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What Biden and Harris promise for health, climate change, COVID-19, racial justice, media freedom and more

President-elect Joe Biden has hit the ground running this week following his momentous win over US President Donald Trump, along with the historic election of his Vice-President-elect Kamala Harris.

The transition to a new presidency promises global shifts in policy, including support for the World Health Organization and other international bodies and agreements, notably on climate change.

This wrap pulls together recommended reading on many of important issues from Biden’s victory for public health, including climate change, COVID-19, health care, racial justice, freedom of the press, and issues for the US, particularly in health care.

There is much hope, in the US and globally, but there remain worrying signs, with a survey published on Wednesday finding that 79 percent of American believe US President-elect Joe Biden won the election, including about 60 percent of Republicans — which means of course that many don’t.

Meanwhile, disinformation is rife on Facebook and other digital platforms, so in the absence of a Trump concession, it’s difficult to see what the coming weeks will mean for the United States as it heads into a dark winter for COVID-19 and an unpredictable incumbent.


Transition: “ready on Day 1”

From the Biden/Harris Transition website

Published hours after their victory was declared, the new Biden–Harris transition website lays out the four key policy areas Biden and Harris have campaigned on, pledging to be ready to address them on Day One:

But, with the president refusing to concede defeat, Associate Professor Lesley Russell writes at Inside Story that it’s unclear how closely the process will resemble the usual orderly handover of powers in the transition to Inauguration Day on 20 January 2021.

Russell outlines the order of the challenge ahead: not just escalating COVID-19 impacts on health and the economy, but also the need for the new president to “look beyond America’s borders and begin the long and difficult task of restoring relationships and trust around the world”.

See also: The tasks Joe Biden faces: from racial justice to restoring faith in science


Science-led COVID-19 response (from January 20)

Biden’s transition team unveiled members of his COVID-19 taskforce, described by Stat News as a “who’s who” of former government health officials, academics and major figures in medicine.

The Washington Post also backed the selection, saying it signalled Biden’s intent to seek a “science-based approach” with three co-chairs: Obama surgeon general Vivek H. Murthy, former Food and Drug Administration head David Kessler, and Marcella Nunez-Smith, associate dean for health equity research at the Yale School of Medicine.

Here’s a breakdown on who is on the taskforce and who experts hope will still be appointed, including — from  Dr. Krutika Kupalli, assistant professor at Medical University of South Carolina — “social scientists, nursing leaders, people with biosecurity experience, some younger people with more front-line experience”.

The taskforce announcement came on Monday as Reuters reported just over 59,000 COVID-19 patients in hospitals across the US, the country’s highest number ever of in-patients being treated for the disease, with new infections at record levels for the sixth consecutive day.

But, as The New York Times reported before Biden’s victory was announced, regardless of the election’s outcome, Trump will be the one steering the country “through what is likely to be the darkest and potentially deadliest period of the coronavirus pandemic”, and he has largely excluded the nation’s leading health experts from his inner circle.

Appearing on ABC TV’s 7.30 on Wednesday night, the White House’s top advisor on COVID-19 Dr Anthony Fauci said he did not want to get involved in political discussions about Trump’s culpability on COVID-19, although he admitted the pressure he has come under in the position has been “stressful”.

Threats of beheading, made this week by former Trump adviser Steve Bannon, were not what he had envisaged when he entered medical school, Fauci said.

Asked if he had met yet with Biden, Fauci said the situation was “rather tense” currently, so the transition process was “on hold for the time being”.


Returning to global health leadership

Biden can rebuild ties with the WHO and make the US an influential player in the fight against COVID-19 and a global health leader again, writes Professor Devi Sridhar, chair of global public health at the University of Edinburgh, in Foreign Policy.

Sridhar was recently a keynote speaker at the Public Health Association of Australia’s national conference (where she warned the global pandemic was “just taking off”).

On 7.30, Fauci said, however, the WHO’s performance on COVID-19 had been “spotty”. The lessons it should learn were to respond in a timely manner on issues without worrying about political ramifications, he said. Countries like China also needed to be immediately transparent in the case of new infection, and allow other scientists and health officials to “look around and see what’s going on”. That had not happened with Wuhan, he said.

Biden’s victory came as the 73rd World Health Assembly (WHA73) opened, with a speech by WHO Director-General calling for predictable and sustainable WHO funding, the launch of a Universal Health and Preparedness Review and the need to “reimagine” global leadership and “forge a new era of cooperation” reflecting the lessons of the COVID-19 pandemic.

Dr Tedros Adhanom Ghebreyesus called on Member States to “address the shocking and expanding imbalance between assessed contributions and voluntary, largely earmarked funds”, observing that WHO’s annual budget is equivalent to what the world spends on tobacco products in a single day.

