**Washington D.C.** – In a move that has ignited considerable controversy within the global public health community, the Trump administration is poised to allocate $1.6 million towards a study examining the hepatitis B vaccine for newborns in Guinea-Bissau. This initiative follows a recent recalibration of recommendations by the US Centers for Disease Control and Prevention (CDC), which now categorises the hepatitis B vaccine at birth as a matter of personal choice, a departure from previous guidance. These policy shifts are reportedly driven by Health Secretary Robert F. Kennedy Jr.'s long-standing convictions regarding vaccine safety.
The decision to fund this specific study in the West African nation, where the prevalence of hepatitis B is alarmingly high – with nearly one in five adults infected – has been met with sharp criticism. Experts are raising serious ethical concerns, with some labelling the endeavour as "highly unethical" and "extremely risky." The study’s focus on an established vaccine in a region with a vulnerable health infrastructure is being viewed by critics as potentially detrimental, risking the erosion of trust in both American scientific endeavours and global health initiatives.
This latest development is intrinsically linked to broader changes in US childhood immunisation strategies championed by Health Secretary Kennedy Jr. His administration’s recent announcement of a withdrawal of funding from Gavi, the Vaccine Alliance, has sent palpable shockwaves through the international health sector. Gavi, a public-private partnership, has been instrumental in vaccinating over 1.2 billion children globally, a feat credited with averting an estimated 20.6 million deaths. The rationale provided for severing ties with Gavi reportedly stems from an interpretation of a 2018 study conducted in Guinea-Bissau concerning the DTP vaccine and its alleged impact on mortality rates.
However, the scientific foundation underpinning this rationale is itself contested. The aforementioned 2018 study, authored by Danish researchers Peter Aaby and Christine Stabell Benn, purportedly suggested a correlation between the DTP vaccine and increased mortality in young girls in Guinea-Bissau. Yet, a subsequent paper published in 2022 by some of the same researchers is understood to have yielded divergent findings, effectively diminishing the impact of the earlier conclusions. This discrepancy has led to questions about the validity of the justification for disengaging from Gavi.
The personal convictions of Health Secretary Kennedy Jr. appear to be a significant driving force behind these policy reorientations. As articulated by Paul Offit, Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, Kennedy Jr. "has a fixed, immutable belief that vaccines cause harm. He will do everything he can to try and prove that." This deeply held conviction is now manifesting in tangible policy decisions with potentially far-reaching global repercussions.
Gavin Yamey, a Professor of Global Health at Duke Global Health Institute and a founding member of Defend Public Health, voiced profound disapproval, stating, "Testing established vaccines in a country with high rates of hepatitis B and a fragile health system reeks of a neocolonialist attitude and risks expanding global mistrust of the US and science." The implications of these actions extend beyond the immediate study, threatening to undermine decades of progress in global health equity and vaccine confidence, particularly in developing nations that rely heavily on organisations like Gavi for essential immunisation programmes. The confluence of shifting domestic policy and international engagement strategies raises significant questions about the future trajectory of US involvement in global public health initiatives.