Celeste Mercier

Regardless of the country, I’ve had the same conversation with each new person I’ve met abroad. From random strangers to host family relatives, everyone’s first question upon learning that I am from America is, “What do you think about the election?” Whether it was in the rural clinics of Udaipur, India in September or at the border between Brazil and Argentina just days ago, this question continues to chain my identity to politics.

In the weeks leading up to the election, my host mother Shahida in South Africa would watch CNN every night to follow the latest polls. I was baffled by how an older, middle-class South African woman was more engaged in my country’s politics than I was.

I asked our host family friend Leslie why the election was so important in South Africa.

“America’s politics are the world’s politics. Our economy, our everything, is influenced by America here,” he responded.

The day after Donald Trump was declared the 47th president, every newspaper I encountered printed in bold letters “What Trump’s Win Could Mean for South Africa” and detailed numerous ways in which America’s change in government could negatively impact South Africa.

These experiences left me grappling with my positionality as an American citizen in the Global South.

Across India, South Africa and Argentina, I have witnessed the impacts of U.S. economic policy on the health of individuals in these countries. In India, the U.S. made its mark through the Structural Adjustment Program, a series of loans provided by the International Monetary Fund and the World Bank to rebuild economic stability in the 1990s. In South Africa, this occurred with U.S. support of the cruel apartheid government during the Cold War and economic pressure to adopt a neoliberal economy post-apartheid through the Washington Consensus. In Argentina, it was through the compliance and support of the military coup d’états that killed tens of thousands of citizens in the name of protecting the Americas from communism through the Condor Plan.

Each of these neoliberal economic policies enforced—either through laws or societal pressure—free-market capitalism at the expense of government support for health systems during important times of development. They maintained the economic power of already rich nations like the U.S. while pushing those falling behind even further. While each of these countries have since rebuilt their public health systems to provide universal coverage to all citizens, neoliberal policies from the late 20th century still perpetuate health disparities between the rich and the poor because of previous neglect of the public health system and growth of the private sector.

In Argentina, the right to health is guaranteed in the Argentine National Constitution for any person in the country, regardless of their citizenship or condition. From basic dental services to reproductive healthcare (including the right to abortion at any clinic) to cancer treatment, the public health sector offers a comprehensive range of services free of cost to those without private care. In rural areas, public health trains bring healthcare to remote areas to ensure access. At the local level, primary health centers offer interdisciplinary approaches to care that target the needs of individuals in the community as opposed to larger corporate interests. Like any country, Argentina still faces many challenges in its healthcare system, but the right to health paves the way for its success.

However, under their recently elected President Javier Milei, the healthcare policies that Argentina has fought to secure after decades of dictatorship are crumbling once again. In just one year, Milei has reintroduced strict neoliberalism, stopped regulating the cost of private healthcare, failed to address the dengue epidemic and shut down many public measures to increase access to care, including the national mental health hospital. While richer provinces like Buenos Aires have the resources to maintain strong public health centers, other provinces slip through the cracks without government support.

In addition to direct cuts to healthcare spending, Argentina’s public health system has been impacted by rising poverty levels that have now reached 53 percent.

“In times of extreme economic crisis, more people will lose their jobs and lose their [job-sponsored healthcare] and come to the public sector. In those times, we lose our minds,” Nora Marcela Lema, director of the Floresta primary healthcare center in Buenos Aires, said.

Economics are intrinsically tied to health outcomes, yet the global economic hegemony does not prioritize public health. While countries like India, South Africa and Argentina try to balance serving the public and boosting the economy, walking the line between the two is extremely difficult.

Returning to the United States is bittersweet as all these thoughts swirl through my head. I feel empowered by the stories I’ve heard abroad and simultaneously disempowered by the fact I am a citizen of a country failing to consider its impact on the rest of the world. I am frustrated that those in the Global South know the destructive nature of American policy so well, yet at home, we are oblivious to the economic and geopolitical manipulation that occurs. And despite all of this, these countries have still enacted more measures to secure universal access to health than the U.S. has ever dared to pass, even with fractions of our budget.

As I near the final weeks of this academic journey, I am left with just as many new questions as answers to take home with me, and I think that’s okay.