How did India’s Cobra Problem Spiral Out of Hand? In 19th century India under the British Raj, cities were ravaged by cobras which were especially troublesome for the British overlords. To combat this, they offered the local Indian populace bounties for each cobra killed, which could be proven by handing in a corpse of the venomous creature. However, it did not take long for the local Indian communities to realize that they could breed the venomous snakes faster than their natural rate, kill a few of their offspring while leaving enough to reproduce, collect the bounties, and repeat as long as the cobra population sustained itself. Soon, the British administrators noticed these cobra farms, and cancelled the bounty program. As a result, those who entered the cobra-breeding industry released their now unprofitable snakes into the wild, worsening the cobra infestation relative to before the bounty program. This isn’t the only time an incentive designed to reduce injections of poison backfired. Big pharma has also profited by worsening crises it was trusted to solve by selling numerous harmful drugs and medications to customers. Pfizer, long before its Covid-19 vaccine brought its record profits in 2021 and 2022, was issued the biggest criminal fine in American history for misbranding its drugs, and paid billions in civil fines for paying doctors to issue improper prescriptions. Predictably, its mRNA vaccines have caused surges in cancer, heart injuries, and diabetes in young adults, contributing to record high excess mortality in said demographic in more vaccinated countries. When these same companies are also planning to sell the cures to these health conditions, and when multiple manufacturers of insulin have colluded to maximize their profits, the perverse incentive becomes only more apparent. In the United States of America, prescription drugs cost magnitudes more than in virtually any other developed country. Pharmaceutical companies justify these price hikes, and politicians argue against price caps, by alleging that they are necessary to fund their research and development of new drugs. But the vast majority of Big Pharma’s expenses are not related to R&D, and in fact, R&D represents a similar share to advertising, due to the United States’ regulations being anomalously permissive among developed countries once again. And given that the research is often conducted in order to develop harmful drugs with the goal of creating even more sick and dependent customers as mentioned, it is safe to say that Americans are getting massively ripped off. This has resulted in Americans rationing their medications, and costs Medicare billions each year. But as long as patent laws allow “evergreening“, the process of extending the patent life of a generic drug for introducing even a slight modification to it, competition will never be unleashed in the pharmaceutical industry. As it turns out, the corruption of Big Pharma has been a bigger threat to public health than any single disease.
By Edward Kim
America has changed dramatically since 1976. Diseases that once claimed thousands of lives are now preventable, technology has transformed nearly every aspect of daily life and many Americans enjoy opportunities that would have been difficult to imagine 50 years ago. Yet despite these advantages, public confidence in the country’s future has steadily declined. As the United States marks its 250th anniversary, an important question emerges: If America is better off in so many measurable ways, why do so many people feel like it isn’t? To answer that question, it is important to separate perception from measurable change. While many Americans face legitimate challenges today, the country has also experienced significant improvements in areas such as public health, technology, environmental protection and quality of life over the past five decades. Although no nation is without its flaws, looking back at 1976 reveals just how dramatically many aspects of American life have changed. One of the clearest examples of America’s progress since 1976 can be found in public health. Over the past five decades, advances in medicine, disease prevention and healthcare technology have transformed the way many Americans live. Treatments for formerly life-threatening illnesses have improved dramatically, while innovations in diagnostic tools, emergency medicine and preventive care have helped people live longer and healthier lives. Although the healthcare system continues to face significant challenges surrounding affordability and access, these medical advancements represent a major shift from what was possible during the nation’s bicentennial. Public safety is another area where long term trends tell a more complicated story than many Americans might expect. Although concerns about crime remain an important part of political debate, violent crime rates today are substantially lower than they were during much of the late twentieth century. Communities across the country still face serious public safety challenges, and crime can vary greatly from one region to another. Even so, national trends suggest that Americans are generally living in a safer country than they were 50 years ago. But perhaps the most visible transformation has been technological progress. In 1976, personal computers were still a novelty, the internet did not exist for the general public and instant access to information was unimaginable. Today, technology influences nearly every aspect of daily life, from education and healthcare to communication and commerce. Alongside these innovations, educational opportunities have expanded and many Americans now have access to resources that previous generations could only have imagined. While technology has introduced new concerns, including misinformation and the effects of social media, it has also fundamentally reshaped how people learn, work and connect with one another. Taken together, these changes paint a picture of progress. Yet, despite all these improvements, surveys consistently show that many Americans believe the nation is headed in the wrong direction. If the data point toward progress, why does it not feel that way? Part of the answer lies in the fact that progress does not erase new challenges. While Americans today benefit from decades of advancements, many also face economic pressures that feel increasingly difficult to ignore. Housing prices have risen dramatically, higher education has become more expensive and many families continue to worry about healthcare costs. For younger generations in particular, milestones such as buying a home or paying off student debt can seem more difficult to achieve than they were for previous generations. As a result, many people judge the country’s success not by long term trends, but by the realities they experience every day. Public perception is also influenced by how Americans consume information. In 1976, most people relied on local newspapers and a handful of television broadcasts for their daily news. Today, smartphones and social media provide a constant stream of headlines, breaking news and political commentary from around the world. Algorithms often prioritize stories that provoke strong emotional reactions, making crises, conflict and controversy more visible than everyday signs of progress. Combined with declining trust in institutions and increasing political polarization, this environment can make the nation feel as though it is in constant decline, even when many long-term indicators suggest otherwise. America in 2026 is undeniably different from the country that celebrated its bicentennial in 1976. Many of the nation’s greatest challenges have evolved, and many of its greatest achievements have become so familiar that they are easy to overlook. At the same time, new economic pressures, political divisions and changes in how Americans experience the world have shaped the populace to adopt a more pessimistic public outlook. The question is not whether America is objectively better or worse than it was 50 years ago, but whether our perceptions have kept pace with the changes around us. Acknowledgement: The opinions expressed in this article are those of the individual author, not necessarily Our National Conversation as a whole.
