Since the beginning of Donald Trump's term, several anti-immigration measures have been implemented, mainly in the border region between Mexico and the United States. That said, last month, the president tried to justify his plans to close the border using a “public health emergency” – that is, through the spread of measles andtuberculosis. This attitude refers to the advent of the Covid-19 pandemic, in which Trump invoked measures (called “Title 42”) that allowed the expulsion of migrants under health arguments, which the government seeks to resume.

Trump and his advisors do not have a public health outbreak to justify their actions, but that does not stop them from incessantly searching for the right disease to support their intentions. They have also argued that migrants at the border are likely to carry unknown diseases, which reinforces the xenophobic content of the current administration's essence, disguised as an attempt to protect the nation.

Turning more specifically to Donald Trump's attitudes towards the health pillar in the United States, it is clear that one of the first actions of his second term was to withdraw the country from the World Health Organization (WHO), claiming, on the one hand, that the organization favored China and was not truly aligned with US interests, and, on the other, that the consequences of poor organizational management can still be seen throughout the COVID-19 pandemic and during other global health crises. This decision raised concerns about the country's ability to face public health crises and affected global health programs that were essentially “dependent” on the country – especially those aimed at vulnerable populations, such as immigrants.

Contrary to the provisions of Title 42 – which focuses on the expulsion of immigrants based on threats of disease –, last month the current president fired hundreds of health inspectors at the United States borders, justifying that their services were nolonger needed. These employees, however, are responsible for investigating sick passengers, examining animals for dangerous pathogens and inspecting plants for infestations. The United States government administration announced significant cuts to the Department of Health and Human Services (HHS), resulting in the elimination of 10,000 jobs initially, with the goal of achieving a total reduction of 20,000 positions. These cuts affected essential agencies such as the FDA, the CDC and the National Institutes of Health, compromising the provision of health services, especially for underserved and immigrant communities. In other words, removing these agents from the borders makes the population vulnerable and susceptible to disease. Related to this was the “accidental” firing, also last month, of agents responsible for containing bird flu by the US Department of Agriculture – although there is now an attempt to reverse the decision and rehire these professionals. It is also important to expose the budget cuts made in relation to the next generation of scientists and publichealth leaders, in addition to the reduction in funding to NGOs that, for justification, “harm” the national interest and the administration's priorities.

Available data shows that in 2024, the US contributed $2.4 billion to Global Health, with 19% of the country's budget going to health. This makes it even clearer how its withdrawal from the WHO could have consequences of varying magnitudes.

In order to understand how the Trump administration's actions affect both access to and use of healthcare by immigrants, it is understood that the mass deportation measures adopted have increased fear among immigrants, leading many to avoid seeking medical services for fear of being detained or deported. The repeal of the policy that protected hospitals as "sensitive locations" from actions by the United States Immigration and Customs Enforcement (ICE) has intensified this concern. In Texas, for example, hospitals began collecting and reporting information on the costs of providing care to immigrants without legal status, exacerbating the climate of fear and making it difficult to access essential medical care.

Another aspect of this issue that is important to mention is the issue of persecution of gender identities and rigidity in relation to reproductive health. The Trump administration has proposed removing recognition of gender identity in official documents and health policies, which would directly affect trans people's access to medical care - including hormone treatments, gender transition surgeries and even basic medical care without discrimination or violence. The imposition of a strict definition of biological sex also goes beyond the practical issues of medical care and weakens population health at a psychological and behavioral level, since it increases the risks of depression and suicide among trans and non-binary people.

Furthermore, regarding reproductive issues, growing fear among immigrants in states such as Texas has led many undocumented women to avoid seeking sexual health care, including contraception and essential medical exams. Strict immigration policies and restrictive state laws have contributed to this situation, resulting in tragic consequences that have already been observed, such as deaths caused by the lack of adequate medical care.

In light of the issues presented here, it is not naïve to claim that the health policies of the current Donald Trump administration not only restrict and affect immigration, but also weaken the American health system as a whole, harming not only (although potentially in magnitude) minority groups, but the entire population. By prioritizing punitive measures over effective solutions, the government puts both human rights and national health security at risk.