The next global epidemic is likely around the corner—and no amount of U.S. retrenchment from globalization will halt that outbreak at the U.S. border.

“There is a real reason for us to be scared of the idea of facing this threat with Donald Trump in the White House,”said Ron Klain, who served as President Obama’s Ebola czar, at the Spotlight Health Festival, which is co-hosted by the Aspen Institute and The Atlantic. Klain said the “president is anti-science” and “trades in conspiracy theories.”

“All those things would lead to the loss of many lives in the event of an epidemic in the United States, where we need the public not to trade in conspiracy theories, not to believe that the news was fake, but to respect scientific expertise,” said Klain, a veteran Democratic operative who served in both the Clinton and Obama administrations.

Klain added that Trump’s isolationist mindset has led to the United States pulling back from its leadership role in global health crises, which, he said, “is … going to be a serious threat to our security.” Klain called Trump’s policies and views “xenophobic, if not racist,” leading to the blaming of immigrants and foreigners for problems that need public-health interventions.

Klain specifically cited Trump’s tweets in the midst of the Ebola outbreak when he advocated that American health-care workers who had contracted the disease in Africa be barred from returning home. “People that go to far away places to help out are great—but must suffer the consequences!,” Trump tweeted at the time.

Global health-emergency preparedness has traditionally been a bipartisan issue. Klain cited President George W. Bush’s much-lauded PEPFAR initiative, which committed the United States to taking a leadership role in tackling HIV/AIDS in Africa. During the 2014 Ebola outbreak, a Republican-controlled Congress authorized more than $5 billion to fight the outbreak.

“We need leadership that is focused, that is pro-science, that doesn’t traffic in conspiracies, that invests in these things,” Klain said. Leadership “that doesn’t have these isolationist attitudes, [which] … put us all at risk.”

Klain identified several large gaps in U.S. preparedness for the next global outbreak.

  • A leadership gap. “There is no one at the White House right now who is in charge of this problem,” Klain said.
  • A funding gap. “We’re underfunding, underinvesting” in preparedness, he said.
  • A facilities and training gap. Klain said that there was exhaustive training of first responders carried out right after the Ebola outbreak in 2014. But there are other diseases for which they are still unprepared. “Training needs to be renewed. People need to be drilled,” he said. “Our first responders need to be trained. We need better and more facilities.”
  • A science gap. “We haven’t yet developed all the vaccines and the therapeutics we need,” Klain added.
  • A policy gap. There are “holes in American law that we need to fill about licensing people in medical emergencies to practice in other states or,” he said, “using the Stafford Act”—the federal law that governs relief and emergency assistance for state and local governments during a natural disaster—“to respond to emergencies.”

But the biggest gap, he said, is the global gap: “We can’t be safe here in America when there’s a risk of pandemics around the world,” Klain said. “The world’s just too small. Diseases spread too quickly … There is no wall we can build that is high enough to keep viruses and the disease threat out of the United States. We have to engage in the world.”

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