Murphy begins from a distinction that structures the entire argument. Some harms from American non-involvement are immediate and measurable, while others unfold over decades and may prove surprisingly modest in the long run. Averting the worst consequences of the climate crisis and preparing for the next pandemic fall squarely into the first category, where the absence of the United States government from global problem solving can have significant consequences. The United States remains one of the largest historical emitters of greenhouse gases and one of the most consequential funders of public health infrastructure, so its disengagement from these domains removes both material capacity and political weight from systems that depend on broad coordination. In these arenas, timing matters: delays in emissions reductions compound physically, and pandemic preparedness is only as strong as the weakest surveillance and response capacity in the chain.

The evidence for immediate, quantifiable harm comes in part from modelling studies published in the medical literature, which Murphy draws on to ground his argument. A mathematical modelling study of seven countries in sub-Saharan Africa, published in EClinicalMedicine, examined the impact of the freeze in funding for PEPFAR, the President’s Emergency Plan for AIDS Relief, and projected increases in HIV deaths and infections as a direct result. A separate retrospective evaluation and forecasting analysis published in The Lancet assessed two decades of USAID interventions and projected the effects of defunding on mortality up to 2030, finding that the programs slated for cuts had been associated with millions of averted deaths. These are not abstract governance questions. They are estimates of human lives, calculated with the standard tools of epidemiological modelling, and they illustrate precisely what Murphy means by dire immediate consequences even where the long-run architecture of global problem solving may endure.

Climate policy presents a parallel case with its own technical texture. Murphy cites the Rhodium Group’s Taking Stock 2025 analysis of United States energy and climate trends, which tracks how federal policy shifts alter the emissions trajectory of the world’s second-largest current emitter. When the American federal government relaxes domestic climate policy and steps back from international climate finance, the global emissions budget, a finite quantity of carbon that can be released before warming thresholds are crossed, absorbs the difference. Unlike some areas of governance, climate physics offers no institutional workaround: the atmosphere integrates emissions from all sources regardless of who is in office. This is why Murphy classifies climate among the domains where American non-involvement may have significant consequences rather than merely symbolic ones, and why parallel scholarship in the same journal examines whether global climate governance nonetheless remains resilient under the current administration.

Yet the article’s most counterintuitive claim concerns the domains where American withdrawal matters less than headlines suggest. Murphy argues that the long-run impact on global problem solving may be small in certain cases, even when immediate consequences are dire, and he offers economic inequality across countries as a likely example. Drawing on Branko Milanovic’s analysis of the three eras of global inequality from 1820 to 2020, Murphy situates present turbulence within long structural trends. The convergence of incomes between countries that defined the past three decades has been driven principally by economic growth in Asia, particularly China and India, rather than by American policy choices. A US government that turns inward may slow or complicate specific redistributive mechanisms, but it neither creates nor controls the deep forces reshaping the global income distribution. The immediate harms of cuts to development assistance are real, as the Lancet modelling demonstrates, but the underlying trajectory of between-country inequality is shaped by forces far larger than any single administration.

This leads to the article’s deeper historical claim, and the one Murphy identifies as the most important lesson for practitioners. Even if the US government becomes unimportant or an impediment to solving global and planetary problems for many years, the basic politics of their solution is likely to remain similar to what it has been since the mid-nineteenth century. Global governance, in Murphy’s telling, was never primarily the creature of great-power governments. From the international public unions of the 1800s through the technical standard-setting bodies documented in his earlier work on engineering rules since 1880, the machinery of global problem solving has been built and maintained by international epistemic communities, networks of scientists and experts, social movements, and civil servants at every level. Susan Strange’s famous critique of the Westfailure system, and the scholarship on non-hegemonic regimes collected under the title Cooperating Without America, both support the proposition that cooperation among other actors can proceed even when the hegemon abstains.

The historical record Murphy invokes is richer than the current moment might suggest. His references span the scholarship on how governments have repeatedly lost control over the proliferating structures of global governance, the role of emerging powers in disrupting and reshaping the World Trade Organization, and the work of what Thomas Weiss and colleagues have called the Third United Nations, the civil society organizations and advocacy networks that operate alongside and often in tension with member states. Recent historical scholarship on Pan-Africanism, including Howard French’s account of Kwame Nkrumah and the high tide of global Black solidarity, reminds readers that transformative global projects have often been driven by movements with no great-power sponsorship at all. Linda Gordon’s study of seven social movements that changed America makes the complementary domestic point: American politics itself has repeatedly been redirected from below rather than from the White House.