By Alan Jimenez
I have often been wary of the argument that foreign aid is merely a form of charity or that it is money that is not expended wisely. Some forms of foreign aid do fall into that category, but programs like The President’s Emergency Plan for AIDS Relief (PEPFAR) are one of the clearest cases where international assistance can have a significant, positive impact. PEPFAR was established under President George W. Bush in 2003 to address the HIV/AIDS epidemic, and it has been credited with saving approximately 26 million lives since its establishment. While this program enjoys bipartisan support, it runs the risk of weakening because of the withholding of funds that Congress has already appropriated for this program. I argue that this is a mistake and that any aim to transition it must require a balanced, gradual, and effective approach. An Investment In Global Health & Soft Power PEPFAR is not merely a charity, but rather a form of strategic generosity aimed at improving global health security, to the benefit of the world and Americans who live at home and abroad. PEPFAR is not only a program that saves millions of lives, but it also helps America buy influence abroad, especially in developing countries. For example, PEPFAR achieved “outsized returns” in global health security and improved relations with recipient countries. For example, under the program, the costs of antiretroviral treatment (ART) in low-income target countries fell from $1,200 per person to just $60 after the first two decades since the program’s inception. In terms of influence, according to a report by the Bipartisan Policy Center, African nations which got aid under PEPFAR have the strongest support of American leadership versus countries that received little to no support. The logic makes sense and follows the evidence; when you make one of the largest single-disease investments to curb it, there is going to be a significant impact on those nations that suffer most from it. And those nations, seeing America’s role in improving their health, are also likely to see America in a more positive light. This investment, however, exists in the context of a larger geopolitical game. China has made its own health investments in Africa, with the aim of gaining influence in the region. And while their move has created controversy, China has been effective at gaining a foothold. For example, according to a 2023 Gallup poll, China’s approval rating in Africa beat that of the U.S., 58% versus 56%, respectively. This illustrates the competing forces at play in Africa. Whereas China is making its own investments via the Belt and Road Initiative, America uses programs like PEPFAR to compete. In other words, while the humanitarian case for PEPFAR should be sufficient, the program enjoys bipartisan support – even at a time when foreign aid is being cut – because choosing to pull back risks ceding space to one of America’s main geopolitical rivals. A Reasonable Goal Pursued Recklessly The Trump Administration, however, is pursuing changes to PEPFAR under the America First Global Health Strategy. The idea is that money would be given directly to governments, rather than external implementers. However, the Administration’s own report claims that it “cut overall spending by 30 percent while preserving critical frontline HIV care”. This sounds good on paper, but the reality is that much of the funds provided for the programs are not being used. Furthermore, Global AIDS Policy Partnership (GAPP) casts doubt on the State Department’s claim that it can cut funds while still keeping treatment levels stable. For example, an analysis by GAPP shows that “PEPFAR-supported testing in Q4 2025 dropped to 17.2 million from 21.9 million during the same period in 2024, a decline of nearly 17% across the full year”. This data is corroborated by an additional report by the Center for Global Development. Additionally, the healthcare workforce under PEPFAR declined by 24% from Fiscal Year 2024 to Fiscal Year 2025. On top of this, millions of orphans, vulnerable children, and young women lost access to the program after the cuts that were implemented in 2025. One review notes that officials frame this disruption under the guise of “creative destruction”, but this argument misses the fact that a more graduated approach, with a well-funded core, could have mitigated these negative effects. Simply put, the withholding of PEPFAR funds during any reform process will only lead to a lower level of reach and efficacy within the program. Indeed, country ownership for these funds is a legitimate and perhaps even a desirable change. The error, however, is in the abrupt way these reforms are being pursued. The Way Forward The withholding of funds overrides Congress’s clear bipartisan will. The Trump Administration should release the appropriated funds and run PEPFAR efficiently and fully while pursuing its reforms in a graduated manner. Any change to existing programming requires time, and time must be given to ensure that the core of the program does not suffer. Congress had already appropriated $6 billion to PEPFAR while rejecting $400 million in cuts to the program under the President’s budget request, illustrating that the bipartisan consensus in our legislative body agrees with my argument. Both Republicans and Democrats understand that PEPFAR not only saves lives, but it is a key tool in America’s arsenal to counter China’s growing influence in Africa. I am not arguing that reforming PEPFAR is not worthwhile, as direct contracts with recipient nations can serve American foreign policy interests even better than how PEPFAR was originally designed. However, we can do so while ensuring that PEPFAR, a program that saves millions of lives, enhances American influence abroad, and protects global health security, must be well-funded and implemented during that transition.
By Vaibhav Sinha
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