “prevented more than 30,000 cases of invasive pneumococcal disease and 3,000 deaths from 2010 to 2013 alone.” Vaccines such as this help safeguard antibiotics from overuse that creates resistance. 

COVID-19 required an international response, and collective action was taken to combat it. COVID-19 taught the world that we are not immune to viruses or infections. The virus evolved into new strains which required global action to combat its rapid evolution into more contagious strains, such as Omicron.

 The CDC’s 2022 report stated that much of the progress was lost in regard to antimicrobial resistance in the US due to the impacts of COVID-19. They stated that the “pandemic pushed healthcare facilities, health departments, and communities near their breaking points in 2020, making it very hard to maintain the progress in combating antimicrobial resistance.” Now that the COVID-19 pandemic is more controlled, the world must face and focus on the pandemic of antimicrobial resistance here and on the horizon. 

Valeria Gigante, a member of the WHO’s antimicrobial resistance division states that people who die from antibiotic resistance outnumber the deaths from HIV, tuberculosis and malaria combined. There has been great mobilization for all three and similar mobilization occurred during COVID-19. 

It is time to see the same call for action for antibiotic resistance because we live in an age with an upsurge of pandemics and superbugs. 

We are no longer strangers to superbugs; we must reimagine a world where our priority is to combat antibiotic-resistant microbes because if we don’t they will always be evolving one step ahead of us. 

The post A Pathogen’s Plight: The International Lethal Pandemic of Antibiotic-Resistant Bacteria appeared first on Glimpse from the Globe.

Trump’s position to swiftly end the war does not come as a surprise. He has said on multiple occasions during his campaign trail that it would be one of his top priorities if reelected. However, despite Trump’s ambiguity and unspecificity on how he would end the conflict, the international community has drawn on statements from the former President to infer how the war will end if his administration takes office: the United States will simply stop funding the Ukrainian War effort. 

Trump’s conservative view on foreign aid toward Ukraine has been expressed numerous times to both the general public and world leaders. In March of this year, when Hungarian Prime Minister Victor Orban visited Trump at his Mar-a-Lago club in Palm Beach, Florida, Orban sat down with ABC News and said that he was assured that Trump would not give Ukraine “a penny” if elected. 

Following the Russian invasion in 2022, Ukraine has become one of the top recipients of US foreign aid, something not seen in Europe since the Harry Truman administration created the Marshall Plan after World War II. Sitting at 41%, the United States is the second largest contributor to Ukraine’s foreign aid behind the European Union. Foreign aid has largely been allocated toward military operations, law enforcement, communication departments and humanitarian efforts. 

Yet, even under the Biden Administration, it has been increasingly difficult in recent months for the United States to get bi-partisan support for funding efforts towards Ukraine. Much of foreign security discourse has shifted to the Israel-Hamas war, and Ukraine is not getting the media coverage that it once relied on for international support. Additionally, domestic chaos has fostered turbulence in Congress, with bi-partisan negotiations taking months. In Dec 2023, Zelensky’s appeal to Congress for funding was unsuccessful, as many GOP members cited domestic security issues like illegal immigration as a bigger priority. The shift of the Republican Party becoming increasingly neo-isolationist has created additional struggles for the Biden administration in terms of foreign policy, as many senators have said that their support remains contingent on stricter immigration policies along the Mexican border. 

On Tuesday, Apr 23, the foreign aid package that took months of deliberation finally passed through Congress, allocating $60.8 billion for the Ukrainian War effort. The majority of House Republicans opposed the effort, but the speaker of the House, Mike Johnson, managed to structure the bill in ways that separated large groups of opposition, preventing a congressional gridlock. However, despite this win for Congress and the Biden Administration to uphold their support for the war effort, Ukraine said that the delay in US aid has already had a direct impact on the ground. Hal Brands, a US foreign policy expert and a professor of global affairs at Johns Hopkins School of Advanced International Studies, said recently in an interview with The Hub that “the cost of this delay can be measured in Ukrainian lives and territory lost”. He cites that these losses, including the loss of the influential fortress city, Avdiivka, are a direct result of the dire need for artillery ammunition, which US aid helps to supply. 

Recognizing the US’ fundamental contribution to the war effort, for months now US allies in Europe have been trying to “Trump-proof” the conflict’s security, fearing the implications of Trump’s potential return to office. The two nuclear powers of Europe, the UK and France, can hardly compare to the US military arsenal, as they are but a small fraction of the size and have failed in test launches. 

Reflecting on this threatening potential reality, Norbert Röttgen, a veteran German lawmaker and ex-chair of the Bundestag’s foreign affairs committee, commented it would mark a big change for Europe.  

“Europe would have to stand up for its own security in an unprecedented way,” Röttgen said. 

Similarly, Valérie Hayer, who leads the Renew Europe group, and is French President Emmanuel Macron’s top lawmaker in Brussels, claims now is the perfect opportunity for Europe to start becoming more independent. 

“Europe has relied on the U.S. to provide its security for too long,” Hayer said.  “It’s high time for Europe to improve its own deterrence capacities and take its security into its own hands.” 

Restructuring trans-Atlantic relations would include multiple components, but the overarching theme centers around diverting economic reliance. Europe must look to other regional and global partners to ensure stability. This effort has already been seen in the geopolitically chaotic, yet productive, move to wean off of Russian oil exports.

Trump has said on multiple occasions, both in interviews and on his Truth social network, that the 2021 Russian invasion of Ukraine would never have happened if he had been in office. He even claimed that he delayed the invasion for years, citing his close-knit relationship and ability to influence Putin. However, Russian Foreign Minister, Sergey Lavrov, has claimed that it would not make a difference if Trump was in power, because the mutual trust between the United States and Russia was tarnished when President George W. Bush Jr. pulled the United States out of the anti-ballistic missile treaties, which many international relations scholars believe escalated a new arms race in the Post-Cold war era. Nevertheless, Trump has continued to double down on his claims on his ability to influence Russian foreign policy. 

Since the Marshall Plan, a bilateral transatlantic security relationship has been fostered between the U.S. and most of Western Europe, materialized in NATO. However, Trump has been a vocal critic of NATO for years, claiming that other states have been freeriding on the US economic and security contributions to the organization. In fact, foreign policy expert and widely-regarded author Anne Applebaum believes that there is a considerable chance that Trump would pull the U.S. out of NATO entirely. 

However, regardless of his win in the election in November, it is clear that an emerging fundamental shift in transatlantic security relations seems imminent. As the war continues on to its third year, US foreign aid is a rising contentious topic among Americans, and Europe will have to adjust accordingly.

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