What does this mean concretely for the scientists, officials, and advocates now confronting an American government hostile to their work? Murphy’s answer, though framed in careful academic language, is essentially a call for persistence grounded in structural analysis. Members of international epistemic communities, social movements, and civil servants at all levels should remember that their work in global problem solving has always been just as important as that of the elected or self-appointed governments of even the most powerful countries. The technical standard-setters who keep the internet, aviation, and global trade interoperable do not require American federal participation to continue meeting. The epidemiologists who maintain disease surveillance networks, the climate scientists whose models inform every national assessment, and the statisticians who track global inequality all operate within institutions whose legitimacy and funding derive from far broader coalitions than Washington’s current disposition.

Murphy is careful not to minimize the danger. The article acknowledges commentary, including Paul Krugman’s argument that Trump is a symptom rather than the cause of declining American democracy, and it engages with assessments of how much damage a determined administration can inflict on institutions at home and abroad. The modelling studies on PEPFAR and USAID stand as evidence that the immediate human costs of withdrawal are severe and quantifiable. A widely discussed recent book on the collapse of large-scale societies, reviewed under the grim headline of a one-in-three chance of apocalypse, reflects the mood of existential concern that Murphy’s measured prose deliberately works against. His point is not that the situation is benign, but that despair is analytically unwarranted: the system of global problem solving has survived hostile hegemons, world wars, and the withdrawal of major powers before, and its resilience resides in actors that no single election can dismantle.

The article thus closes the loop between diagnosis and prescription. The differentiation of harms is the analytical core: climate and pandemic preparedness suffer significantly from American absence, inequality between countries follows its own long trajectory, and the politics of global problem solving remains fundamentally continuous with its nineteenth-century origins. For a readership of researchers and practitioners, the practical implication is to direct scarce attention toward the domains where American withdrawal does structural damage, while refusing the temptation to treat every global institution as hostage to Washington. The lesson Murphy draws from nearly two centuries of global governance is that the work has never depended on the goodwill of the powerful alone, and that the experts, movements, and public servants who built it retain, even now, the capacity to keep building.

Subject of Research: The impact of the Trump administration's policies on global governance and the resolution of planetary problems

Article Title: Global problems and Trump’s Republican Party government

Article References: Murphy, C. N. (2025). Global problems and Trump’s Republican Party government. Global Public Policy and Governance, 5(4), 393-400. https://doi.org/10.1007/s43508-025-00127-7

Image Credits: AI Generated

DOI: 10.1007/s43508-025-00127-7

Keywords: global governance, Trumpism, planetary crises, climate policy, pandemic preparedness, PEPFAR, USAID, economic inequality, epistemic communities, social movements, international institutions, US foreign policy

The scale of the challenge is considerable. Nigeria is home to roughly two million people living with HIV, the second-largest such population in the world. With the global target of ending HIV/AIDS set for 2030, the authors note that only a few years remain, and a single policy factor continues to compromise that timeline: the legal treatment of sex work as a criminal matter. Nigeria’s legal landscape is fragmented, with southern states punishing allied activities such as pimping and brothel-keeping, while northern states, applying versions of Sharia law, criminalise prostitution outright. This patchwork, the authors argue, creates an environment in which poor health outcomes and economic inefficiency flourish together.

The epidemiological logic of the critique is straightforward. Criminalisation drives sex work underground, where stigma and the persistent fear of arrest deter people from seeking HIV testing, prevention tools, and treatment. Studies cited in the commentary document that sex workers in Nigeria are frequently refused care by healthcare providers and routinely avoid health services out of fear of police encounters. This is despite the existence of the Nigerian HIV and AIDS (Anti-Discrimination) Act of 2014, which was intended to prohibit discrimination based on real or perceived HIV status. In practice, the authors observe, sex workers remain discriminated against by the very systems that are supposed to protect them, and enforcement activities themselves are associated with violence, extortion, and human rights abuses.

The numbers illustrate the consequences. A 2023 review of HIV trends in Nigeria reported a cumulative HIV prevalence of 10.8 percent among key populations in Kano State, dramatically higher than in the general population, with stigma and insufficient services identified as major barriers to care. Because criminalisation obstructs access to the very interventions that prevent and treat HIV, the commentary argues, it directly drives new infections and keeps the epidemic concentrated and expensive to manage. Treating advanced HIV disease, managing opportunistic infections, and funding long-term antiretroviral therapy and hospitalisations cost far more than preventive care would, meaning the current legal framework effectively forces Nigeria to spend more money for worse outcomes.

