There are times when the narcissism of a political leader distracts us from attending to what matters in the world. US President Donald Trump is a case in point. Jeffrey Sachs recently observed that Trump’s conduct, characterised by "grandiose self-regard, pathological lying, lack of remorse, expressive shallowness, impulsiveness, failure to take responsibility for his own actions" and, as the events of Charlottesville illustrate, a frightening lack of a moral sense, has brought about a meltdown in the White House that may undermine many of the good projects started by his predecessors. One of these projects is the 2014 Global Health Security Agenda (GHSA). Set up with an emergency appropriation of $1bn from the US Congress, the agenda helped countries scale up disease outbreak prevention in the world’s weakest health systems by funding — among others — the Centres for Disease Control, the National Institutes of Health and the Pentagon’s disease-detection and vaccine-development pro...

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