He warned that a vaccine cannot address the global under-investment in essential public health functions and resilient health systems, nor the urgent need for a “One Health” approach that encompasses the health of humans, animals and the planet we share.

“There is no vaccine for poverty, hunger, climate change or inequality,” he said.

Also in the wake of Biden’s victory, Friends of the Global Fight Against AIDS, Tuberculosis and Malaria released a “transition document” for his administration, calling on the new President-elect to “update and revitalize” the US strategic approach on global health, not just return to normal.

It outlines five priority actions:

  1. Increase U.S. global health investments and align them with other public programs
  2. Rally the world to end the three biggest infectious disease killers—AIDS, TB and malaria
  3. Reaffirm global leadership in support of the Global Fund
  4. Strengthen pandemic preparedness and health security
  5. Advance rights and good governance alongside health.

The WHO also pointed out that COVID-19 was “not the only pathogen we’ve dealt with in 2020”, saying it had responded to more than 60 emergencies this year, including major outbreaks of chikungunya in Chad, yellow fever in Gabon and Togo, measles in Mexico, flooding in Sudan, storms in the Philippines and Vietnam, and much more.


Leading global climate action (Canberra wake-up call)

Fiji’s prime minister, Voreqe Bainimarama, the first world leader to congratulate Biden on his victory, said the whole world, but particularly the imperilled Pacific, would be looking to the US for global leadership in addressing the climate crisis, Guardian Australia reported.

Not only has Biden promised to recommit the US to the Paris Agreement, but also to “lead an effort to get every major country to ramp up the ambition of their domestic climate targets”.

That could “prove awkward for Canberra”, with Australia so far refusing to join other countries in the Asia-Pacific—including New Zealand, Japan, South Korea and even China—who are pledging net-zero mid-century climate targets, according to Dr Wesley Morgan, Adjunct Research Fellow with the Griffith Asia Institute.

See also: Biden’s climate goals turn up heat on Morrison

But this Guardian article warned that climate advocates rejoicing at Biden’s  victory are also quietly absorbing the blow of Republicans possibly keeping control of the US Senate – “which would kneecap significant efforts to fight globe-heating pollution”.

The signs globally are also not good, WHO Secretary General Dr Tedros Adhanom Ghebreyesus told the opening of the Race to Zero Dialogue on Climate Change and Health this week.

Despite calls to for a greener and more healthy recovery from COVID-19, Tedros said much of the world “has already fallen back to the old ways of doing things”, with G20 governments this year committing more than $US200 billion to polluting fossil fuel energy sources. (See the Australian Federal Budget for a case study in point).

Hailing the UK’s NHS plan, adopted last month, to become the first national health system to reach net zero carbon emissions, Tedros said the health community has a key role to play in zero emission targets, as part of their commitment to ‘do no harm’.

The WHO’s wider global concerns are echoed in the Guardian, citing its analysis that reveals the prospect of a global green recovery from the coronavirus pandemic is “hanging in the balance”, as countries pour money into the fossil fuel economy to stave off recession, as promises of a low-carbon boost fail to materialise.

The article says:

In at least 18 of the world’s biggest economies, more than six months on from the first wave of lockdowns in the early spring, pandemic rescue packages are dominated by spending that has a harmful environmental impact, such as bailouts for oil or new high-carbon infrastructure, outweighing the positive climate benefits of any green spending, according to the analysis.”

Guess who is missing in action?


Protecting US health care

All eyes in American healthcare are on how the Supreme Court will rule on the Affordable Care Act, with the Public Health Association of America leading a massive coalition of health concerns to say this week that invalidating it will “cause severe harm to patients, providers, and communities across the country, particularly amid a deadly pandemic.

It said 23 million Americans will directly lose coverage, possibly overnight, and the 135 million Americans with preexisting conditions will lose benefits and vital protections enshrined into law.

“Additionally, this lawsuit would have catastrophic consequences for public health and dramatically inhibit our ability to fight the virus. It would also throw the entire health care system into chaos, leading it to melt down across the country just as hospitals are being pushed the brink by the pandemic.”

Biden’s election means that, if the ACA survives its Supreme Court challenge, the constant barrage of incoming attacks on it should be weakened considerably, according to Professor Nicolas P. Terry, from the Indiana University Robert H. McKinney School of Law.

“If the Supreme Court critically injures the ACA, it will create even more pressure on Congress and the new administration to resuscitate it, ensuring the law lives up to its stated ideals of granting affordable coverage for all,” he writes.


Restoring faith in science

Scientific American has published An Open Letter to Joe Biden by Ben Santer, who was until September 2020 a federally funded climate scientist used pattern recognition methods to identify human “fingerprints” on climate — research that “did not survive a president who has falsely dismissed climate change as a hoax and a Chinese conspiracy”.