The fiscal dimension is central to the authors’ case. The Nigerian government and major international funders, including PEPFAR and the Global Fund, have invested heavily in HIV prevention programmes. Yet when one of the most vulnerable populations cannot safely access those programmes, the return on investment collapses. Police raids, detentions, and the cost of running detention facilities for arrested sex workers consume taxpayer money and law-enforcement capacity that the authors describe as counterproductive, straining an already overstretched judicial system. Decriminalisation, by contrast, would relieve pressure on the courts and police, freeing funds that could be redirected toward healthcare and reducing the sexual and gender-based violence documented during law-enforcement operations.

The commentary is careful to distinguish decriminalisation from legalisation, a distinction with significant practical implications for Nigeria. Legalisation typically involves formal state regulation through registration and licensing schemes, which can improve labour standards in theory but, in a politically conservative society, risks driving sex workers further underground if they are unwilling to identify themselves to authorities. Decriminalisation, as defined by the Global Network of Sex Work Projects, means the complete removal of criminal and administrative penalties against the sale and purchase of sex, advertising, solicitation, and third-party involvement, eliminating extraordinary policing and surveillance. International evidence, including a major global epidemiological review published in The Lancet, links decriminalisation to reduced HIV risk environments and increased uptake of services among sex workers, making it the more context-appropriate reform for Nigeria.

From a programmatic standpoint, decriminalisation would transform how prevention reaches the population that needs it most. The authors point to evidence that Nigerian sex workers are eager to engage with prevention: in one recent study, 95.9 percent obtained HIV testing when it was available, and 68 percent used pre-exposure prophylaxis, or PrEP, when it was accessible. Removing the threat of arrest would allow health authorities to systematically supply and track tools such as PrEP and condoms, and to establish regular testing within sex worker communities rather than relying on ad hoc, low-trust outreach. Instead of being treated as a public health liability, sex workers would be integrated into the healthcare system, with unhindered access to sexual and reproductive health programmes.

The economic argument extends beyond the health budget. The authors highlight an emerging contradiction in Nigerian policy: recent government proposals to tax all income, including earnings from sex work, sit awkwardly alongside laws that criminalise that same income. Decriminalisation would resolve this contradiction, bringing an active segment of the informal economy into the tax base and generating revenue that could be invested in public health programmes, including HIV prevention and sexual health clinics. Economic empowerment effects would follow, the authors argue, as sex workers gained the ability to demand fair pay and safer working conditions, spend less on bribes to law enforcement, negotiate condom use more effectively, refuse dangerous clients, and reduce their exposure to violence and abuse.

The commentary also addresses a common counterargument: that economic and educational exit programmes are a preferable empowerment strategy in conservative societies. The authors acknowledge that such programmes can help some women transition out of sex work, citing studies from Africa and Canada, but note that in criminalised environments their effectiveness is limited by legal precarity, violence, and stigma, and that the best results come from integrated, voluntary, rights-based support rather than stand-alone exit mandates. Decriminalisation, in their framing, is best understood as a structural harm-reduction reform that enhances the reach and effectiveness of every other intervention.

Ultimately, the authors present Nigeria with a clear choice. The country can continue along an expensive and futile path of criminalisation that feeds the epidemic it claims to fight, or it can adopt a realistic, health-centred policy of decriminalisation. They are explicit that decriminalising sex work should not be read as an endorsement of the profession but as an acknowledgement that containing HIV requires unimpeded access to prevention and care, unobstructed by law. Framed as an investment in public health, the reform promises lower infection rates, more efficient use of national and donor funds, and meaningful progress toward ending AIDS by 2030. From a health economics standpoint, the authors conclude, it is an investment Nigeria cannot afford to postpone.

Subject of Research: Health economics analysis of sex work decriminalisation and its impact on HIV prevalence in Nigeria

Article Title: Decriminalising sex work and the health economics impact on HIV prevalence in Nigeria

Article References: Decriminalising sex work and the health economics impact on HIV prevalence in Nigeria. (n.d.). https://doi.org/10.1007/s44155-026-00452-0

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00452-0

Keywords: sex work decriminalisation, HIV prevalence, Nigeria, health economics, PrEP, HIV prevention, key populations, stigma, public health policy, harm reduction, PEPFAR, Global Fund