Trump, Brexit, Right-wing Anti-globalisation, and An Uncertain Future for Public Health

Global public health is intimately linked with political, economic and social determinants. The current global order has been built on the assumption that the globalisation agenda shared by political elites of the last several decades will continue. Individuals, businesses and countries have all made decisions, many of them linked to health, based on this assumption. The election of Donald Trump to the US presidency and the vote in Britain to exit the European Union exemplify a recent wave of right-wing anti-globalisation, which has risen in much of the West. The right-wing anti-globalisation movement will substantially affect global health through four pathways. Restrictions on trade will dampen economic growth and could diminish food security and the availability of medical supplies. Xenophobia will harm mental health through the lived experience of minorities, and will elevate the risk of economic and military conflict between countries. Increased defence expenditure in a time of limited government budgets will constrict funding available for healthcare and the social determinants of health. Mistrust of international treaties, including for climate change, will undermine the Paris Agreement and hasten greenhouse gas emissions. Without rapid mitigation, climate change could devastate population health globally through a range of mechanisms, including diminished food security and increased violent conflict. These would amplify many of the other health effects of right-wing anti-globalisation. By emphasising the shared humanity of all people, population health offers an antidote to the narrow focus of right-wing anti-globalisation.