As well as seeking to address COVID-19 escalation in the US and the climate crisis, Santer said Biden also faces an additional challenge “to restore public trust in science and scientists”. He writes:

You must rebuild public trust in the scientific impartiality of the Environmental Protection Agency, the National Oceanic and Atmospheric Administration, the Department of Energy, the Centers for Disease Control and many other federal agencies with scientific remits.

You must convince the women and men working in these agencies that their new prime directive is not political loyalty to one person—the new directive is “get the science right.

You will have to inspire the disillusioned and disheartened, reverse the loss of critical expertise at key scientific agencies and make public service at these agencies an aspirational goal for the next generation of young scientists. In achieving this restoration of trust, you can count on the help of many thousands of U.S. scientists.”

However, this report from STAT, says no matter who wins, “the 2020 election results were a disaster for public health”, with tens of millions of Americans siding with a president who has called the nation’s top scientists “idiots,” openly mocked mask-wearing, and has insisted states must be “liberated” from lockdowns.

See also this pre-election piece: Confused About Where to Get Public Health Guidance on the Coronavirus? You’re Not Alone


Racial justice

With racial justice at the top of the Biden/Harris agenda, Dr Jamila Perritt, CEO and President of Physicians for Reproductive Health, has written in the New England Journal of Medicine on #WhiteCoatsForBlackLives — Addressing physicians’ complicity in criminalizing communities.

Calling on physicians to step up on racial justice, she says “the notion that medical providers are unbiased and objective, practicing within a profession free from the legacies of racism, genocide, and White supremacy, is fictitious”.


Reversing damage to media freedom and trust

Reporters Without Borders (RSF) has called on Biden to act immediately to begin to reverse the extensive damage done to media freedom in the US during Trump’s presidency, warning that hostility towards the media had “never been worse”.

RSF said Trump’s hostile rhetoric towards the press – whom he has labelled as “enemies of the people” – contributed to an environment of real-life violence for journalists, helped spread disinformation, and led to weakened protections for press freedom globally.

According to Mashable on Monday, since vote counting began on Election Day (Nov. 3), Twitter and Facebook have been forced to flag the president’s posts (including retweets and reposts) for spreading misleading or disputed election claims a total of 34 and 27 times, respectively.

An analysis by the Guardian of posts shows that since election day, 16 of the top 20 public Facebook posts that include the word “election” feature false or misleading information casting doubt on the election in favour of Trump. Of those, it says, 13 are posts by the president’s own page.


Recognising Native Americans

Croakey readers may have seen the outcry on election night to on-air graphic broadcast by CNN that listed voters by the following categories: White, Black, Latino, Asian and Something Else — with the “something else” referring to Native and Indigenous Americans.

The graphic “exemplified the continued erasure of Native and Indigenous Americans from political conversations”, made all the more galling by their impact on the election, said Katrina Phillips (Red Cliff Band of Lake Superior Ojibwe), an assistant professor of history at Macalester College in Minnesota in the Washington Post. She wrote:

In an election where a record-breaking six — yes, six — Native American and Native Hawaiian candidates were elected to Congress, and where Native voters in states like Arizona and Wisconsin may have helped tip the scales in President-elect Joe Biden’s favor, it’s critical Americans recognize the long history of the battles over Native citizenship, suffrage and representation.”


Pathways to citizenship and migration

Biden’s election also means massive change for a group of people who “had everything riding on this election were not allowed to vote”: the so-called Dreamers, people who were brought to the US as children but are not US citizens.

Biden has vowed in his first 100 days in office to send to Congress “a pathway to citizenship for over 11 million undocumented people, and made clear he will end the Trump era policy requiring asylum-seekers to make their case outside the United States.

See what that and other changes might mean: https://www.washingtonpost.com/opinions/2020/10/29/just-imagine-how-different-bidens-immigration-policy-would-be/

(It’s worth listening to this devastating account, “The Out Crowd” which won the very first Pulitzer Prize ever awarded to a radio show, on what the Trump administration’s “Remain in Mexico” policy meant, on the ground, at the Mexican border.)


Risks (beyond pressure on climate change) for Australia

Many in Canberra breathed a sigh of relief at Biden’s election, writes Adam Triggs, Director of Research at the Asian Bureau of Economic Research at ANU and a Non-Resident Fellow at the Brookings Institution, saying Trump attacked the strong, predictable international rules and norms that are vital to our interests.

But he says Biden “will only buy us time” and that the structural forces that produced Trump — most notably America’s rising inequality — haven’t gone away and will continue to prompt the question: is Australia too dependent on America?

Further reading:

Goodbye Trump, hello Biden: how America is waving goodbye to a shocking, shameful era

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