Trade experts are now dissecting the newly announced North American trade deal to determine if President Trump’s “bully” negotiating style will really make a difference to dairy markets or automobile production.

Indeed, much attention has been paid to the president’s negotiating style in international trade and foreign relations more generally, especially his cavalier disregard and disrespect for international organizations like the World Trade Organization or strategic alliances like NATO.

{mosads}But beneath the radar, the Trump administration is driving just as disastrous a record in international public health. To be fair, previous administrations have less-than-sterling records in that regard. One only needs to look at U.S. efforts to protect the international tobacco and pharmaceutical industries over the years.

But what sets this administration apart is its blatant efforts to undermine international public health initiatives, from promoting breastfeeding, obesity prevention, combating antimicrobial resistance, to name a few.

Take the new NAFTA. That was all about preserving American jobs, right? But at the behest of food and soft-drink companies, the U.S. pushed a provision that would have prevented the United States, Mexico, and Canada from requiring more explicit labels about nutritional content on the front of food and beverage packages.

It certainly had nothing to do with jobs, and it was a curious way to combat obesity and diet-related diseases. In the end, the final agreement announced Monday did not include that provision. In the past, some administrations had enough decency to be at least somewhat ashamed of what they were doing. Not so with the current crew.

When the World Health Organization was preparing a report this summer on how to fight non-communicable diseases like obesity, it initially included a recommendation for taxes on soda and other sugary drinks. That recommendation, which was based in part on an earlier report from a WHO expert panel, never made it into the final document. Why? Deputy Secretary of Health and Human Services Eric Hargan, U.S. representative on the WHO commission, scuttled the tax proposal and proudly claimed credit for having done so.

That must have pleased big soda. Soft-drink companies have spent tens of millions of dollars to oppose sugar-drink taxes in city after city in the United States, from San Francisco to Chicago to Philadelphia, and in country after country, from Mexico to the United Kingdom to South Africa. Never mind the early evidence from Mexico, and from Berkeley and Philadelphia in this country, that soda taxes reduced sugary-drink consumption.

But bullies don’t know when to stop. 

For years, public health advocates and the U.S. government itself have promoted breastfeeding, and multinational infant-formula companies have resisted. Ecuador sought to introduce a resolution promoting breastfeeding this year at the annual WHO World Health Assembly. This time U.S. representatives balked, the said that they thought Ecuador’s resolution was ill-timed and that they were “deeply concerned” by it and allegedly threatening trade sanctions and the withdrawal of military assistance. This time the Americans denied pressuring Ecuador, which nonetheless withdrew the resolution. Enter the Russians who introduced a similar replacement measure (which the US supported in altered form).

It’s the same story with international public health efforts to reduce the use of antibiotics in farm animals. At home, at the urging of the Food and Drug Administration, the U.S. industry has voluntarily withdrawn approval of medically important antibiotics for promoting weight gain in animals. 

The Codex Alimentarius commission, an influential, but  little-known international food standard-setting body, is developing a global proposal on the use of antibiotics in agriculture. 

Yet the Trump administration, which is leading a working group developing that proposal,has left the door open to the use of antibiotics to promote growth, so long as a risk analysis is conducted. That would encourage farmers in other countries to engage in practices that are currently prohibited here.

The perverse irony is that the Trump administration proclaims a doctrine of self-interest and independence for the United States, then bullies other countries that are pursuing policies that their leaders believe are in the self-interest of their people.

These initiatives to thwart public health actions in other countries have no discernible benefit for American consumers. They may even threaten our health, for example, by contributing to the rise of antibiotic resistant bacteria that leak across our borders. But they do appear aimed at making American corporations great again.

Viewed in a different light the Trump administration is actually undermining the true self-interest of the United States. When the health of other nations’ citizens is put at risk, those countries are less stable and the forces of discontent have fertile soil in which to grow. And remember: Those pesky bacteria don’t respect border walls, no matter how high.

That much seems to have eluded the president. The world order and global institutions that the United States helped create and lead are ultimately about our self-interest as well as that of our fellow nations. Undermining them is self-inflicting a wound that will have consequences not only for global health but for the U.S. itself.

Even a bully ought to be able to see that.

Dr. Peter Lurie is the president of the Center for Science in the Public Interest and former associate commissioner at the Food and Drug Administration.